Visual Outcomes Following Implantation Of A Non-Diffractive Wavefront-Shaping Extended Depth Of Focus Toric Intraocular Lens

To evaluate the clinical outcomes following bilateral implantation of the Acrysof IQ Vivity toric extended vision intraocular lens(IOL) which utilises non-diffractive wavefront-shaping transition elements over the central optical zone to extend the range of vision.

Private ophthalmic centre in Ipoh, Malaysia.

Prospective interventional case series of patients with bilateral significant cataracts and corneal astigmatism undergoing cataract surgery and implantation of the Acrysof IQ Vivity Toric IOL. Dominant eyes were targeted at emmetropia and non-dominant eyes at -0.50D. Primary endpoints were binocular uncorrected distance(UDVA), intermediate(UIVA at 66cm) and near(UNVA at 40cm) acuities at 3 months. Secondary outcomes were binocular best corrected distance(BDVA), distance corrected intermediate(DCIVA) and distance corrected near(DCNVA) acuities, refractive predictability, rotational stability, binocular defocus curve, contrast sensitivity, Questionnaire for Visual Disturbances(QUVID) and Visual Function Index(VF-14) scores.

60 eyes(30 patients) underwent uneventful phacoemulsification by a single surgeon and the 1 month postoperative results are reported. Visual acuities were converted to logarithm of minimum angle of resolution(logMAR) for analysis. The mean binocular UDVA, UIVA and UNVA were 0.08+0.10, 0.14+0.10 and 0.30+0.11 respectively. The mean binocular BDVA, DCIVA and DCNVA were 0.04+0.08, 0.17+0.15 and 0.41+0.12 respectively. The mean refractive spherical equivalent(MRSE) was -0.18+0.46 with 80.7% of eyes within 0.5D of target. Mean IOL rotation was 3.85º + 5.09. QUVID results showed 26.7%, 20% and 36.7% of patients reported starbursts, haloes and glare respectively but were only mildly bothered by the symptoms. The mean VF-14 score was 90.62+7.40.

The clinical outcomes at 1 month following bilateral implantation of the Acrysof IQ Vivity Toric IOL showed very good functional binocular unaided visual acuities at all distances with high satisfaction scores from the patients.