Clinical Performance And Visual Outcomes With A Full Visual Range Toric Intraocular Lens

Cataract surgery has evolved to include the option of laser-assisted technology to enhance surgical precision and reliability, toric intraocular lenses (IOLs) to correct for astigmatism, and full visual range (FVR) IOLs to optimize visual outcomes at all distances. These options can be paired as needed to reduce residual astigmatism and improve postoperative visual acuity outcomes following surgery. This study aimed to evaluate the real-world effectiveness and safety of a FVR IOL in individuals undergoing femtosecond laser-assisted cataract surgery.

This was a retrospective case series reporting real-world outcomes following implantation of a FVR IOL (enVista ENVY Toric, ETN) in individuals undergoing femtosecond laser-assisted cataract surgery. All surgeries were performed by a single ophthalmologist at a center in the United States between October 2024 and March 2025.

A total of 99 eyes (OD, n=48) from 49 individuals were implanted with ETN, and were followed up for 2–6 months. Clinical outcomes assessed included uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA). Monocular and binocular visual acuity outcomes are reported. Scores for postoperative refractive outcomes were compared with preoperative target values determined at baseline. Safety monitoring for adverse events was performed. Preoperatively, mean±SD spherical equivalent (SEQ) target was 0.12±0.22 and delta K was 0.32±1.01.

At last follow-up, 100% of eyes achieved a monocular CDVA of 20/20 or better; 85% achieved a monocular UDVA of 20/25 or better; 100% achieved a monocular UIVA of 20/25 or better; and 96% achieved a monocular UNVA of J2 or better (all n=97). Similarly, 100% of patients achieved a binocular CDVA of 20/20 or better; 98% achieved a binocular UDVA of 20/25 or better; 100% achieved a binocular UIVA of 20/25 or better; and 96% achieved a binocular UNVA of J2 or better (all n=45). Mean±SD SEQ was 0.25 ± 0.46 D (n=95) versus a target of 0.12±0.22 (n=98), representing a mean±SD difference of 0.12±0.44 D (n=99). Mean±SD residual refractive cylinder was 0.46±0.40 D (n=81). No serious adverse events were reported.

In patients undergoing femtosecond laser-assisted cataract surgery, ETN demonstrated excellent real-world performance for near, intermediate and distance monocular and binocular visual acuity scores. Post-operative refractive outcomes were highly satisfactory, with minimal residual refractive error recorded and mean residual cylinder below the threshold associated with reduced distance vision quality (0.5 D). No major safety signals were observed.