Abstract
Purpose: :
To assess the efficacy of astigmatic correction achieved at the time of cataract surgery performed by Ophthalmology residents using toric intraocular lens (IOL) implantation versus aspheric monofocal IOL implantation.
Methods: :
A retrospective review assessed the outcomes of phacoemulsification cataract surgery performed by Ophthalmology residents and fellows at the Michael E. DeBakey Veterans Affairs Medical Center between June 2009 and March 2011. Patients receiving a toric IOL (Acrysof Toric SN60T3, -T4, or T5, Alcon Laboratories, Inc) or an aspheric monofocal IOL (Acrysof IQ SN60WF, Alcon Laboratories, Inc.) were included in the study. Eyes with irregular astigmatism, vision limiting conditions, postoperative cystoid macular edema, intraoperative complications, or intraoperative peripheral corneal relaxing incisions were excluded from the study. Main outcome variables included postoperative uncorrected distance visual acuity (UDVA) and manifest refractive cylinder. Each group was stratified by the amount of preoperative keratometric astigmatism into two groups (≤2D or >2D) for comparative analysis.
Results: :
A total of 82 eyes were included in the study; 41 received a toric IOL and 41 received a monofocal IOL. Preoperative keratometric astigmatism was statistically different between the two groups; which was higher in the toric IOL group (P<0.05). Postoperative refractive cylinder results were lower in the toric IOL group (0.57) when compared to the monofocal group (0.82). Average surgically induced astigmatism was 2.15 diopters (D) and 0.72 D in the toric and monofocal groups, respectively. 100% of patients in the toric group achieved 20/40 or better UDVA, while only 73% of patients in the monofocal group achieved this benchmark.
Conclusions: :
The toric IOL yielded good results in the surgical correction of astigmatism at the time of phacoemulsification cataract surgery performed by residents and fellows.
Keywords: astigmatism • cataract