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David Wang, Robert Osher; Early Uncorrected Vision in Astigmatic Eyes Undergoing Microcoaxial Phacoemulsification with Toric Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2998.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the uncorrected visual acuity (UCVA) on the first postoperative day following implantation using a toric intraocular lens.
This retrospective chart review analyzed UCVA in 184 consecutive eyes of 133 patients who have undergone microcoaxial phacoemulsification with an AcrySof single-piece toric IOL (Alcon) between Sept 2010 and Oct 2012. Pre-operative examination to determine the sphere, amount of astigmatism, and steepest cylindrical axis were obtained with a manual keratometer and four automated keratometers. Both IOLmaster and Lenstar were used to obtain the axial length measurements. Intraoperative identification of the target meridian and alignment of the toric IOL were determined using iris ‘fingerprinting’ and limbal registration with the SMI unit. Unaided visual acuity was measured in the office on the first postoperative day and at 3 weeks following surgery. The results were stratified by toric models.
The UCVA on the first postoperative day was 20/40 or better in 96.8% of the T3 group; 92.5% in the T4 group; 88.7% in the T5 group; 62.5% in the T6 group; 100% in the T7 group; 100% in the T8 group; 100% in the T9 group. Each category improved at the 3 week visit.
Excellent early uncorrected vision following toric IOL implantation requires thorough preoperative diagnostic testing, thoughtful selection of the toric IOL power and target meridian, careful surgical technique, and accurate alignment of the IOL. The unaided visual acuity continues to improve throughout the postoperative period.
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