Purpose: To evaluate multifocal toric IOL to manage astigmatism during cataract surgery.
Methods: Eyes with cataract and corneal astigmatism (2.38 ± 0.82 D) had AT LISA toric 909M implantation. IOL calculations were performed using Z-CALC online calculator, taking into account the surgeon SIA.IOL axis alignment during surgery was accurately performed using the Z-ALIGN tool from the CALLISTO eye modular system.  Outcomes measurements were subjective refraction, corneal astigmatism using ATLAS™ 9000 Corneal Topography System or Tomey TMS 2 Corneal Tomographer, visual acuity, contrast sensitivity using OPTEC 6500.
Results: The study included 23 eyes from 16 patients (mean age 51.46 years ± 11.12 [SD]). Preoperatively, mean BCVA and SE were 0.85 ± 0.25 (decimal) and 2.40 D ± 3.40 respectively. Patients presented with a mean corneal cylinder and mean refractive cylinder of  2.38 D ± 0.82 and 1.48 D ± 1.26 respectively. 
Six months postoperatively, mean monocular UCVA and BCVA were  0.73 ± 0.22 and 0.90 ± 0.18 respectively for far vision. Near monocular UCVA was 20/34.The mean residual refractive cylinder was 0.32 ± 0.31.
Photopic contrast sensitivity were within the normal range (phakic patients older than 18) for lower spatial frequencies. Similar outcomes were observed in mesopic conditions with or without glare.
Conclusion: AT LISA toric 909M is an advanced generation multifocal IOL preferably indicated for bilateral implantation. Initial clinical outcomes indicate that this is a new effective multifocal design.