ASPHERIC TORIC IOL USED FOR BLENDED VISION REFRACTIVE TARGET IN BILATERAL CATARACT SURGERY: VISUAL OUTCOMES IN A PROSPECTIVE OBSERVATIONAL CASE SERIES
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO142 | Type: Free Paper | DOI: 10.82333/9are-d371
Authors: Alexandros John Kanellopoulos 1 , Anastasios John Kanellopoulos* 2 , Despoina Karadimou 1 , Stellia Georgiadou 1
1Ophthalmology,Laservision Ambulatory Eye Surgery Unit,Athens,Greece, 2Ophthalmology,Laservision Ambulatory Eye Surgery Unit,Athens,Greece;Ophthalmology,NYU Med School,New York,United States
Purpose
To evaluate the safety and efficacy and the visual outcomes when targeting Toric IOL and blended vision in bilateral cataract surgery, as refractive outcome
Setting
The Laservision Clinical and Research Institute, Athens, Greece
Methods
In 80 consecutive bilateral clear corneal cataract patients-160 eyes, by one surgeon (AJK), we used 2 types of IOLs: an aspherical hydrophobic acrylic IOL, targeting toric in all cases: (Clareon, CNW0Tx, toric powers: T2 to T9, Alcon, Ft. Worth, TX, USA). IOL calculation was based on total corneal power and axial length as measured with IOL Master 700 biometry (Zeiss, Jenna, Germany). Given that no further significant pathology co-existed, in the dominant eye plano to -0.3 D post-op refraction was targeted, whereas the goal was -0.75 to -1.0 residual myopia for the non-dominant. Postoperative UDVA, CDVA and UNVA, contrast sensitivity and refraction were evaluated up to 3 months.
Results
Residual refractive astigmatism was up to -0.5 Diopters in 89% of cases by month 3, in 148 cases a toric IOL was used . Mean UDVA changed from 20/400 preop to 20/22 postop, CDVA: from 20/50 to 20/16. The average postoperative spherical refraction change from pre- to post-op in Diopters: sphere: -4.5 (-12.50 to +5.5) to -0.50 (+0.50 to -1) and cylinder: from -2.5 (-5.5 to 0) to -0.35 (plano to -0.75) respectively. 86% of the patients reached binocular UDVA 20/20 along with binocular UNVA J2 at 35-40 cm distance Jaeger Reading card. Contrast sensitivity was above or at high normal in all special frequencies studied for all cases.
Conclusion
When targeting slight postoperative residual myopia in the non-dominant eye with our blended vision protocol,-along with careful corneal astigmatism measurement and toric IOL planning- in bilateral cataract surgery, the majority of the cases can benefit from the use of even a lower power toric IOL in order to achieve effective UDVA, along with very functional UNVA.