Comparison of Refractive Outcomes After Phacoemulsification and Combined 25-Gauge Phacovitrectomy with Implantation of Plate-Haptic Toric Intraocular Lenses

Objectives: To compare intraocular lens (IOL) position and refractive outcomes between eyes that underwent sole phacoemulsification with those that underwent combined 25-gauge phacovitrectomy with a plate-haptic toric IOL implantation. Methods: This retrospective study included 60 eyes of 60 patients. Of these, 30 eyes underwent 25-gauge phacovitrectomy, while the other 30 eyes received phacoemulsification alone. In both groups, a plate-haptic toric intraocular lens (AT Torbi 709M, Carl Zeiss Meditec AG) was implanted. The main outcome measures were the refractive outcome, the refraction prediction error (PE), the difference in the postoperative anatomical lens position (ALP) change, and rotational stability. Results: The mean spherical equivalent decreased considerably from -2 ± 4.4 diopters (D) to -0.6 ± 1.4 D after phacovitrectomy (p = 0.05) and -0.7 D ± 5.5 D to -0.1 ± 1.1 D after phacoemulsification (p = 0.5). The prediction error (PE) was comparable between the two groups for all formulas (Haigis-T: p = 0.8, Barrett TK Toric: p = 0.8, Z CALC: p = 0.7). No significant difference in absolute ALP change and postoperative rotational stability was observed between the phacovitrectomy and phacoemulsification group (1.4 mm vs. 1.4 mm, p = 0.96; 2.9° vs. 2.1°, p = 0.5). Conclusions: The implantation of plate-haptic toric IOLs in the combined phacovitrectomy group resulted in refraction and IOL positioning outcomes comparable to those in the phacoemulsification-only group.