Non-Toric Multifocal In Corneal Astigmatism: Presbyopia Correction Is A Better Choice Than Astigmatism Correction: A New Thinking.

To Study the Efficacy of NON-TORIC Multifocal iol in Corneal Astigmatism and to study Patient Satisfaction in the same category. 

The nonavailability of Toric iols and price considerations in a third-world country led to this study. 

It is a common belief that nontoric iol should not be implanted in corneal astigmatism of more than one cylinder. 

Here we have done the opposite, and the idea might be shocking to some individual surgeons. The results were Amazing from the beginning, so the study continued till more than one hundred eyes were done. 

Lions Sight First Eye hospital is the leading tertiary care eye hospital in Nairobi,  Kenya. All surgeries were done in any one of the three operation theatres. Proper informed consent and special consent was taken to implant a nontoric multifocal iol in corneal astigmatism. Patients with multifocal iols were included in this study. EDOF IOL patients were specifically excluded. Most patients have corneal astigmatism between 1.0 and 2.5 dioptres and a maximum of 4.0 dioptres.  

All patients for cataract surgery with multifocal iol underwent detailed slit-lamp examination, biometry, optical biometry with lenstar, and fundus examination. The hospital has three operation theatres for cataract surgery with three centurion phaco Machines and new Leica microscopes. 

In the post-op period, all patients were examined for any infection or reaction on post-op day one and day 7.  At the 15 /21/ 30 day visit, a detailed analysis was done...which included refraction, repeat auto k readings, and repeat lenstar readings. Then detailed sia calculations, elpo calculations, lens constant calculations were done. Patients were prescribed mono-focal distance-only glasses for correction of astigmatism. 

A total of 107 patients underwent the procedure of Phacoemulsification and multifocal iol from a leading multinational company over one year.  Two patients had PCR but were successfully managed. [Video available] 82 patients had significant astigmatism. Only two opted for Toric Multifocal iol, and the rest were implanted with Non-Toric Multifocal Iol.   One patient complained of nighttime glare while driving, which is expected.  The satisfaction level is too good to be believed.  Distance vision is 6/12 Snellens with up to 1.5 dioptres of astigmatism, 6/18 to 6/24 Snellens with cornea astigmatism up to 2.5 dioptres. Patients are amazingly happy with mono-focal glasses correcting astigmatism than progressive glasses correcting presbyopia. 

IT IS LIFE CHANGING DISCOVERY.  This is an original idea. Correction of Presbyopia is a bigger boon than correction of Astigmatism.  Corneal Astigmatism Patients with NON-TORIC MULTIFOCALS were happier than those with Toric Monofocal and no Presbyopia correction.  Due to price constraints and iol cost structure ....we advise patients to use Toric Monofocal first than Non-Toric Multifocal. But we have to change our second-best choice. ALL PATIENTS are happy with Distance Glasses which might be partially required. The evolution of mankind has led to the use of mobiles...and correcting Presbyopia first should be the Number One Priority. We need to change our mindset