Abstract Objective To assess binocular visual function after combined implantation of toric and multifocal or monofocal intraocular lenses in unilateral astigmatism cataract patients. Methods This was a prospective case control study. A total of thirty unilateral astigmatism patients undergoing phacoemulsification were recruited. AcrySof Toric IOL were implanted in the astigmatic eye of patients, with ReSTOR (15 eyes) or AcrySof IQ (15 eyes) in the contralateral eye. Six months postoperatively, patients were assessed for visual acuity (5.0 m, 60.0 cm, 40.0 cm), contrast sensitivity, amplitude of accommodation, and stereoacuity. Patients were surveyed for visual disturbances and lifestyle visual quality. Data were analyzed with a paired t test, an independent samples t test, or chi-square test. Results At 6 months postoperatively, for Toric-ReSTOR patients, uncorrected binocular logMAR visual acuity at 5.0 m, 60.0 cm, 40.0 cm was 0.05±0.05, 0.24±0.10, and 0.14±0.06, respectively. For Toric-AcrySof IQ patients, uncorrected binocular logMAR visual acuity was 0.06±0.07, 0.26±0.08, and 0.37 ±0.10, respectively. These values between the two group did not achieve significant differences except for near visual acuity (t=5.476, P=0.000). The contrast sensitivity for ReSTOR eyes was lower at 18 cpd under photopic and photopic glare circumstance than for the AcrySof IQ eyes (0.30 ± 0.37 versus 0.94 ±0.58, t=3.476, P=0.001; 0.34 ± 0.44 versus 0.88 ±0.52, t =2.975, P= 0.006). And was lower at 12 cpd under scotopic and scotopic glare circumstance than for the AcrySof IQ eyes (0.05±0.22 versus 0.50±0.61, t=3.057, P=0.005; 0.05±0.22 versus 0.59±0.75, t=3.154, P=0.004). The amplitude curve of accommodation in Toric-ReSTOR patients had two wave peak (0 and-2.5 D), but only one (0 D) in Toric-AcrySof IQ patients. The stereopsis of Toric-ReSTOR eyes decreased slightly (53% versus 73%, x2=1.262, P=0.263). Patient satisfaction for mean near vision was significantly different: 80% for Toric-ReSTOR patients versus 26% for Toric-AcrySof IQ patients (x2=8.571, P=0.003). There were no visual symptoms in either group. Conclusion Although a combination of toric and mutifocal intraocular lens implantation compromises stereoacuity, it can still provide patients with high levels of spectacle freedom and good overall binocular visual acuity.
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