Clinical Ophthalmology (Jul 2024)

Outcomes After Implantation of a Trifocal Toric Intraocular Lens Using Intraoperative Aberrometry, Digital Image Tracking, and Femtosecond Laser

  • Melendez RF,
  • Nguyen TH,
  • Solis AI,
  • Ortiz D,
  • Moezzi C,
  • Hall B

Journal volume & issue
Vol. Volume 18
pp. 2033 – 2039

Abstract

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Robert F Melendez,1,2 Thao Huong Nguyen,1,2 Angelica Isabella Solis,1 Danielle Ortiz,2 Cody Moezzi,2 Brad Hall3 1Juliette Eye Institute, Albuquerque, NM, USA; 2University of New Mexico School of Medicine, Department of Ophthalmology, Albuquerque, NM, USA; 3Sengi, Penniac, NB, CanadaCorrespondence: Robert F Melendez, Juliette Eye Institute, 8801 Horizon Blvd., Suite 130, Albuquerque, NM, 87113, USA, Tel +1 505-355-2020, Email [email protected]: To evaluate the refractive and visual acuity outcomes when using trifocal toric intraocular lenses (IOLs), femtosecond laser assisted cataract surgery (FLACS), swept-source optical coherence tomography (SS-OCT) biometry, digital image tracking (DT) and intraoperative aberrometry (IA).Methods: This prospective, single-arm, observational study of refractive and visual outcomes included 40 eyes of 34 subjects. Preoperative biometry was performed with the Argos, FLACS and digital marking with LenSx, and IA and DT with ORA. Eyes were implanted with the Clareon PanOptix toric IOL. Study outcome measures included absolute prediction error, residual refractive astigmatism, and monocular uncorrected and distance corrected visual acuity at distance (UDVA, CDVA), intermediate (UIVA, DCIVA; 60cm), and near (UNVA, DCNVA; 40cm).Results: Mean absolute prediction error (spherical equivalent) was 0.43 ± 0.36 D, and the percentage of eyes with absolute prediction error ≤ 0.5 D was 72.5% (29/40 eyes). Mean residual astigmatism was 0.36 ± 0.65 D, and the percentage of eyes with residual astigmatism ≤ 0.5 D was 80% (32/40 eyes). Monocular UDVA, UIVA, and UNVA was 20/25 or better in 75%, 64%, and 87% of eyes respectively. Monocular CDVA, DCIVA, and DCNVA was 20/25 or better in 95%, 64%, and 87% of eyes respectively.Conclusion: The results of this study suggest that trifocal toric implantation with SS-OCT, FLACS, DT, and IA can provide excellent refractive and visual outcomes.Plain Language Summary: When the natural lens inside the eye becomes opaque (develops a cataract), it can be surgically replaced with a clear artificial intraocular lens (IOL). There are many different technologies available to the cataract surgeon in order to maximize postoperative visual outcomes with implanted IOLs. These include, modern biometers, femtosecond laser-assisted cataract surgery (FLACS), trifocal IOLs, toric IOLs, image-guided digital tracking (DT), and intraoperative aberrometry (IA). Individually, good refractive outcomes have been reported with these technologies. However, there is minimal data on outcomes using a combination of all of them. The purpose of this study was to determine the refractive and visual acuity outcomes when using modern biometers, toric IOLs, FLACS, DT, IA, and trifocal IOLs. The results of this study suggest that trifocal toric implantation with modern biometry, FLACS, DT, and IA can provide excellent refractive and visual outcomes.Keywords: Clareon PanOptix, Argos, intraoperative aberrometry, FLACS

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