Comparison of astigmatism correction and visual outcomes in mix-and-match implantations of trifocal intraocular lenses with femtosecond laser-assisted arcuate keratotomy and contralateral bifocal Toric intraocular lenses

Jiying Shen; Zhixiang Hua; Zhixiang Hua; Zhixiang Hua; Zhixiang Hua; Zhixiang Hua; Limei Zhang; Baoxian Zhuo; Baoxian Zhuo; Baoxian Zhuo; Baoxian Zhuo; Baoxian Zhuo; Wenqian Shen; Wenqian Shen; Wenqian Shen; Wenqian Shen; Wenqian Shen; Xuanzhu Chen; Haike Guo; Jin Yang; Jin Yang; Jin Yang; Jin Yang; Jin Yang

doi:10.3389/fmed.2023.1237319

Frontiers in Medicine (Aug 2023)

Comparison of astigmatism correction and visual outcomes in mix-and-match implantations of trifocal intraocular lenses with femtosecond laser-assisted arcuate keratotomy and contralateral bifocal Toric intraocular lenses

Jiying Shen,
Zhixiang Hua,
Zhixiang Hua,
Zhixiang Hua,
Zhixiang Hua,
Zhixiang Hua,
Limei Zhang,
Baoxian Zhuo,
Baoxian Zhuo,
Baoxian Zhuo,
Baoxian Zhuo,
Baoxian Zhuo,
Wenqian Shen,
Wenqian Shen,
Wenqian Shen,
Wenqian Shen,
Wenqian Shen,
Xuanzhu Chen,
Haike Guo,
Jin Yang,
Jin Yang,
Jin Yang,
Jin Yang,
Jin Yang

Affiliations

Jiying Shen: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Zhixiang Hua: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
Zhixiang Hua: The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
Zhixiang Hua: Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
Zhixiang Hua: Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
Zhixiang Hua: The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
Limei Zhang: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Baoxian Zhuo: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
Baoxian Zhuo: The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
Baoxian Zhuo: Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
Baoxian Zhuo: Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
Baoxian Zhuo: The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
Wenqian Shen: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
Wenqian Shen: The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
Wenqian Shen: Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
Wenqian Shen: Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
Wenqian Shen: The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
Xuanzhu Chen: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Haike Guo: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Jin Yang: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
Jin Yang: The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
Jin Yang: Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
Jin Yang: Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
Jin Yang: The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

DOI: https://doi.org/10.3389/fmed.2023.1237319
Journal volume & issue: Vol. 10

Abstract

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IntroductionAstigmatism reduces the postoperative visual performance after non-toric intraocular lenses (IOLs) implantation, and limits the use of refractive IOLs in cataract surgery. The purpose of this study was to compare the efficacy in astigmatism correction and the postoperative visual outcomes between the implantation of a trifocal IOL with femtosecond laser-assisted arcuate keratotomy (FSAK) in one eye and a bifocal toric IOL (TIOL) in the other, in patients with cataract and moderate astigmatism.MethodsThis prospective observational paired-eye study enrolled patients with cataract and corneal astigmatism (CA) between 0.75 and 2.25 D in both eyes. The patients underwent a mix-and-match treatment comprising trifocal IOL implantation with FSAK and bifocal TIOL implantation. We compared the visual acuity (VA) at all distances, defocus curve, postoperative refractive astigmatism (RfA), CA, high-order aberrations, modulation transfer function (MTF) curve, and Strehl ratio between the two eye groups.ResultsIn total, 41 patients (82 eyes) were enrolled and completed a 6-month follow-up. The 1- and 3-month uncorrected distance VA and 3-month uncorrected near VA were greater in eyes with bifocal TIOLs than with trifocal IOLs and FSAK (p = 0.036, 0.010, and 0.030, respectively), whereas the latter had greater uncorrected intermediate VA at every visit and greater VA in the intermediate range of defocus curve (at −1.50 and − 2.00 D) than the eyes with bifocal TIOLs. The postoperative RA of the eyes with trifocal IOL and FSAK was significantly higher than that of the bifocal TIOL-implanted eyes at the 3- and 6-month follow-ups.DiscussionBoth FSAK and TIOL implantation effectively reduce pre-existing moderate astigmatism in patients with cataract. The eyes with bifocal TIOLs had more stable long-term astigmatism correction, whereas those with trifocal IOLs and FSAK had better intermediate VA. Therefore, a mix-and-match implantation of trifocal IOL with FSAK and contralateral bifocal TIOL could achieve effective astigmatism correction and provide an overall optimal VA.

Published in Frontiers in Medicine

ISSN: 2296-858X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: http://www.frontiersin.org/journals/medicine

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