Abstract
Purpose :
To evaluate visual outcomes of 103 consecutive Toric intra-ocular lens (IOL) placement procedures from 2017-2019 at a single center using an FDA-approved Toric IOL with non-frosted haptics.
Methods :
We conducted a retrospective chart review of consecutive monofocal Toric IOL’s from a single manufacturer, performed at a single surgery center by a single surgeon. All patients underwent femtosecond laser capsulotomy with placement of 2 marks on the anterior capsule 180 degrees apart on the target axis. Iris registration technology aided identification of the steep corneal axis at the capsular plane for alignment and accounted for head positioning during laser. IOL powers were planned with Barrett Toric calculator. Pre- and post-operative data points were recorded and analyzed. Patients with reduced best-corrected-visual-acuity (BCVA) due to pre-existing retinal (epiretinal membrane) and corneal (keratoconus or Fuch’s dystrophy) conditions were excluded from the final analysis. Four eyes were excluded due to lack of follow up, and 18 eyes were that were targeted for near were excluded as well.
Results :
103 consecutive surgeries were evaluated. The mean cohort age was 72 years old and 56% female and 44% male. 67% of patients identified as non-Hispanic white, 26% identified as Hispanic and 7% did not report. After application of all exclusion criteria, our final cohort included 74 eyes, of which 58 eyes (78.4%) achieved our goal of 20/30 or better uncorrected visual acuity (UCVA). Of the 16 eyes (21.6%) that did not achieve the goal of 20/30 UCVA or better, 9 of 16 (56%) had >0.75D residual astigmatism, and 12 of 16 (75%) had >0.50D of myopic spherical equivalent. 5 eyes (6.8%) underwent post-operative IOL rotation for axis correction, and 5 eyes (6.8%) underwent laser vision correction adjustments. No patients underwent IOL exchange.
Conclusions :
While Toric IOLs with unfrosted haptics have potential to provide excellent UCVA for patients undergoing cataract surgery, the 6.8% rate of return to the OR for repositioning the toric IOL to the correct axis in our study population is high. Frosted haptics potentially improve visual outcomes by increasing rotational stability through a textured surface creating more friction between the haptic and the capsular bag. Our future goal is to evaluate outcomes in a matched cohort of eyes with monofocal toric IOLs that have frosted haptics.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.