Rotational Stability of Toric Capsular Bag–Fixated Intraocular Lenses in Duet Procedure for Reversible Trifocality

Purpose : To evaluate the long-term rotational stability of capsular bag-fixated toric intraocular lenses (IOLs) in polypseudophakic eyes of patients who underwent duet procedure for reversible trifocality. Design : Retrospective interventional case series. Methods : We included 34 eyes of 20 patients who underwent duet procedure with implantation of a monofocal toric IOL (RayOne toric, Hoya XY1AT or a Tecnis ZCT800) into the capsular bag and a trifocal-diffractive Sulcoflex IOL into the ciliary sulcus. All toric IOLs were implanted with image-guided navigation. The manifest refraction and uncorrected and distance corrected visual acuity at far, intermediate and near distance were measured. The position of the axis of the toric IOL was determined with the Pentacam device (Oculus GmbH, Wetzlar, Germany) by evaluating retroillumination images. The results were compared with the preoperatively planned axis position. Results : The median follow-up was 27 months. The spherical equivalent of manifest refraction was -0.04 ± 0.34 diopters postoperatively, and the refractive cylinder was -0.14 ± 0.22 diopters on average. Binocular UDVA and CDVA were 0.05 ± 0.11 logMAR and 0.02 ± 0.09 logMAR, respectively. The mean deviation from the calculated cylinder axis was 3.8± 3.5 ° with a median of 2.8° and a maximum deviation of 15.0°. 94% of all eyes showed a deviation of less than 10°. Conclusions : The long-term axial alignment of capsular bag-fixated toric IOLs in polypseudophakic eyes was comparable to the results reported for single implantation of toric IOLs. The polypseudophakic approach did not affect the rotational stability of capsular bag-fixated IOLs.