The current investigation evaluates the efficiency of the trifocal toric Liberty 677MTY intraocular lens (IOL) in correcting preoperative corneal astigmatism in cataract patients demanding spectacle independence. The retrospective evaluation included 28 eyes of 15 patients with preoperative corneal astigmatism of at least 1.0 Dioptre (D). All patients were followed up for one year postoperatively. Residual refractive errors and visual acuities at multiple distances were measured. Binocular visual acuity and contrast sensitivity defocus curves were plotted. Visual functions and patient satisfaction were assessed. The efficiency of astigmatism correction was determined using the vector analysis method. The mean spherical equivalent refraction (SEQ) improved from 2.72 ± 1.62 D to 0.10 ± 0.48 D. The cylindric refraction decreased from 1.18 ± 0.45 D to 0.16 ± 0.31 D. Vector analysis proved efficient astigmatism correction with a centroid of 0.10 ± 0.34 D at 161°. Ninety-two percent of eyes resulted within 0.5 D from the target refraction. Visual acuities were 0.1 logMAR or better from +1.0 to -3.5 D defocus values. Visual tasks could be performed without major difficulties. Our patients were highly satisfied. Refractive and visual outcomes with the investigated presbyopia-correcting toric IOL are predictable and the lens provides excellent trifocal vision.

Department of Ophthalmology Institute of Aviation Medicine Prague 160 00 Prague Czech Republic

Department of Ophthalmology Military University Hospital Prague 1st Faculty of Medicine Charles University Prague 121 08 Prague Czech Republic

Department of Ophthalmology School of Medicine Hradec Králové Charles University Prague 500 03 Hradec Králové Czech Republic

Department of Ophthalmology University Hospital Ostrava 708 00 Ostrava Czech Republic

Department of Opthalmology University Hospital Královské Vinohrady 3rd Faculty of Medicine Charles University Prague 100 00 Prague Czech Republic

Zobrazit více v PubMed

Berdahl J., Bala C., Dhariwal M., Lemp-Hull J., Thakker D., Jawla S. Patient and economic burden of presbyopia: A systematic literature review. Clin. Ophthalmol. 2020;14:3439–3450. doi: 10.2147/OPTH.S269597. PubMed DOI PMC

Carones F. Residual astigmatism threshold and patient satisfaction with bifocal, trifocal and extended range of vision intraocular lenses (IOLs) Open J. Ophthalmol. 2017;7:73363. doi: 10.4236/ojoph.2017.71001. DOI

Day A.C., Dhariwal M., Keith M.S., Ender F., Vives C.P., Miglio C., Zou L., Anderson D.F. Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. Br. J. Ophthalmol. 2019;103:993–1000. doi: 10.1136/bjophthalmol-2018-312025. PubMed DOI PMC

Cervantes-Coste G., Tapia A., Corredor-Ortega C., Osorio M., Valdez R., Massaro M., Velasco-Barona C., Gonzalez-Salinas R. The Influence of angle alpha, angle kappa, and optical aberrations on visual outcomes after the Implantation of a high-addition trifocal IOL. J. Clin. Med. 2022;11:896. doi: 10.3390/jcm11030896. PubMed DOI PMC

Ferrer-Blasco T., Montés-Micó R., Peixoto-De-Matos S.C., González-Méijome J.M., Cerviño A. Prevalence of corneal astigmatism before cataract surgery. J. Cataract Refract. Surg. 2009;35:70–75. doi: 10.1016/j.jcrs.2008.09.027. PubMed DOI

World Medical Association World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–2194. doi: 10.1001/jama.2013.281053. PubMed DOI

Qvision Almería Vision C visual Acuity Measurement Application. [(accessed on 6 September 2019)]. Available online: https://www.test-eye.com/en/apps-for-eye-care-research/visionc.

Qvision Almería Multifocal Lens Analyzer 3.0 Visual Acuity and Contrast Sensitivity Defocus Curve Measurement Application. [(accessed on 6 September 2019)]. Available online: https://www.defocuscurve.com/en/

Medicontur Medical Engineering Ltd Medicontur IOL Optimizer. [(accessed on 1 September 2019)]. Available online: https://toriccalculator.net.

Haigis W. IOL Calculation According to Haigis, Last Revision: 7 December 1998. [(accessed on 1 September 2019)]. Available online: http://www.augenklinik.uniwuerzburg.de/uslab/ioltxt/haie.htm.

Nováček L.V., Němcová M., Tyx K., Lahodová K., Rejmont L., Rozsíval P., Studený P. Evaluation of astigmatism-correcting efficiency and rotational stability after cataract surgery with a double-loop haptic toric intraocular lens: A 1-year follow-up. Biomed. Hub. 2021;6:30–41. doi: 10.1159/000513894. PubMed DOI PMC

Abulafia A., Koch D.D., Holladay J.T., Wang L., Hill W. Pursuing perfection in intraocular lens calculations IV. Rethinking astigmatism analysis for intraocular lens-based surgery: Suggested terminology, analysis, and standards for outcome reports. J. Cataract Refract. Surg. 2017;44:1169–1174. doi: 10.1016/j.jcrs.2018.07.027. PubMed DOI

Nováček L.V. Simultaneous presbyopia- and astigmatism-correction with a novel trifocal toric intraocular lens—A one-year follow-up. Mendeley Data. 2022;1 doi: 10.17632/58xgbgsx8b.1. PubMed DOI PMC

Reinstein D.Z., Archer T.J., Srinivasan S., Mamalis N., Kohnen T., Dupps W.J., Randleman J.B. Standard for reporting refractive outcomes of intraocular lens-based refractive surgery. J. Refract. Surg. 2017;33:218–222. doi: 10.3928/1081597X-20170302-01. PubMed DOI

Fernández J., Rodríguez-Vallejo M., Tauste A., Albarrán C., Basterra I., Piñero D. Fast measure of visual acuity and contrast sensitivity defocus curves with an iPad application. Open Ophthalmol. J. 2019;13:15–22. doi: 10.2174/1874364101913010015. DOI

Rodríguez-Vallejo M., Remón L., Monsoriu J.A., Furlan W.D. Designing a new test for contrast sensitivity function measurement with iPad. J. Optom. 2015;8:101–108. doi: 10.1016/j.optom.2014.06.003. PubMed DOI PMC

VectorVision Population Values for VectorVision Contrast Sensitivity. [(accessed on 18 February 2022)]. Available online: https://vectorvision.com/csv1000-norms/

Bachernegg A., Rückl T., Strohmaier C., Jell G., Grabner G., Dexl A.K. Vector analysis, rotational stability, and visual outcome after implantation of a new aspheric toric IOL. J. Refract. Surg. 2015;31:513–520. doi: 10.3928/1081597X-20150727-01. PubMed DOI

Nováček L., Němcová M., Tyx K., Lahodová K., Rejmont L., Rozsíval P., Studený P. Comparison of clinical outcomes, visual quality and visual function of two presbyopia-correcting intraocular lenses made from the same material, but with different design and optics. J. Clin. Med. 2021;10:3268. doi: 10.3390/jcm10153268. PubMed DOI PMC

Gundersen K.G., Potvin R. Comparison of visual outcomes after implantation of the diffractive trifocal toric intraocular lens and a diffractive apodized bifocal toric intraocular lens. Clin. Ophthalmol. 2016;10:455–461. doi: 10.2147/OPTH.S103375. PubMed DOI PMC

Piovella M., Colonval S., Kapp A., Reiter J., Van Cauwenberge F., Alfonso J. Patient outcomes following implantation with a trifocal toric IOL: Twelve-month prospective multicentre study. Eye. 2019;33:144–153. doi: 10.1038/s41433-018-0076-5. PubMed DOI PMC

Kretz F.T.A., Breyer D., Klabe K., Hagen P., Kaymak H., Koss M.J., Gerl M., Mueller M., Gerl R.H., Auffarth G. Clinical outcomes after implantation of a trifocal toric intraocular lens. J. Refract. Surg. 2015;31:504–510. doi: 10.3928/1081597X-20150622-01. PubMed DOI

Vandekerckhove K. Rotational stability of monofocal and trifocal intraocular toric lenses with identical design and material but different surface treatment. J. Refract. Surg. 2018;34:84–91. doi: 10.3928/1081597X-20171211-01. PubMed DOI

Ribeiro F.J., Ferreira T.B. Comparison of visual and refractive outcomes of 2 trifocal intraocular lenses. J. Cataract Refract. Surg. 2020;46:694–699. doi: 10.1097/j.jcrs.0000000000000118. PubMed DOI

Ninomiya Y., Minami K., Miyata K., Eguchi S., Sato R., Okamoto F., Oshika T. Toric intraocular lenses in eyes with with-the-rule, against-the-rule, and oblique astigmatism: One-year results. J. Cataract Refract. Surg. 2016;42:1431–1440. doi: 10.1016/j.jcrs.2016.07.034. PubMed DOI

Felipe A., Artigas J.M., Díez-Ajenjo A., García-Domene C., Alcocer P. Residual astigmatism produced by toric intraocular lens rotation. J. Cataract Refract. Surg. 2011;37:1895–1901. doi: 10.1016/j.jcrs.2011.04.036. PubMed DOI

Rementería-Capelo L.A., Contreras I., García-Pérez J.L., Blázquez V., Ruiz-Alcocer J. Visual quality and patient satisfaction with a trifocal intraocular lens and its new toric version. J. Cataract Refract. Surg. 2019;45:1584–1590. doi: 10.1016/j.jcrs.2019.06.014. PubMed DOI

Mojzis P., Majerova K., Plaza-Puche A.B., Hrckova L., Alio J.L. Visual outcomes of a new toric trifocal diffractive intraocular lens. J. Cataract Refract. Surg. 2015;41:2695–2706. doi: 10.1016/j.jcrs.2015.07.033. PubMed DOI

Pomerance G., Evans D. Test-retest reliability of the CSV-1000 contrast test and its relationship to glaucoma therapy. Investig. Ophthalmol. Vis. Sci. 1994;35:3357–3361. PubMed

García-Bella J., Ventura-Abreu N., Morales-Fernández L., Talavero-González P., Carballo-Álvarez J., Sanz-Fernández J.C., Vázquez-Moliní J.M., Martínez-de-la-Casa J.M. Visual outcomes after progressive apodized diffractive intraocular lens implantation. Eur. J. Ophthalmol. 2018;28:282–286. doi: 10.5301/ejo.5001030. PubMed DOI

Gundersen K.G., Potvin R. Comparing visual acuity, low contrast acuity and contrast sensitivity after trifocal toric and extended depth of focus toric intraocular lens implantation. Clin. Ophthalmol. 2020;14:1071–1078. doi: 10.2147/OPTH.S253250. PubMed DOI PMC

Serdiuk V., Ustymenko S., Fokina S., Ivantsov I. Comparison of three different presbyopia-correcting intraocular lenses. Rom. J. Ophthalmol. 2020;64:364–379. doi: 10.22336/rjo.2020.58. PubMed DOI PMC

Győry J.F., Srinivasan S., Madár E., Balla L. Long-term performance of a diffractive-refractive trifocal IOL with centralized diffractive rings: 5-year prospective clinical trial. J. Cataract Refract. Surg. 2021;47:1258–1264. doi: 10.1097/j.jcrs.0000000000000670. PubMed DOI

Höhn F., Tandogan T., Breyer D.R., Kaymak H., Hagen P., Klabe K., Koss J., Gerl M., Auffarth G.U., Kretz F.T.A. Funktionelle Ergebnisse 1 Jahr nach Implantation einer bitorischen, trifokalen Intraokularlinse [Functional results one year after implantation of a bitoric, trifocal intraocular lens] Klin. Mon. Augenheilkd. 2015;232:957–961. (In German) PubMed

Simultaneous Presbyopia and Astigmatism Correction with a Novel Trifocal Toric Intraocular Lens-A One-Year Follow-Up