Abstract
Purpose :
To determine patient characteristics and biometry data associated with residual refractive error after toric lens implantation for patients with astigmatism.
Methods :
A retrospective case-control chart review of eyes with residual refractive error and eyes that met target refraction at one month and beyond after cataract surgery with toric lens implantation by the same surgeon was conducted. Eyes with residual refractive error were defined as achieving UCVA of 20/40 or worse and BCVA better than 20/40 with a difference in logMAR UCVA and BCVA of 0.3 or more, while eyes that met target refraction achieved an UCVA of better than 20/40 after cataract surgery. All patients were aimed for distance. Pre-operative exam findings, ophthalmologic comorbidities, and intraocular lens measurements were collected.
Results :
In total, 30 eyes in 29 patients with residual refractive error and 194 eyes in 167 patients who met target refraction were included. The mean age of patients with residual refractive error was 63.1 years (SD 11.3) vs. 69 years (SD 7.9) for patients who met target refraction (p=0.009). Compared to eyes at target refraction, a greater percentage of eyes with residual refractive error had undergone previous LASIK surgery (23.3% vs. 5.7%) and carried a keratoconus diagnosis (6.7% vs. 0.5%). Both groups had a similar prevalence of dry eye (30.0% vs. 30.4%) and ABMD (10.0% vs. 9.3%). A smaller percentage of patients with residual refractive error had Fuch’s dystrophy (3.3%) compared to those at target refraction (13.9%). There was no significant difference in axial length between eyes with residual refractive error (24.68 mm, SD 1.84 mm) and those at target (24.60 mm, SD 1.60, p=0.83) or anterior chamber depth (3.29 mm, SD 0.52 vs. 3.35 mm, SD 0.42, p=0.54). There was a trend toward eyes with residual refractive error having a greater average corneal astigmatism (2.03 D, SD 1.49) compared to eyes at target refraction (1.51 D, SD 0.62, p=0.076).
Conclusions :
Patients who had residual refractive error after cataract extraction with toric lens implantation on average were younger than those who met target refraction. In addition, a greater proportion of patients who had residual refractive error had previous LASIK and keratoconus compared to those at target refraction. Understanding these factors can help manage visual outcome expectations after toric lens implantation in patients with astigmatism.
This is a 2021 ARVO Annual Meeting abstract.