To evaluate the clinical outcomes of patients with diffractive multifocal toric intraocular lens (IOL) implantation.

Thirty-four eyes of 26 patients underwent diffractive multifocal toric IOL. Uncorrected visual acuity (UCVA) at distant, intermediate and near and residual refractive astigmatism were measured on the first day, at 2 weeks, and 1, 3 and 6 months postoperatively. Optical quality obtained using the Optical Quality Analysis System II (OQAS II), high-order aberrations (HOA) and patient satisfaction questionnaire were evaluated 3 months postoperatively.

At the 6 month postoperative visit, the mean UCVA at distant, intermediate (63 cm, 100 cm) and near were 0.06 ± 0.07, 0.18 ± 0.11, 0.16 ± 0.12 and 0.03 ± 0.06 (log MAR), respectively. The refractive astigmatism decreased significantly from -1.66 ± 1.04 D to -0.54 ± 0.32 D at 6 months postoperatively ( p < 0.01). The means of objective scatter index, modulation transfer function (MTF) cut-off value, Strehl ratio and pseudo-accommodation range measured by OQAS II were 1.33 ± 0.67, 37.24 ± 9.67 cdp, 0.22 ± 0.09 and 3.08 ± 0.53 D, respectively. HOA scores for 5 mm and 6 mm were 0.30 ± 0.09 and 0.49 ± 0.15, respectively; 82.3% of the patients were satisfied with the postoperative results, 79.4% of the patients reported they would recommend the procedure to others, and 14.7% of patients reported moderate or severe visual disturbance at night.

Implantation of a diffractive multifocal toric IOL in patients with cataract and corneal astigmatism provided excellent distant, intermediate, and near visual outcomes, good optical quality and high patient satisfaction.