Visual acuity and refraction with a diffractive multifocal toric intraocular lens

PURPOSE: To evaluate clinical outcomes and optical performance of the AT Lisa 909M diffractive multifocal toric intraocular lens (IOL). SETTING: Multicenter study. DESIGN: Cohort study. METHODS: The measured outcomes included refractive error; distance, near (40 cm), and intermediate (60 cm and 80 cm) visual acuities; defocus curve; rotational stability; and monocular and binocular photopic and mesopic contrast sensitivity. Astigmatism was evaluated by Alpins vector analysis. RESULTS: The multifocal toric IOL was implanted in 284 eyes of 142 patients. At 6 months, 89.4% of eyes were within +/- 1.00 diopter (D) of emmetropia. The mean refractive cylinder decreased from -2.39 D +/- 1.48 (SD) to -0.49 +/- 0.53 D; it was lower than 1.00 D in 80.9% of eyes. The mean visual acuities (logMAR) were monocular uncorrected distance 0.16 +/- 0.22, monocular corrected distance 0.04 +/- 0.15, binocular corrected distance -0.00 +/- 0.09; monocular uncorrected near 0.21 +/- 0.22, monocular corrected near 0.08 +/- 0.16, binocular distance-corrected near 0.07 +/- 0.14; intermediate at 60 cm (80 cm): monocular uncorrected 0.16 +/- 0.21 (0.09 +/- 0.21), monocular distance corrected 0.13 +/- 0.19 (0.07 +/- 0.20), and binocular distance corrected 0.07 +/- 0.17 (0.00 +/- 0.18). At 3 months and 6 months, 95.8% of IOLs showed no rotation over 5 degrees. CONCLUSIONS: This is the largest study yet on the first commercially available diffractive multifocal toric IOL. Results confirm its efficacy, predictability, and safety in restoring distance, near, and intermediate vision and allowing patients with significant levels of corneal astigmatism to achieve spectacle independence.