Abstract
Purpose :
To determine if post-operative (post-op) eyeglass prescribing is impacted by type of intraocular lens implant (IOL), specifically analyzing toric (T) versus monofocal (MF) lens types.
Methods :
A retrospective chart review of patients that underwent cataract surgery at the VA Tennessee Valley Healthcare System over three years (9/2020-9/2023). 103 patients receiving at least one T implant and 103 patients receiving at least one MF implant were randomly selected. Collected data included laterality of surgery, IOL type for each operated eye, pre-operative (pre-op) and post-op refraction, pre-op mean pachymetric corneal astigmatism in diopters (D), pre-op and post-op distance best corrected distance visual acuity (BCVA), post-op uncorrected (SC) distance visual acuity (VA), whether eyeglasses were prescribed post-op, and type of eyeglasses prescribed.
Results :
Of the 206 patients reviewed, 64 patients had bilateral surgery in the MF group and 73 had bilateral surgery in the T group (at least one eye with T IOL), of which 43 had bilateral T IOLs. The mean pre-op corneal astigmatism was 0.853D in the MF eyes versus 2.043D in the T eyes (p=0.0001). The mean post-op refractive cylinder power was 0.726D in the MF eyes versus 0.433D in the T eyes (p=0.0002). Mean logMAR pre-op BCVA was 0.373 in the MF eyes and 0.242 in the T eyes (p=0.0001). Mean post-op logMAR SC VA was and 0.188 for MF and 0.121 for the T group (P=0.0019). Post-op logMAR BCVA was 0.062 for the MF group and 0.038 for the bilateral T group (P=0.091). Post-op eyeglasses were prescribed 51/64 (79.7%) in the bilateral MF group and 34/43 (79.1%) in the bilateral T group (p=1.00). Fisher's exact test did not show a difference in rate of eyeglass prescription or type prescribed between the two groups.
Conclusions :
Post-op uncorrected visual acuity was significantly better in the toric group than the monofocal group. Interestingly, despite having higher mean corneal astigmatism, the toric group also had statistically significant better BCVA pre-op than the monofocal group in this study. Although toric IOLs may achieve a more ideal uncorrected refractive outcome for distance visual acuity when there is pre-existing corneal astigmatism, eyeglass prescribing practices may not be affected, with bifocal lenses being prescribed equally frequently regardless of IOL type.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.