Toric, nontoric IOLs provide full range of useful vision

Chicago-Results from two prospective studies demonstrate that patients with either the toric or nontoric versions of an acrylic, apodized diffractive multifocal IOL (AcrySof IQ ReSTOR +3.0 D Multifocal Toric and Multifocal IOLs, Alcon) implanted bilaterally achieve good uncorrected vision for near, intermediate, and distance along with a high rate of spectacle independence, said Michael C. Knorz, MD, at Refractive Surgery 2012 during the annual meeting of the American Academy of Ophthalmology.

Dr. Knorz is professor of ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. He summarized findings from two multicenter studies. In one, 44 patients with preoperative corneal astigmatism ≥0.75 D and ≤2.5 D had the toric version of the multifocal IOL implanted using one of three available models, which correct between 1.0 and 2.0 D of astigmatism at the corneal plane. The study of the nontoric multifocal IOL included 138 patients who had up to 1 D of corneal astigmatism preoperatively. In both cohorts, outcomes were analyzed for data collected at the 6-month visit.

Mean near logMAR UCVA measured at 40 cm in the toric and nontoric groups was 0.07 and 0.10, respectively; at preferred distance (39 cm for toric and 37 cm for nontoric), mean near logMAR UCVA values were 0.05 and 0.09, respectively. In distance UCVA testing, mean logMAR UCVA was 0.05 for the patients with the toric lenses and 0.03 in the nontoric study. Intermediate UCVA was measured at 50, 60, and 70 cm, and logMAR values for those distances were 0.05, 0.09, and 0.15, respectively, for the toric group and 0.13, 0.16, and 0.21, respectively for the nontoric group.

 “As expected, the best intermediate visual acuity results were achieved at the closer distance because there is no real intermediate focus with this lens. However, patients still had useful acuity at 70 cm with both the toric and nontoric designs,” Dr. Knorz said.

When asked about the need for spectacles, 90% of patients in the toric multifocal IOL study said they never needed glasses, while 78% of patients receiving the nontoric version of the multifocal IOL reported not needing glasses at all. With just a few exceptions, the remaining patients in both cohorts said they wore glasses only sometimes.

The toric version of the AcrySof multifocal IOL is not FDA approved. Dr. Knorz is a consultant for Alcon.

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