Visual performance after bilateral toric extended depth-of-focus intraocular lens exchange targeted for micro-monovison.

PURPOSE To evaluate overall patient satisfaction, spectacle independence, binocular visual acuity, rotational stability, prevalence of optical phenomena, as well as decentration and tilt after bilateral toric extended depth-of-focus intraocular lens (EDOF IOL) implantation targeted for micromonovision. SETTING Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. DESIGN Prospective case series. METHODS The study included 52 eyes of 26 patients with regular corneal astigmatism from 0.75 to 2.60 diopters (D) were implanted bilaterally with a toric EDOF IOL targeted for micromonovision. Postoperative visual acuity, astigmatism reduction, rotation, tilt, decentration, spectacle independence, patient satisfaction, and photic phenomena were assessed. RESULTS Binocular means expressed in logarithm of the minimum angle resolution for postoperative corrected distance, uncorrected distance, uncorrected intermediate, and uncorrected near visual acuities were -0.10 (±0.12), -0.01 (±0.13), 0.01 (±0.14), and 0.13 (±0.14), respectively. Mean refractive astigmatism reduction was 1.31 ± 0.67 D resulting in a mean refractive cylinder of 0.47 ± 0.46 D at the 3-month visit. Mean postoperative rotation was 3.5 ± 3.5 degrees, at the 3-month time point. Most prevalent dysphotopsia were halos, starburst, and glare affecting 6 (23%), 6 (23%) and 5 (19%) of 26 patients, respectively. 20 (77%) of 26 patients reported spectacle independence, with 19 (95%), 19 (95%) and 14 (70%) of 20 patients questioned being satisfied with distance, intermediate, and near vision, respectively. CONCLUSIONS Toric EDOF IOL implantation targeted for micro-monovision, resulted in reliable reduction of preoperative astigmatism with a high degree of postoperative rotational predictability and centration, enabling functional distance, intermediate, and near vision, which manifested itself in high patient satisfaction.