Initial Eperiences 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 multifocal toric intraocular lens (IOL) (Medicontur Medical Engineering Ltd, Zsámbék, Hungary) in cataract patients with a preoperative corneal astigmatism of at least 1.0 Diopters (D). In our current work we aim to introduce the clinical results of our first 14 patients, after an initial 3-months follow-up period.

Department of Ophthalmology, Semmelweis University, Budapest, Hungary

In this prospective non-comparative clinical investigation, 30 cataract patients with a preoperative corneal astigmatism between 1.0 and 6.0 D were included. 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 (UDVA, CDVA, UIVA, CIVA, UNVA, CNVA, respectively) were measured. Monocular and binocular visual acuity defocus curves, as well as contrast sensitivity defocus curves were plotted 3 months postoperatively. Visual functions were assessed using the Visual Function Queastinnare-25 (VFQ-25). IOL-axis position was registered during each postoperative visit.

Interim analysis of 20 eyes after 3 months could be performed. The spherical equivalent of 83% of eyes resulted within 0.5 D, and all eyes (100%) resulted within 1.0 from the target refraction, emmetropia. Monocular defocus curves showed visual acuities of better, than 0.2 logMAR throughout the defocus range from +1.0 to -3.5 D, while average binocular curves were better, than 0.1 logMAR at all defocus values in the same range. Contrast sensitivity defocus curves confirmed good visual quality at all distances. VFQ-25 evaluation showed high patient satisfaction with a mean of 93.4 scores out of 100 scores. Distance vision achieved 97.5, while near vision achieved a rating of 92.5. The performance of everyday activities received 96.3 scores.

Based on our currently available clinical data the implantation of the trifocal toric Liberty 677MTY IOL is safe and efficient in correcting refractive errors including astigmatism. Refractive outcomes are predictable. The IOL provides excellent visual acuity and contrast sensitivity at all three examined distances. Patients report on high satisfaction in general, and in all sub-scales of the VFQ-25 questionnaire. More accurate and established conclusions will be feasible to be drawn after all our patients have completed the one-year follow-up, however the initial results are promising.