Capsulaser-Assisted Implantation Of Toric Trifocal Intraocular Lenses: A Comparative Study Of Stability And Visual Outcomes

To evaluate the surgical outcomes, rotational stability, and long-term centration of toric trifocal intraocular lens (IOL) implantation assisted by CAPSULaser capsulotomy compared with conventional manual continuous curvilinear capsulorhexis (CCC).

magrabi eye hospital, jeddah, ksa

This comparative retrospective study included 36 eyes of 27 patients who underwent cataract surgery or refractive lens exchange between April 2023 and January 2024 at Magrabi Eye Hospital. Patients were divided into two groups: Group A, in which CAPSULaser capsulotomy was performed, and Group B, in which manual capsulorhexis was used. Corneal and refractive astigmatism, uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, and UNVA), rotational stability, photopic and mesopic contrast sensitivity (CS), presence of dysphotopsia, and spectacle dependence were evaluated at the third postoperative month. Outcomes were compared between the CAPSULaser and manual groups.

 The mean UDVA, UIVA, and UNVA were 0.05 ± 0.07, 0.08 ± 0.08, and 0.06 ± 0.07 log MAR, respectively. All patients achieved ≥0.3 logMAR uncorrected visual acuity at all distances. UDVA was significantly better in the CAPSULaser group (p = 0.03). All eyes had ≤1.0 D of subjective postoperative refractive astigmatism. Spectacle independence was achieved in 88.7% of patients. Photopic and mesopic CS were within the normal range in all patients. The mean IOL axis rotation was 2.1° ± 2.3° in Group A.  Capsular bag behavior remained stable with reduced anterior capsule contraction and improved IOL positioning compared to the manual CCC group. No significant intraoperative or postoperative complications related to laser capsulotomy were observed.

CAPSULaser-assisted implantation of toric trifocal IOLs provides superior capsular precision, enhanced IOL centration, and improved long-term rotational stability. This technique contributes to optimized refractive outcomes and represents a valuable advancement in premium IOL cataract surgery, particularly in cases requiring high positional accuracy.