Visual Outcomes and the Impact of Intermediate Segment Orientation on the Performance of an Asymmetric Multifocal Intraocular Lens

PURPOSE: To evaluate the visual outcomes and the impact of intermediate segment orientation on the performance of an asymmetric multifocal intraocular lens (IOL) in patients who have cataract. METHODS: In this retrospective single-center study, 251 eyes of 251 patients who underwent phacoemulsification with the Lentis Comfort LS-313 MF15 IOL (Oculentis BV) implantation were analyzed. Patients' data were divided into four groups: one non-toric and three toric IOL groups based on astigmatic type (with-the-rule [WTR], against-the-rule [ATR], and oblique astigmatism). Visual outcomes including uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), and near visual acuity (UNVA) were compared between the groups. Regression analysis was used to evaluate the relationship between visual outcomes and angle alpha, derived from Purkinje images from the ANTERION biometer (Heidelberg Engineering). RESULTS: This study found no significant difference in uncorrected visual outcomes (UDVA, UIVA, UNVA) among the four groups: non-toric (60 eyes) and toric IOL groups comprising WTR (63 eyes), ATR (64 eyes), and oblique (64 eyes) across different intermediate segment orientations. Uncorrected visual acuity was comparable across all groups, with 90% of eyes or more achieving 20/25 UDVA, 90% or more achieving 20/40 UIVA, and 70% or more achieving 20/70 UNVA. The majority of eyes (80% or more) achieved refractive outcomes within ±0.50 and 0.50 diopters (D) or less residual cylinder. Regression analysis showed no significant relationship between angle alpha and visual outcomes. CONCLUSIONS: The Lentis MF IOL demonstrated good visual outcomes in both the non-toric and toric groups, with no significant impact of intermediate segment orientation or angle alpha on postoperative visual and refractive parameters.