Visual outcomes and patient satisfaction after cataract surgery with toric multifocal intraocular lens implantation

PURPOSE: To evaluate visual outcomes and patient satisfaction after toric multifocal intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism. SETTING: University Eye Clinic Maastricht, The Netherlands. DESIGN: Cohort study. METHODS: Patients with cataract, corneal astigmatism, and a motivation for spectacle independency had cataract surgery with implantation of a toric diffractive multifocal IOL (AT Lisa). Three months postoperatively, the uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; corrected distance, intermediate, and near visual acuities; residual refractive astigmatism; defocus curve; contrast sensitivity; and patient satisfaction were evaluated. RESULTS: Forty-five eyes of 25 patients were enrolled. Postoperatively, the mean UDVA was 0.04 logMAR +/- 0.15 (SD) and 98% of eyes achieved a UDVA of 20/40 or better. The mean UNVA was 0.20 +/- 0.16 logMAR and the mean UIVA (at 60 cm), 0.40 +/- 0.16 logMAR. Residual refractive astigmatism of -1.00 diopter or less was achieved in approximately 90% of eyes. Contrast sensitivity levels were high. Approximately 50% of patients reported moderate glare, halos, and starburst symptoms. Spectacle independency for distance and near vision was achieved by 95% of patients and 79% of patients, respectively. CONCLUSIONS: Toric IOL implantation in patients with cataract and corneal astigmatism provided good distance and near visual outcomes and acceptable intermediate visual outcomes, allowing patients with considerable amounts of corneal astigmatism to achieve spectacle independence at distance and near.