Slit lamp

Distance visual acuity (VA) was measured using a logarithm of the minimum angle of resolution (LogMAR) chart (Nidek, Gamagori, Japan). In the case of uncorrected VA in either eye being > 0.1, best-corrected visual acuity (BCVA) was subsequently measured in a monocular fashion using a trial frame. Refractive status was measured both before and after cycloplegia using an auto-refractor (Nidek ARK-510A, Gamagori, Japan). Two cycles of 1% cyclopentolate (Cyclogyl, Alcon-Convreur, Rijksweg, Belgium) and 1% tropicamide (Santen, Osaka, Japan) were given ten minutes apart. An additional third cycle of cyclopentolate and tropicamide drops was administered thirty minutes after the last drop if either a pupillary light reflex was still present, or pupil size was less than 6.0 mm. Detailed ocular examinations for the anterior segment and the retina were conducted by an ophthalmologist using a slit-lamp (Haag-Streit, Koeniz, Switzerland) and binocular ophthalmoscope with a 20D lens (Volk, Houston, TX) respectively.

Comprehensive ocular examinations were conducted, including measurement of best-corrected visual acuity (BCVA), intraocular pressure (IOP), and axial length. Slit-lamp microscopy, ultrasound biomicroscopy (UBM), ultrasound B scanning, and MRI were performed. To evaluate the fundus, ultrawidefield scanning laser ophthalmoscopy, spectral domain OCT (SD-OCT), swept-source OCT (SS-OCT), FFA, and ICGA were performed. Electrooculography and electroretinography were performed to evaluate retinal function.
Visual acuity was examined via an Early Treatment Diabetic Retinopathy Study chart (Precision Vision, La Salle, IL, USA). IOP was measured with a noncontact TX-20 Canon tonometer. Anterior segment photographs were obtained using a slit lamp (Haag-Streit, Bern, Switzerland), and UBM was conducted using a model SW-3200L instrument (Tianjin Suowei Electronic Technology Co., Ltd., Tianjin, China). Fundus photography was performed using a Zeiss FF450 instrument (Zeiss, Oberkochen, Germany). OCT images were obtained via spectral domain OCT (Heidelberg Engineering, Heidelberg, Germany). FFA, ICGA, and SD-OCT were performed using a Heidelberg Spectralis HRA (Heidelberg Engineering, Heidelberg, Germany). A-scan ultrasonic biometry (Model Cinescan; Quantel Medical, Clermont-Ferrand, France) was used to measure axial length.

All patients were followed for a minimum of 1 month after surgery. Preoperative and postoperative month 1 data were collected from patient charts for analysis. When available, data also were collected from follow-up at 3–13 months after surgery.
The main outcome measures included corneal and manifest refractive cylinder, refractive predictability, uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) measured at 70–80 cm, uncorrected near visual acuity (UNVA) measured at 40 cm, IOL rotational stability, and safety parameters (adverse events, surgical complications, and best-corrected visual acuity (BCVA)). As part of the safety evaluation, patients were evaluated for visual disturbances, and all patients were asked specifically if they had any problems with night vision.
Rotational stability of the lens was evaluated at a slit-lamp (Haag-Streit, Mason, OH) that has degree marks labeled on the beam, which allows measurement of the toric IOL axis when the slit beam is aligned with the toric IOL axis markings in a dilated eye [11 (link)].