Refractive outcomes following bilateral implantation of a diffractive toric intraocular lens in a multisurgeon hospital setting

Published:November 24, 2022DOI:



      To assess residual postoperative refractive astigmatism following bilateral implantation of a trifocal toric intraocular lens (IOL) in a real-world multisurgeon setting.


      Six surgeons at two sites.


      Prospective multisurgeon study.


      Bilateral implantation of a trifocal toric IOL (PanOptix; Alcon, Geneva, Switzerland) was performed in 140 eyes of 70 patients. Patients were assessed on day 1 and 3 months postoperatively. The primary outcome measure was residual astigmatism. Secondary endpoints included absolute prediction error, IOL rotation, binocular uncorrected and distance-corrected visual acuities at near (40 cm), intermediate (60 cm), and distance (6 m) and spectacle independence evaluated with the Intraocular Lens Satisfaction questionnaire.


      Mean preoperative cylinder was 1.25 ± 0.72 D and was 0.39 ± 0.28 D at 3 months postoperatively. At 3 months postoperatively, mean residual astigmatism was 0.39 ± 0.28 D (range, 0–1.25 D), and 118 eyes (84.3%) had postoperative astigmatism of 0.5 D or less. Mean absolute prediction error was 0.25 ± 0.21 D (range, 0–1.13 D), and 124 eyes (88.6%) had absolute prediction error of 0.5 D or less. At 3 months postoperatively, mean absolute rotation was 2.0 ± 2.7 degrees compared with baseline (range, 0–15 degrees), and 133 IOLs (95.0%) were within 5 degrees of the implanted axis. Additionally, 55 patients (79%) reported never or rarely using spectacles at near, 66 (94%) at intermediate, and 67 (96%) at distance.


      The results of this study demonstrate that implantation with the PanOptix toric IOL can provide excellent refractive and visual outcomes with minimal residual astigmatism.
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