Refractive outcome and subjective quality of vision after toric lens implantation in cataract surgery

Abstract

Purpose: To evaluate the refractive outcome and subjective quality of vision of toric IOL implantation, for correction of pre-existing corneal astigmatism, after cataract surgery.

Methods: Retrospective study of 26 eyes (17 patients) who underwent micro-incisional cataract surgery, through a 1.8mm corneal incision, with toric IOL implantation (AT TORBI® 709M, Carl Zeiss Meditec, Germany.) to treat over one diopter (D) of preoperative corneal astigmatism. Preoperative evaluation included keratometry, subjective refraction and complete slit-lamp examination. Three months postoperatively, uncorrected distance visual acuity (UDVA), corrected distance visual acuity, manifest refraction, and keratometry were measured. Individual patient satisfaction, with uncorrected vision was also documented. The cylinder axis of the toric IOL was determined by dilated slitlamp photography.

Results: Three months postoperatively, the mean UDVA was 7.34/10e ± 1.67 (0,14±0.10 LogMar). The mean refractive cylinder decreased significantly postoperatively, from -2.95±1.03 D to -0.88±0.79 D (p<0.00001). No significant change in keratometric cylinder was observed (p=0.11). The surgically inducted astigmatism was less than 1 D in 88.4% of eyes. The mean intraocular lens axis rotation was of 4.3±2.7°. The good UDVA resulted in high levels of patient satisfaction. Spectacle independence was observed in 76.4% of patients.

Conclusions: Implantation of the toric lens (AT TORBI® 709M) is safe and effective for correction of corneal astigmatism in 1.8mm micro-incisional cataract surgery.

Keywords: 567 intraocular lens • 428 astigmatism • 445 cataract