PURPOSE: Many patients have some degree of corneal astigmatism; even mild amounts of astigmatism can impact post-operative visual outcomes following cataract surgery. This case series aims to present real-world clinical outcomes of patients implanted with a low-powered toric (1.25D) enVista ASPIRE™ IOL (ETA) to correct for mild corneal astigmatism.

METHODS: This retrospective case series includes a single surgeon's experience implanting ETA between 23 January and 23 April 2024. All eyes were implanted with a low-powered ETA lens (1.25D) to correct for mild corneal astigmatism. Outcome measures included spherical equivalent refractive (SEQ) outcomes, best-corrected distance visual acuity (BCDVA), uncorrected VA (distance and intermediate), delta Ks, and refractive residual cylinder. The study protocol received exemption from a central institutional review board.

RESULTS: ETA 1.25D was implanted in 9 eyes of 8 pts (4 OD, 3 OS, 1 OU); 4 pts underwent bilateral implantation with an ETA lens >1.25D in their fellow eye. At baseline, mean±SE delta K and SEQ target were 0.78±0.09 and 0.03±0.09 (N=9 eyes). At follow-up, mean±SE SEQ outcome and difference were 0.01±0.15 and -0.01±0.08, respectively; mean±SE refractive and corneal residual cylinder were 0.35±0.14 and 0.84±0.14, respectively (N=9 eyes). At follow-up, 89% of eyes achieved 20/20 or better and 100% of eyes achieved 20/25 or better BCDVA; 89% of eyes achieved 20/25 or better UCDVA; 78% of eyes achieved 20/32 or better UCIVA (N=9 eyes). For eyes implanted bilaterally, 100% achieved 20/20 BCDVA OU (N=5 pts).

CONCLUSION: This single surgeon case series demonstrates good vision outcomes for patients with mild corneal astigmatism implanted with this low-powered toric monofocal IOL. Further data are required to understand how this single-surgeon's experience is reflected more broadly in real-world clinical practice.