AIMS: This pilot study aims to present a novel method for quantitatively assessing the decentration of a trifocal intraocular lens (IOL) (Acrysof IQ PanOptix®) relative to three ocular reference points: the visual axis (first Purkinje reflex), the photopic pupil center, and, for the first time, the corneal geometric center. Additionally, the study evaluates the influence of postoperative chord mu, chord alpha, and the distances of the IOL from these reference points on visual outcomes. MATERIALS AND METHODS: This retrospective, observational study included 18 eyes from 12 patients who underwent cataract surgery with PanOptix® IOL implantation. Postoperative IOL positioning was assessed using OPD-Scan III images, applying a novel approach that combines diffuse frontal and retroillumination views. Distances between the IOL center and three ocular reference points, including the corneal geometric center, were measured, and postoperative patient satisfaction was evaluated using the Catquest-9SF survey. Statistical analyses were performed to assess correlations among reference distances, chord measurements, and visual performance. RESULTS: The study found that in 72.2% of cases, the IOL center was closer to the visual axis than to the corneal geometric center. A greater distance between the IOL and the corneal geometric center was associated with an improved near-vision area under the visual acuity defocus curve. However, no significant correlations were found between chord mu or chord alpha and visual outcomes, patient symptoms, or satisfaction. CONCLUSION: This new approach to determining IOL centration proved practical, showing that the PanOptix® IOL tends to remain close to the visual axis over time, aligning with the surgeon's initial placement. No clear associations were found between chord mu, chord alpha, or most IOL distances (except the distance to the corneal geometric center) and visual quality or patient satisfaction. Further studies are needed to confirm these findings and to refine selection criteria for multifocal IOLs to enhance patient satisfaction and visual outcomes.

• Klíčová slova
• IOL decentration, Trifocal intraocular lens, chord alpha, chord mu, corneal geometric center, visual axis,
• MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• multifokální intraokulární čočky * MeSH
• nitrooční čočky * MeSH
• pilotní projekty MeSH
• posunutí nitrooční čočky * diagnóza   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spokojenost pacientů MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

PURPOSE: The aim of the study was evaluation and comparison of rotational stability and the effect of multifocal toric intraocular lens rotation (T-MIOL) at visual quality of two types of intraocular lens AcrySof IQ ReSTOR Toric SND1Tx (Alcon Laboratories, Inc.) and AT LISA toric 909M (Carl Zeiss Meditec AG). There was evaluated a pseudophakic dysphotopsia based on patients subjective feelings as well as the independence on glasses and overall satisfaction with the visual quality after T-MIOLs were implanted. METHODS: The retrospective study included 68 eyes (100 %) of 34 patients, who underwent an uncomplicated cataract surgery with multifocal toric intraocular lens was implanted. 68 eyes were divided into two groups. Group A consisted of 48 eyes (70,6 %) with AcrySof IQ ReSTOR Toric SND1Tx and group B included 20 eyes (29,4 %) with AT LISA toric 909M multifocal toric intraocular lenses were implanted. The T-MIOL position, planned axis and misalignment were evaluated one week and 6 months after surgery. Surgical lens reposition was indicated in case of worsening visual quality due to T-MIOL rotation from its planned position. RESULTS: In the group of 68 eyes, the mean uncorrected distance visual acuity (UDVA) before surgery was 0,08 (n = 48) in group A and 0,09 (n = 20) in group B. The mean UDVA after T-MIOL were implanted improved to 0,83 ± 0,06 (n = 48) in group A and 0,75 ± 0,08 (n = 20) in group B. The mean UDVA in patients before T-MIOL surgical rotation was 0,57 ± 0,03 (n = 5) in group A and 0,59 ± 0,08 (n = 5) in group B. At six months after T-MIOL surgical rotation, the uncorrected distance visual acuity was 1,0 in both groups (p = 0.70). The surgical rotation of T MIOL was performed in 10 eyes (14,7 %) of 68 eyes (p = 0.48), in group A (n = 48) in 5 eyes (10,4 %) and in group B (n = 20) in 5 eyes (25,0 %). Mean deviation from the planned axis was 8,2 ± 1,78 degrees in group A and 13,4 ± 3,04 degrees in group B. At six months postoperatively, the T-MIOL rotational stability showed less than 5 degrees for all surgically rotated lenses in both groups. Mean cylinder decreased in all patients from -2,92 ± 1,85Dcyl to -0.85 ± 0.61Dcyl after surgery. The mean spherical equivalent for all patients decreased from 0,56 ± 4,75D to 0,06 ± 1,33D after surgery. Presence of disturbing fotic phenomenon had reported 11 (32.4 %) of 34 patients, 9 of them they were subsequently indicated T-MIOL reposition. All 34 patients were able to perform normal daily tasks independently on spectacle correction. At six months after surgery, there was very high satisfaction with the quality of postoperative vision in both groups. CONCLUSION: Implantation of toric multifocal intraocular lens, both of AcrySof ReSTOR Toric SND1Tx (Alcon Laboratories, Inc.) and AT LISA toric 909M (Zeiss Meditec AG Carl) in cataract patients is safe and effective method to correct corneal astigmatism and maintain the visual multifocality. Early surgical T-MIOL reposition should be performed to put the T-MIOL to planned axis in steepest meridian if unwanted lens rotation is identified. KEY WORDS: cataract surgery, toric multifocal intraocular lens, rotation, rotational stability, quality of vision.

• MeSH
• astigmatismus patofyziologie   MeSH
• fakoemulzifikace metody   MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• multifokální intraokulární čočky * MeSH
• posunutí nitrooční čočky patofyziologie   MeSH
• pseudofakie patofyziologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spokojenost pacientů MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH