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Background . The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously.  Objectives . To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes.  Methods . Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate.  Results . Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12 ± 0.20 (standard deviation), 0.24 ± 0.16, and 0.29 ± 0.21, respectively. Corresponding binocular values were −0.01 ± 0.14, 0.13 ± 0.12, and 0.20 ± 0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all  P  ≤ 0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all  P  > 0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence.  Conclusions . Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction.

Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes