PURPOSE: The enVista ASPIRE toric (ETA) intraocular lens (IOL) is a hydrophobic acrylic monofocal IOL designed to provide an extended depth of focus (DOF) compared to standard monofocal lenses. These lenses are indicated for primary implantation in the capsular bag to correct aphakia following cataract extraction in adult patients with pre-existing astigmatism. The purpose of this study is to evaluate the visual outcomes at different distances, rotational stability, and defocus curve, to assess the functional benefits of this new platform of enhanced monofocal IOLs.

SETTING: This study is conducted in two sites in Spain (Unidad de cirugía facorrefractiva, Hospital Universitario Miguel Servet, Zaragoza, Spain, and Hospital Universitario Ramón y Cajal, Madrid, Spain) in patients presenting for cataract surgery with pre-existing astigmatism.

METHODS: Prospective, multicenter, clinical study of an enhanced toric monofocal (ETA) IOL in participants undergoing cataract surgery with pre-existing astigmatism. Patients with no previous ocular surgery or serious ocular disease and normoreactive pupil were included. All procedures were femtosecond laser assisted cataract surgeries (Victus, Bausch and Lomb, Inc) with APEX-centered implantation. The clinical outcomes included best-corrected and uncorrected visual acuity at distance (BCDVA and UDVA) and intermediate (DCIVA and UIVA), rotational stability and defocus curve. Follow-up was 4-6 weeks.

RESULTS: 30 eyes implanted with ETA IOLs after cataract surgery with pre-existing astigmatism are included. At 4-6 weeks postoperative, over 80% of eyes achieved BCDVA of 20/20 or better and DCIVA of 20/30 or better at 66 cm. The monocular defocus curve postoperative showed a wide range of functional vision, with a typical enhanced lens performance greater than 1.25 diopters at 0.2 logMAR, which translates into outstanding intermediate performance. Good rotational stability has been demonstrated without modification of the lens position at 1-month and 3-month. No significant dysphotopsias has been reported.

CONCLUSIONS: Our study confirms that the enVista hydrophobic toric platform is a safe and reliable option for correcting corneal astigmatism after cataract surgery, with proven rotational stability. enVista ASPIRE toric IOLs have excellent visual acuity at far and intermediate distances.