title: Visual outcomes and patient satisfaction after cataract surgery with toric multifocal intraocular lens implantation.
abstract: OBJECTIVE
  To evaluate visual outcomes and patient satisfaction after toric multifocal intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism.
  
  
  METHODS
  University Eye Clinic Maastricht, The Netherlands.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Patients with cataract, corneal astigmatism, and a motivation for spectacle independency had cataract surgery with implantation of a toric diffractive multifocal IOL (AT Lisa). Three months postoperatively, the uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; corrected distance, intermediate, and near visual acuities; residual refractive astigmatism; defocus curve; contrast sensitivity; and patient satisfaction were evaluated.
  
  
  RESULTS
  Forty-five eyes of 25 patients were enrolled. Postoperatively, the mean UDVA was 0.04 logMAR ± 0.15 (SD) and 98% of eyes achieved a UDVA of 20/40 or better. The mean UNVA was 0.20 ± 0.16 logMAR and the mean UIVA (at 60 cm), 0.40 ± 0.16 logMAR. Residual refractive astigmatism of -1.00 diopter or less was achieved in approximately 90% of eyes. Contrast sensitivity levels were high. Approximately 50% of patients reported moderate glare, halos, and starburst symptoms. Spectacle independency for distance and near vision was achieved by 95% of patients and 79% of patients, respectively.
  
  
  CONCLUSIONS
  Toric IOL implantation in patients with cataract and corneal astigmatism provided good distance and near visual outcomes and acceptable intermediate visual outcomes, allowing patients with considerable amounts of corneal astigmatism to achieve spectacle independence at distance and near.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
authors.affiliation: University Eye Clinic, Maastricht University Medical Center, Maastricht, The Netherlands. nienke.visser@mumc.nl
authors.forename: Nienke
authors.initials: N
authors.lastname: Visser
authors.forename: Rudy M M A
authors.initials: RM
authors.lastname: Nuijts
authors.forename: Niels E
authors.initials: NE
authors.lastname: de Vries
authors.forename: Noël J C
authors.initials: NJ
authors.lastname: Bauer
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000503:physiopathology; D015331:Cohort Studies; D015350:Contrast Sensitivity / Q000502:physiology; D005139:Eyeglasses; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011446:Prospective Studies; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology*; D014786:Vision Disorders / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology*