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. 2024 Mar 8:18:755-763.
doi: 10.2147/OPTH.S448427. eCollection 2024.

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

Hiroko Bissen-Miyajima  1 , Yuka Ota  1 , Saori Yaguchi  1 , Kunihiko Nakamura  1 , Noriyuki Sasaki  2
Affiliations

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

Hiroko Bissen-Miyajima et al. Clin Ophthalmol. .

Abstract

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.

Keywords: low corneal astigmatism; toric IOL; toric calculator; trifocal IOL; visual acuity.

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Conflict of interest statement

Dr Hiroko Bissen-Miyajima received grants and research support from Alcon, Johnson & Johnson Vision, and HOYA, and is a consultant for Alcon, Johnson & Johnson Vision, BVI, and Zeiss. Dr Yuka Ota, Dr Saori Yaguchi, and Dr Kunihiko Nakamura received grants and research support from Alcon Vision LLC, Johnson & Johnson Vision, and HOYA. Noriyuki Sasaki is an employee of Alcon Japan Ltd. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Percentage of eyes within a specified threshold of absolute magnitude of refractive astigmatism (all-implanted analysis set).
Figure 2
Figure 2
Double-angle plots of the preoperative keratometric astigmatism (A) and postoperative refractive astigmatism (B). Concentric circles indicate 0.5 D cylinder steps. Horizontal and vertical axes in both plots range from −2 D to +2 D.
Figure 3
Figure 3
Double-angle plot of postoperative refractive astigmatism prediction error of the formula. Concentric circles indicate 0.5 D cylinder steps. Horizontal and vertical axes in both plots range from −2 D to +2 D.
Figure 4
Figure 4
Percentage of eyes with TFNT20 achieving visual acuity ≥1.0 for CDVA, UDVA, and UIVA, and ≥0.4 for UNVA.
See this image and copyright information in PMC

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Grants and funding

This study was funded by Alcon Vision LLC. Alcon assisted with the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript.

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