Surgical And Refractive Outcomes In Cataract Surgery With Toric Intraocular Lens Implantation In A Resident-teaching Institution

Abstract

Purpose: : To evaluate refractive and surgical outcomes in cataract surgery utilizing the Acrysof toric intraocular lens (TIOL) in a teaching institution.

Methods: : Retrospective consecutive case series. Cases are patients undergoing cataract extraction with Acrysof TIOL placement at the Miami Veterans Affairs Medical Center (VAMC).

Results: : The authors present a series of 95 eyes (81 patients) that underwent cataract surgery with placement of Acrysof TIOL. Follow-up ranged from 1 month to 28 months (mean 7 months). The mean best corrected visual acuity (BCVA) improved from 20/115 at baseline to 20/35 with 92% of eyes having 20/50 or better visual acuity postoperatively. The mean deviation from targeted spherical correction was +0.07 diopters (D) (range -2.6 D to +3.6 D, SD 0.8, n=95) with 79% of patient achieving a spherical equivalent within 1 D of the target refraction. Post-operative residual cylinder was significantly reduced from baseline with 78% of eyes having at least a 0.5 D improvement in astigmatism after surgery (P<.0005). The mean deviation from targeted cylindrical correction was -0.51 D (range -5 D to 2.8 D, SD 1.2, n=86). The lens was placed in an incorrect position in two patients, and reoperation with lens rotation into the proper axis was required.

Conclusions: : We found that the added complexity associated with TIOL placement in a teaching institution resulted in significant visual and astigmatic improvements without compromising patient safety.

Keywords: training/teaching cataract surgery • intraocular lens • treatment outcomes of cataract surgery