Postoperative Outcomes Following Enhanced Monofocal Toric Intraocular Lens Implantation In Patients Over 85 Years Old

This study aims to assess the postoperative outcomes of enhanced monofocal toric intraocular lens (T-IOL) implantation in cataract surgery patients aged over 85 years.

We retrospectively reviewed 25 eyes of 18 patients aged over 85 years (mean age: 88.0±2.9 years) with preexisting astigmatism ranging from 0.75 diopters (D) who underwent cataract surgery with enhanced monofocal T-IOL implantation (TECNIS Eyhance toric ™, Johnson and Johnson vision, USA). All studies were performed at Ryugasaki Saiseikai Hospital, Ryugasaki, Ibaraki, Japan.

Conventional cataract surgery was performed under digital axis guidance system (VERION® Alcon, USA).  Postoperative outcomes, including uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA) were measured by logarithm of the minimum angle of resolution (logMAR), postoperative astigmatism (D), and axis misalignment of the IOL in degrees against the planned axis (°), were assessed at 3 months postoperatively. Results were compared with those from 48 eyes of 24 younger patients (mean age: 75.5±7.4 years) who underwent the same T-IOL implantation procedure.

There were no statistically significant differences in preoperative parameters between the two age groups, except for age and UDVA logMAR (p<0.001 each). Postoperatively, there were no statistically significant differences observed in mean UDVA UIVA, and UNVA logMAR (UDVA-0.04 for the >85 age group and -0.04 for the younger age group P=0.78, UIVA 0.16 vs.0.19 P=0.29, UNVA o.57 vs. 0.64 P=0.12 respectively) postoperative astigmatism (0.10D vs. 0.19D, p=0.19), or IOL axis misalignment (0.83° vs. 1.42°, p=0.11) between the two groups.