Clinical Outcomes With Combined Presbyopia- And Astigmatism-Correction Following The Implantation Of A Trifocal Toric Intraocular Lens In Cataract Patients

To assess the clinical performance, visual functions, and patient satisfaction of the Liberty 677MTY trifocal toric intraocular lens (IOL) (Medicontur Medical Engineering Ltd, Zsámbék, Hungary) in cataract patients with preoperative corneal astigmatism requiring correction with IOLs with cylindric power range between 1.0 to 6.0 D.

Department of Ophthalmology, Semmelweis University, Budapest, Hungary

In this prospective non-comparative clinical investigation, 31 cataract patients with preoperative corneal astigmatism were enrolled. After the binocular implantation of the study lens, patients were followed up for one year. Spherical and cylindric correction, as well as uncorrected and best-corrected distance, intermediate, and near visual acuities, were measured. Visual acuity defocus curves were plotted at 3 and 12 months, and contrast sensitivity defocus curves at 1 and 12 months postoperatively. Visual functions and patient satisfaction were assessed using a protocol-defined Visual Functioning Questionnaire at 3 and 12 months postoperatively. IOL-axis position was registered at surgery and 1, 3, and 12 months postoperatively.

Mean rotation was below 2° and mean absolute rotation was below 5° during the 12-month follow-up. Significant improvement (P<0.05) was achieved in UDVA and CDVA from preoperative values at all postoperative visits, as well as in subjective cylinder values. Binocular defocus curves, showed visual acuities of better than 0.2 logMAR in the defocus range from +1.0 to -3.5 D. Contrast sensitivity defocus curves confirmed good visual quality. VFQ evaluation at 12 months showed mild or no difficulty with visual disturbances and everyday tasks by 84% of patients, spectacle independence was 96.7% for far vision, 83.3% for intermediate vision, 93.3% for near vision, and 90% of the patients rated at least 8/10 their satisfaction with their vision.

Based on our clinical data the implantation of the trifocal toric Liberty 677MTY IOL is safe and efficient in correcting refractive errors including astigmatism. Refractive and visual outcomes are predictable and provide excellent vision correction. The IOL provides excellent visual acuity and contrast sensitivity at all three examined distances. Patients report on high satisfaction and low rates of visual difficulties on the VFQ questionnaire. The overall safety profile of the IOL was found to be similar to the ones described in the scientific literature.