Visual function and patient experience after bilateral implantation of toric intraocular lenses.

Purpose: To evaluate the efficacy, stability, predictability, and patient-reported outcomes of bilateral toric intraocular lens (IOL) implantation in cases of cataract with preexisting astigmatism.

Setting: Fourteen universities, hospitals, or private practices, Canada.

Methods: Patients with cataracts and corneal astigmatism from 1.00 to 2.50 diopters (D) were included in a prospective study of bilateral AcrySof toric IOL implantation. Binocular uncorrected distance visual acuity (UDVA), manifest refraction, and IOL rotational stability were assessed 1 day and 1, 3, and 6 months postoperatively. Patients completed a questionnaire that assessed spectacle independence, visual disturbances, and satisfaction with vision (1 = completely unsatisfied; 10 = completely satisfied) preoperatively and 3 and 6 months postoperatively.

Results: The study included 117 patients (234 eyes). The binocular UDVA was 20/40 or better in 99% of patients and 20/20 or better in 63% of patients. The mean residual refractive astigmatism was 0.4 D +/- 0.4 (SD). The spherical equivalent was within +/-0.5 D of target in 77% of eyes. At last observation, IOL alignment was within +/-5 degrees in 91% of eyes and within +/-10 degrees in 99%. Sixty-nine percent of patients reported never using distance spectacles. The frequency and severity of halos and glare were significantly reduced from preoperatively to postoperatively. Satisfaction with vision was rated 7 or higher by 94% of patients.

Conclusion: Bilateral implantation of toric IOLs yielded excellent and stable visual outcomes that patients rated as highly satisfactory.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.