Clinical Results of a Trifocal Toric Intraocular Lens Using the Holladay Total Surgically Induced Astigmatism Formula for Correcting Low Corneal Astigmatism in Japanese Patients

Purpose: To evaluate the effectiveness and safety of the AcrySof IQ PanOptix toric intraocular lens (IOL) with cylinder power of 1.0 D (TFNT20) in a Japanese population with low corneal astigmatism and compare with historical control data for nontoric IOLs. Setting: Tokyo Dental College Suidobashi Hospital, Tokyo, Japan. Design: Prospective, single -center study. Methods: Patients >= 20 years old received TFNT20 IOL in at least 1 eye based on Alcon Toric calculator (Holladay Total surgically induced astigmatism). Effectiveness endpoints included the percentage of eyes with refractive cylinder <= 0.25 D at 30-60 days after surgery, which was compared with a historical control threshold rate of 29.2% for nontoric IOLs and refractive cylinder <= 0.50 D. Monocular uncorrected distance visual acuity (UDVA; 5 m), uncorrected intermediate visual acuity (UIVA; 60 cm), uncorrected near visual acuity (UNVA; 40 cm), and adverse events were evaluated. Results: Of 41 eyes implanted with TFNT20 IOLs, 37 eyes (90%) achieved refractive cylinder <= 0.25 D at 30-60 days after surgery, demonstrating the superiority of TFNT20 compared with historical data (P<0.0001). Refractive cylinder of <= 0.50 D was achieved by 41 eyes (100%). At 30-60 days, mean +/- SD monocular CDVA was -0.15 +/- 0.07 logMAR, UDVA was -0.09 +/- 0.09 logMAR, UIVA was -0.00 +/- 0.07 logMAR, and UNVA was 0.03 +/- 0.07 logMAR. Six eyes (15%) had elevated postoperative intraocular pressure, which returned to normal and was not device -related. Conclusion: TFNT20 IOLs successfully reduced postoperative refractive cylinder and provided good distance, intermediate, and near uncorrected VAs in Japanese patients with low corneal astigmatism.