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Bishoy Said, David Boulos Kneiber, Samir I Sayegh; Pre- and Post-Operative Analysis of Astigmatism in 12 Refractive Cataract Surgeries in 8 Southern California Patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1320.
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© 2017 Association for Research in Vision and Ophthalmology.
To analyze the refractive results of a subset of 300 eyes of 200 patients receiving a toric intraocular lens (tIOL) operated in a southern California clinic and to identify tools to improve surgical outcomes.
This is a retrospective study where 12 eyes of 8 patients receiving a tIOL in 2015 were analyzed for refractive outcomes with a minimum of 3 months of follow up. The patients had their biometry obtained by IOL Master and IOL selection was performed using a multi-formula approach followed by the use of the Alcon online toric calculator, where a single surgeon (BS) selected the IOL. All patients were targeted to plano with zero residual astigmatism. The same surgeon operated all cases using a standardized temporal approach with incisions at 030 degrees for the right eye, and 210 degrees for the left eye. The spherical equivalent was calculated for each patient using postoperative refraction and the postoperative uncorrected and best corrected visual acuities were obtained. The full data was also run retrospectively using the UniversIOL calculator (SIS), and differences including the "simultaneous sphere and cyl" technique were used to assess the results.
12 eyes of 8 patients were analyzed. The average age was 62 years and the average preoperative best corrected visual acuity was 20/30, with an average astigmatism of 1.73 D. The female to male ratio was 5:3. The average postoperative uncorrected visual acuity was 20/21.5, the average refractive error was 0.30 D, and the average astigmatism was 0.4375 D. The use of UniversIOL allowed for the simultaneous calculation of sphere and cylinder and optimization on the blur function, instead of a sequential, possibly suboptimal, traditional sphere then cylinder approach. It also allowed for the choice of a variable as well as fixed toricity ratio calculation.
Excellent results in cataract refractive surgery can be obtained with tIOLs for patients with moderate to high astigmatism with appropriate biometry and computational tools. Improvements and flexibility using a universal calculator are possible and potentially provide more accurate IOL power predictions in postoperative refractive outcomes. The remaining patients of a group of 300 eyes are under further analysis to confirm our findings. Additionally, a prospective study is under way.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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