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Naveen Rao, Amal Althawabi, Kirstin Tawse, Sarkis Soukiasian; Refractive Outcomes of Toric Intraocular Lens Implantation for Correction of Astigmatism During Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1848.
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© ARVO (1962-2015); The Authors (2016-present)
To establish criteria for determining quality of refractive outcomes after toric intraocular lens (IOL) implantation. To assess whether implantation of toric IOLs with higher cylindrical power is associated with inferior refractive outcomes.
Charts were reviewed for patients who underwent cataract surgery and toric IOL implantation with the Alcon AcrySof Toric IQ lens at Lahey Clinic from July 2009 - June 2012. Data collected included: cylindrical power of toric IOL used; postoperative uncorrected distance visual acuity (UDVA); postoperative corrected distance visual acuity (CDVA); postoperative residual astigmatism by manifest refraction; and presence of ocular co-morbidities. Eyes were assigned to groups based on outcomes defined as good (UDVA 20/25 or better with ≤ 0.50 D residual astigmatism), fair (either UDVA 20/30 with ≤ 0.50 D residual astigmatism, or UDVA 20/25 or better with 0.75 D residual astigmatism), and poor (UDVA 20/30 or worse with ≥ 0.75 D residual astigmatism).
133 eyes of 96 patients were included. 56.4% (n=75), 16.5% (n=22), and 27.1% (n=36) of eyes met criteria for the good, fair, and poor outcome groups, respectively. In the good outcome group, mean postoperative UDVA was 20/22 and mean residual astigmatism was 0.14±0.22 D. In the fair outcome group, mean postoperative UDVA was 20/28 and mean residual astigmatism was 0.38±0.33 D. In the poor outcome group, mean postoperative UDVA was 20/44 and mean residual astigmatism was 0.79±0.31 D. 13.5% of eyes (n=18) had ocular co-morbidities (corneal or retinal pathology) that limited postoperative CDVA; all met criteria for the poor outcome group. 38.4% (n=51) of eyes received implantation of the lowest cylindrical power toric IOL (T3), and 61.6% (n=82) of eyes received implantation of higher cylindrical power toric IOLs (T4-T9). There was no significant difference in postoperative UDVA between the T3 and T4-T9 groups (20/26 versus 20/28, p=0.3537). Residual astigmatism was lower in the T3 group than in the T4-T9 group (0.24±0.33 D versus 0.43±0.46 D, p=0.0115).
Establishing criteria for determining quality of refractive outcomes after toric IOL implantation can be helpful in counseling patients before cataract surgery. Implantation of higher cylindrical power toric IOLs is associated with slightly more residual astigmatism, but there is no association with inferior postoperative UDVA.
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