PURPOSE: Evaluate postoperative astigmatic outcomes in eyes implanted with an ultra-low cylinder powered toric (ULPT) intraocular lens (IOL) compared with a non-toric IOL for the surgical management of astigmatism in cataract surgery.

PATIENTS AND METHODS: This is a retrospective, controlled consecutive case series from 3 Canadian ophthalmology centers. Cases were included if they were adults (≥18 years), qualified for the 0.90D toric based on the Barrett Toric Calculator without "flipping" the axis of astigmatism by 0.2D or more, and underwent surgery either with the enVista Toric 0.9 D IOL (ULPT, Bausch + Lomb) or enVista Non-toric (spherical). All surgeries were performed using standard phacoemulsification and IOL implantation under topical anesthesia with 2.0 to 2.2-mm biplanar square clear corneal incision at 190° for OD and 10° for OS. The mean±SD incision angle was 94.0±89.70° for the ULPT group and 103.0±89.37° for the non-toric group. Primary effectiveness endpoint was the mean reduction in cylindrical power of the eye. Other endpoints were manifest refraction, keratometry, visual acuity, IOL axis, and safety.

RESULTS: 290 screened patient charts were enrolled and included 383 eyes (192 eyes with the ULPT IOL and 191 eyes with the non-toric IOL). The mean reduction in cylindrical power was 0.432±0.447 D in the Toric 0.9 D IOL group and 0.071±0.407 D in the Non-toric group, with the mean difference (0.351 D) in favor of the ULPT IOL (P<0.0001). significantly more of the ulpt group than the non-toric group had plano outcomes or had a cumulative residual cylinder within 0.25 d 0.50 d and 0.75 d of plano p0.001 for all. there were no serious aes reported in patient charts.>

CONCLUSION: The ULPT IOL was safe and effective for eyes with low to ultra-low preoperative astigmatism and resulted in significantly greater reduction in postoperative manifest cylinder compared to the monofocal IOL.