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James C. Lockwood, Claudia Perez-Straziota, Rhonda G. Waldron, James Bradley Randleman; Manual vs Femtosecond Laser-Assisted Cataract Surgery with Toric Intraocular Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1313.
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© ARVO (1962-2015); The Authors (2016-present)
The majority of patients presenting for cataract surgery have visually significant corneal astigmatism. In response, the use of toric intraocular lenses have greatly expanded in recent years as wider ranges of toricity correction have become available. With the advent of the femtosecond laser, cataract surgeons now have the ability to be even more precise with their corneal incisions and fragmentation of cataracts before removal, along with more exact toric lens placements in the capsular bags. The purpose of this study was to analyze postoperative refractive outcomes of one surgeon (JBR) performing traditional manual cataract surgery and femtosecond laser–assisted (femto) cataract surgery in patients with visually significant corneal astigmatism electing to have toric intraocular lens implantation after cataract removal.
We performed a retrospective review of 77 human eyes (44 patients) with manual cataract surgery and 25 human eyes (16 patients) with femto cataract surgery. Data collected was: pre-operative anterior steep and flat corneal powers and axis; 1-month post-operative measurements including uncorrected distance visual acuity (UDVA) and manifest refraction sphere, cylinder and axis.
For manual cataract surgery: average pre-operative corneal astigmatism was 1.92 diopters (D) (0.61 to 6.05 D), 1-month average UDVA was 20/27 (20/20 to 20/60), and average post-operative cylinder was 0.56 D (0 to 1.75 D). For femto cataract surgery: average pre-operative corneal astigmatism was 1.55 D (0.81 to 2.87 D), 1-month average UDVA was 20/21 (20/20 to 20/25) and average post-operative cylinder was 0.25 D (0 to 1.00 D).
Outcomes with manual cataract surgery were good; however, femto cataract surgery results were superior. Femto cataract surgery appears to give patients with visually significant pre-operative corneal astigmatism the greatest opportunity to reduce post-operative manifest refraction cylinder with the possibility of being spectacle-free for their desired distance after cataract surgery.
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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