Results of higher power toric intraocular lens implantation

• Published in: Journal of cataract and refractive surgery Vol. 37; no. 8; pp. 1411 - 1418
• Main Authors: Hoffmann, Peter C., MD, Auel, Sebastian, MD, Hütz, Werner W., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2011; Elsevier
• Subjects: Acrylic Resins; Adult; Aged; Aged, 80 and over; Astigmatism - complications; Astigmatism - physiopathology; Astigmatism - surgery; Biological and medical sciences; Cataract - complications; Cataract - physiopathology; Corneal Topography; Female; Follow-Up Studies; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Medical sciences; Microsurgery; Middle Aged; Ophthalmology; Ophthalmoscopy; Phacoemulsification; Prospective Studies; Pseudophakia - physiopathology; Refraction, Ocular - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Treatment Outcome; Visual Acuity - physiology; Toric lens; Treatment; Surgery; Implantation; Ophthalmology; Intraocular lens; Power
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2011.02.028

Purpose To evaluate the efficacy, predictability, and safety of coaxial microincision phacoemulsification and toric intraocular lens (IOL) implantation in eyes with high corneal astigmatism. Setting Two eye clinics in Germany. Design Case series. Methods Routine cataract extraction using 2.2 mm coaxial phaco equipment and Acrysof toric IOL (3.00 to 6.00 diopters [D] cylinder) implantation were performed. Examinations included optical biometry, Haigis IOL calculation, topography, and objective and subjective refractions. Retroillumination images were used to evaluate IOL alignment. Postoperative examinations were scheduled at 1 week and 3 months. Results The study enrolled 40 eyes (30 patients). The mean preoperative keratometric cylinder was 3.55 ± 0.73 D (range 2.64 to 5.39 D) and the mean 3-month postoperative subjective cylinder, 0.67 ± 0.32 D. The mean logMAR uncorrected distance visual acuity improved from 0.93 to 0.20 and the mean logMAR CDVA, from 0.41 to 0.09. The mean prediction error (spherical equivalent) was +0.14 ± 0.44 D. The mean IOL rotation between 1 week and 3 months was 0.23 ± 1.9 degrees clockwise. The mean surgically induced astigmatism was 0.08 ± 0.41 D. The alignment error was below 10 degrees in 97.5% of cases. The mean vector change in refractive cylinder between 1 week and 3 months was 0.31 ± 0.19 D. The Alpins correction index was +1.01, indicating a slight tendency toward overcorrection. Conclusions Coaxial microincision phacoemulsification with toric IOL safely and predictably reduced high corneal astigmatism and improved surgical outcomes. Thorough planning and precise execution are necessary. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.