Purpose To evaluate the clinical outcome in eyes with significant corneal astigmatism after cataract surgery with implantation of a new diffractive multifocal toric intraocular lens (IOL).

Methods Prospective, non-randomised multicentre clinical study including 57 eyes of 38 consecutive patients with an age between 37 and 84 years that underwent cataract surgery with implantation of the toric multifocal IOL Tecnis ZMT (Abbott Medical Optics, Santa Ana, California, USA). Changes in uncorrected and corrected logMAR distance, intermediate and near visual acuity ((uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), corrected near visual acuity) and manifest refraction were evaluated during a 2–4 month follow-up. Additionally, patients were asked about photic phenomena and spectacle dependence. The surgeons subjectively assessed various aspects of the surgery.

Results A significant improvement in CDVA was observed postoperatively (p<0.01), with a significant reduction in manifest cylinder (p<0.01). Mean postoperative binocular UDVA and UNVA were 0.04±0.10 and 0.06±0.12, respectively. Monocular UDVA and UNVA was 0.20 or better in 85.4% and 87.0% of eyes, respectively. Mean binocular logMAR UIVA was 0.21±0.20. Only 10.5% of patients required postoperative correction for near or intermediate distance. The incidence of moderate to severe photic phenomena was limited. Surgeons defined the IOL implantation in most cases as easy or very easy, with a satisfaction rate with the procedure of 84%.

Conclusions The implantation of the multifocal toric IOL is a safe procedure that provides a very good visual rehabilitation in eyes with corneal astigmatism.