Purpose: To evaluate the visual and wavefront outcomes after cataract surgery with implantation of a diffractive multifocal toric intraocular lens (IOL). Setting: Two clinical centers, Lisbon, Portugal. Design: Case series. Methods: This study comprised patients with cataract and corneal astigmatism between 0.75 diopter (D) and 2.50 D who had phacoemulsification with implantation of an Acrysof IQ Restor toric IOL. Over a 3-month follow-up, the main outcome measures were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm, uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, residual astigmatism, rotational stability of the IOL, higher-order aberrations, and the presence of dysphotopic phenomena. Results: The study included 38 eyes (19 patients). The mean UDVA was 0.07 logMAR ± 0.10 (SD), the mean UIVA was 0.16 ± 0.10 logMAR, and the mean UNVA was 0.02 ± 0.09 logMAR. Predictability of refractive results was very good, with an SE refraction within ±0.50 D of the attempted spherical correction in 33 eyes (87%). The mean toric IOL axis rotation was 2.97 ± 2.33 degrees. One eye required a second surgery to align the IOL axis. Ocular aberrometry and dysphotopic phenomena results were similar to those published for the nontoric version of the toric IOL. Conclusion: Implantation of the diffractive multifocal toric IOL in patients with cataract and corneal astigmatism provided excellent distance, intermediate, and near visual outcomes; predictability of the refractive results; rotational stability; and good optical performance, allowing all patients to achieve complete spectacle independence. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.
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