Table 1_Long-term visual outcomes and rotational stability of two diffractive toric intraocular lenses with different design combinations in cataract patients with long axial length.xlsx

Sample size was based on IOL rotation as the primary endpoint (≥25 eyes per group to detect a 3° difference, 80% power, α=0.05). Inclusion criteria required axial length ≥25.0 mm and corneal astigmatism >0.75 D. Patients were followed at 1 week, 1 month, and 3 months postoperatively. Primary endpoint was IOL rotation at 3 months; secondary endpoints included uncorrected visual acuity, corneal astigmatism, defocus curve, objective visual quality, and satisfaction scores.</p>Results<p>At 3 months, mean rotation was (2.83 ± 2.56)° in the hydrophobic trifocal group and (3.25 ± 2.29)° in the hydrophilic bifocal group (P > 0.05).

At 1 month, uncorrected intermediate visual acuity (LogMAR) was significantly better in the hydrophobic trifocal group (0.01 ± 0.07 vs. 0.16 ± 0.09, P < 0.001). Cumulative uncorrected distance visual acuity of 0.1 LogMAR or better was achieved in 96.6% and 92.9% of eyes, respectively. No significant differences were found in uncorrected distance and near visual acuity, total higher-order aberrations, Strehl ratio, or questionnaire scores.

Both IOLs achieved comparable visual quality and rotational stability despite design differences.</p>Conclusions<p>Both diffractive toric multifocal IOLs demonstrate comparable long-term visual outcomes and rotational stability in cataract patients with long axial length. Differences in material, haptic configuration, and IOL color did not result in significant visual quality disparities. The trifocal design demonstrates advantages in intermediate visual acuity.</p>