Comparative Analysis of Clinical Outcomes Obtained With a New Diffractive Multifocal Toric Intraocular Lens Implanted Through Two Types of Corneal Incision

PURPOSE: To analyze and compare the clinical outcomes obtained after cataract surgery with the implantation of a new multifocal toric intraocular lens (IOL) using two different types of corneal incision. METHODS: Retrospective study including 64 eyes of 35 patients who underwent surgery with implantation of the AT LISA 909M multifocal toric IOL (Carl Zeiss Meditec) in 2 different ophthalmologic centers using different criteria for corneal incision size: sub-1.8 mm (micro-incision surgery [MICS] group) and 2.2 mm (mini-incision group). Visual, refractive, and corneal topographic outcomes were evaluated during 6-month follow-up. Additionally, refractive astigmatic changes were analyzed using the Alpins vectorial method. RESULTS: Significant reductions of refractive sphere and cylinder were observed postoperatively ( P <.03), with associated visual improvements for near and distance ( P <.01) in both groups. Mean postoperative magnitudes of difference vector, torque, and magnitude of error in the overall sample were 0.52±0.36 diopters (D), 0.36±0.36 D, and 0.08±0.38 D, respectively. A mean overcorrection of 4% in refractive astigmatism was found. Mean angle of error was 0.37±5.50° and −4.51±13.16° for the MICS and mini-incision groups, respectively ( P =.09). Significant positive correlations were found between the magnitudes of torque and difference vector (r=0.78, P <.01) as well as between the magnitude of torque and absolute angle of error (r=0.76, P <.01). CONCLUSIONS: Implantation of the AT LISA toric IOL using corneal incisions <2.2 mm provides excellent predictability for astigmatic correction.