Abstract
Purpose :
Axis misalignment of toric intraocular lenses (IOLs) can be caused by inaccurate IOL orientation during cataract surgery, postoperative IOL displacement, or both. Due to the unique nature of individual eyes, even a correctly calculated alignment can ultimately be imprecise. We evaluated the need to correct remaining astigmatism due to axis misalignment of implanted toric IOLs.
Methods :
We evaluated postoperative eyes that needed adjustment procedures for axis misalignment of implanted toric IOLs (TECNIS® OptiBlue Toric IOL, Abbott Medical Optics, Inc., Santa Ana, CA [Johnson & Johnson Vision]) after cataract surgeries performed by the same surgeon (Dr. Hirotaka Tanabe) at Ashikaga Red Cross Hospital in Japan from Nov 1, 2016 to Oct 31, 2017. The difference between the calculated alignment axis and the actual postoperative toric IOL axis before and after the adjustment procedure was measured using high-resolution, slit-lamp digital retroillumination photographs taken with a dilated pupil during each examination. These postoperative adjustments were performed only when patients requested additional treatment for remaining astigmatism detected during routine examination after providing informed consent. The study protocol was reviewed and approved by the institutional review board. This retrospective study was conducted in accordance with the Declaration of Helsinki and the Ministerial Ordinance on Good Clinical Practice for Medical Devices.
Results :
Twelve eyes of 11 patients among 245 eyes of 157 patients required adjustment procedures for axis misalignment of toric IOLs after cataract surgeries. Following adjustment procedures, significant decreases were observed in the difference between the calculated alignment axis and the actual postoperative toric IOL axis, as well as astigmatism values (20.25±12.79 to 2.58±2.19, P<0.001, -1.27±0.33 to -0.5±0.21, P<0.001, respectively).
Conclusions :
A number of factors can contribute to the misalignment of toric IOLs. The need for active adjustment procedures for axis misalignment of toric IOLs should be anticipated when patients request additional treatment to reduce remaining astigmatism after toric IOL implantation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.