Visual and refractive outcomes of eyes with low corneal astigmatism implanted with low toric or non-toric trifocal intraocular lenses.

OBJECTIVE: To evaluate visual and refractive outcomes of cataract patients with low corneal astigmatism (-0.50 D to -1.50 D) implanted with either a low toric or non-toric trifocal IOL. METHODS: This retrospective cross sectional study included patients with low corneal astigmatism measured by the IOLMaster 700 (Carl Zeiss AG, Germany). Patients received either a trifocal toric IOL (FineVision Toric POD FT) or a trifocal non-toric IOL (FineVision POD F or POD F GF). Toric implantations formed the TT (True Toric) group while non-toric IOLs were named as NTT (Non-Toric IOL, Toric) and those not recommended toric IOL placed in the NTNT group (Non-Toric IOL, Non-Toric). Visual acuity, refraction, and astigmatism were assessed preoperatively and 6-12 months postoperatively. RESULTS: Among 167 eyes (88 TT, 65 NTT, 14 NTNT), postoperative uncorrected visual acuities were similar across groups. The TT IOLs are significantly more effective at reducing residual refractive cylinder, particularly in patients with preoperative astigmatism between - 0.50 D and - 1.50 D. While uncorrected distance, intermediate, and near visual acuities were generally comparable (non-inferior), the TT group achieved superior distance vision (UDVA) in the - 0.76 D to -1.00 D against-the-rule subgroup. Ultimately, low toric trifocal IOLs provide more predictable refractive outcomes and better astigmatism correction without increasing patient-reported visual disturbances like glare or haloes. CONCLUSION: The use of the low toric models of trifocal IOLs resulted in a significant reduction in preoperative corneal astigmatism, leading to good visual outcomes. Patients with - 0.50 D to -1.50 D of astigmatism benefit from these lenses, with correction being particularly effective for those with at least - 0.75 D of against-the-rule astigmatism.