Effects of bifocal intraocular lenses implantation combined with opposite clear corneal incisions versus bifocal toric intraocular lenses in cataract patients with low corneal astigmatism.

Purpose: To investigate long-term effects of bifocal intraocular lenses (IOLs) implantation combined with opposite clear corneal incisions (OCCIs) and bifocal toric IOL implantation solely in cataract patients with low corneal astigmatism.

Methods: The study included 58 patients (60 eyes) with corneal astigmatism of 0.75 to 1.5 diopter (D) who underwent cataract surgery. 30 eyes received bifocal IOLs implantation through steep meridian incisions combined with OCCIs (OCCI group), and 30 eyes received bifocal toric IOLs implantation solely (control group). Uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), corneal astigmatism, rotational stability of bifocal toric IOLs, corneal higher-order aberrations (HOAs) and spectacle independence were collected postoperatively.

Results: No significant difference in UCDVA and UCNVA between the two groups (all P > .05) at 1 week, 1 month, 3, 6 and 12 months postoperatively. Compared with preoperative data, corneal astigmatism in the OCCI group was significantly decreased at 1 month, 3 and 12 months postoperatively (all P < .001), but in the control group, no statistically decreased was detected at 1 month, 3 and 12 months (all P > .05). No obvious rotation of IOLs in the control group postoperatively. No significant difference in corneal HOAs in either group postoperatively compared with preoperative values (all P > .05) or between the two groups (P > .05). The rates of spectacle independence were above 90% in both groups.

Conclusions: Both bifocal IOLs implantation through steep meridian incisions combined with OCCIs and bifocal toric IOL implantation solely can significantly reduced corneal astigmatism in cataract patients with low corneal astigmatism, providing good visual quality and stable long-term effects. So bifocal IOLs implantation through steep meridian incisions combined with OCCIs can serve as an alternative to bifocal toric IOL implantation solely.