First experience with a new toric trifocal IOL implantation in refractive lens exchange patients

Session Details

Session Title: Interactive Free Paper Session: Pseudophakic IOLs/ Toric

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 17:16

Venue: Capital Hall B

First Author: : P.Schraepen BELGIUM

Co Author(s): :    E. Mertens              

Abstract Details

Purpose:

To evaluate the clinical performance, efficacy and safety and to study the implantation technique of a toric trifocal IOL (Toric Fine Vision).

Setting:

Medipolis Eye Center, Antwerp, Belgium

Methods:

Prospective study. 18 eyes of 36 patients with cataract or presbyopia, no ocular or systemic comorbidity and with at least 1.50 diopters of preoperative corneal astigmatism underwent phacoemulsification and implantation of a toric, trifocal IOL. Targeted refraction was emmetropia for all cases. Lens powers were calculated using the respective manufacturer’s online calculator. Intraoperative refraction was measured using the Optiwave Refractive Analysis (ORA) system wavefront aberrometer (WaveTec Vision Systems, Aliso Viejo, CA, USA) and the IOL position was optimised using the ORA instructions. Uncorrected visual acuity (UCVA), best corrected distance visual acuity (CDVA), intermediate and near vision (35 and 70 cm) with the best distance correction, residual refractive spherical equivalent and IOL misalgnment were evaluated one day (for far vision), one week and one month postoperatively. Postoperative IOL misalignment was assessed using a KR-1W Wavefront analyzer (Topcon, Tokyo, Japan).

Results:

After 1 month, all eyes obtained a UCVA of 20/30 or better. All eyes had binocular vision at 40 cm higher than 20/25. The intermediate vision was better than 20/25 with the best distance correction for pupil lower than 4.5 mm in photopic conditions. The improvement of the near and intermediate vision was simultaneous with the far vision. Toric IOL implantation in 18 eyes resulted in an average of 1,9° rotation with the Toric FineVision IOL. For every degree of error in a toric IOL’s rotational misalignment, there is a 3.3 percent decrease in the correction of astigmatism. So If a toric IOL is misaligned by 10 degrees, the astigmatism will be 33 percent undercorrected. If the toric IOL is misaligned by 30 degrees, there will be no astigmatism correction. No complaints of excessive halos or glare were reported.

Conclusions:

The new toric Trifocal IOL implantation after phacoemulsification was a safe and effective method for pseudophakic presbyopia and astigmatism correction in patients at all distances. In this series were no misaligned IOLs due to the verification of the toric IOL positioning at the end of surgery with the Optiwave Refractive Analysis (ORA) system wavefront aberrometer.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented