Outcomes of toric IOL implantation guided by iris-registered femtosecond laser capsulotomy markings

Author(s):  
Bradley P. O’Neill ◽  
Vasilios F. Diakonis ◽  
Konstantinos T. Tsaousis ◽  
Robert J. Weinstock
2020 ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah

Abstract Objectives To compare the efficacy of astigmatic correction between simultaneous femtosecond laser-assisted intrastromal arcuate keratotomy (AK) combined with femtosecond laser-assisted cataract surgery (FLACS) and toric intraocular lens (IOL) implantation during cataract surgery in moderate astigmatism. Design: Retrospective observational study, tertiary care medical center Methods We retrospectively reviewed medical records of patients who underwent astigmatic correction via femtosecond laser-assisted intrastromal AK (AK group; 27 eyes of 27 patients) with FLACS or toric IOL implantation (toric IOL group; 21 eyes of 21 patients). All patients had senile cataracts with corneal astigmatism ranging from + 1.00 to + 2.00 diopters (D) before cataract surgery. We measured visual acuity, intraocular pressure, automated keratometry, manifest refraction and topography preoperatively and at 1-day, 1-month, 3-month, and 6-month postoperatively. Results Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. There was significant difference in corneal astigmatism from topography and automated keratometer between the two groups at 6-month postoperatively (0.94 ± 0.40 vs 1.53 ± 0.46 D, P = 0.018 for topography and 0.98 ± 0.69 vs 1.37 ± 0.41 D, P = 0.032 for automated keratometer). Conclusions Femtosecond laser-assisted intrastromal AK in FLACS could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hoon Noh ◽  
Young-Sik Yoo ◽  
Kyoung Yoon Shin ◽  
Dong Hui Lim ◽  
Tae-Young Chung

AbstractThis study tried to compare the clinical outcomes of femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric intraocular lens (IOL) implantation for astigmatism correction and identify factors affecting the efficacy of FSAK and toric IOL implantation in astigmatism correction. This retrospective case series comprised patients with corneal astigmatism ranging between 0.5 D and 4.5 D. Patients underwent FSAK or toric IOL implantation for cataract treatment and correction of astigmatism at the Samsung Medical Center, a tertiary surgical center, between April 2016 and December 2018. All patients underwent examination before and at three months after the surgery for comparative evaluation of refractive astigmatism, corneal high order aberrations and irregularity index. The astigmatism correction was analyzed by the Alpins method. Subgroup analysis of preoperative factors was based on the extent of target-induced astigmatism (TIA), the degree of astigmatism, and astigmatism classification based on topography. Thirty-one eyes underwent toric IOL implantation and 35 eyes underwent FSAK. The refractive astigmatism was significantly decreased in both toric IOL (P = 0.000) and FSAK group (P = 0.003). The correction index (CI) of refractive astigmatism was 0.84 ± 0.39 in the toric IOL and 0.71 ± 0.60 in the FSAK group. There was no difference between the two groups (P = 0.337). The CI of the FSAK group was significantly lower than in the toric IOL group when TIA was more than 1.5 D (P = 0.006), when correcting against-the-rule (P = 0.017), and limbus-to-limbus astigmatism (P = 0.008). In conclusion, toric IOL implantation is an effective and safe procedure for correcting preoperative astigmatism in cataract surgery in the short-term observation.


2015 ◽  
Vol 31 (9) ◽  
pp. 574-578 ◽  
Author(s):  
Aeri Yoo ◽  
Samyoung Yun ◽  
Jae Yong Kim ◽  
Myoung Joon Kim ◽  
Hungwon Tchah

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah. Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah

Abstract Background To compare the efficacies in astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus toric intraocular lens (IOL) implantation with conventional phacoemulsification in moderate astigmatism. Methods A retrospective chart review was conducted for patients who had undergone cataract surgery by one surgeon. We identified patients with preoperative corneal astigmatism from + 0.75 to + 2.00 diopters (D) who had undergone astigmatic correction with FLACS with ISAK or toric IOL implantation with conventional phacoemulsification. We measured the visual acuity, intraocular pressure, automated keratometer, manifest refraction, and topography preoperatively and 1-day, 1-month, 3-month, and 6-month postoperatively. The vector analysis of refractive astigmatism was performed. Results Of a total of 48 eyes of 48 patients, 27 eyes of 27 patients had FLACS with ISAK (AK group), and 21 eyes of 21 patients had conventional cataract surgery with toric IOL implantation (toric IOL group). Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. Corneal astigmatism from topography and the automated keratometer were significantly lower in the AK group 6-month postoperatively compared to toric IOL group (0.94 ± 0.40 vs. 1.53 ± 0.46 D, P = 0.018 for topography; and 0.98 ± 0.69 vs. 1.37 ± 0.41 D, P = 0.032 for the automated keratometer). Conclusions FLACS with ISAK could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.


2021 ◽  
Author(s):  
Meng-Yin Lin ◽  
Yun-Dun Shen ◽  
Hsin-Yuan Tan ◽  
I-Jong Wang ◽  
I-Chan Lin

Abstract Background: Both femtosecond laser-assisted arcuate keratotomy (FS-AK) and toric intraocular lens (IOL) implantation were effective in correction for eyes with corneal astigmatism. The objective of this study was to evaluate the postoperative refractive outcomes of patients receiving femtosecond laser-assisted cataract surgery (FLACS) with FS-AK and patients receiving standard phacoemulsification with toric intraocular lens implantation Methods: This retrospective study reviewed the postoperative outcome of patients undergoing FLACS with FS-AK (FS-AK group) and patients undergoing standard phacoemulsification with toric IOL implantation (toric IOL group). The main outcome measures were bare and corrected visual acuities, keratometric and refractive astigmatism, and vector analysis.Results: The FL-AK group included 41 eyes with preoperative keratometric astigmatism of −1.64 diopters (D) ± 0.42 (standard deviation), and the toric IOL group included 53 eyes with preoperative keratometric astigmatism of −2.29 ± 0.91 D (P < 0.001). Postoperative refractive astigmatism was comparable between the two groups. Postoperative bare vision was significantly better (P = 0.005) and corrected visual acuity was marginally better in the toric IOL group than in the FS-AK group (P = 0.051). The absolute angles of error were 9.95 ± 9.57 degrees and 5.08 ± 4.94 degrees (P = 0.02) in the FS-AK and toric IOL groups, respectively.Conclusion: Both FLACS with FS-AK and standard phacoemulsification with toric IOL implantation represent safe and effective methods for astigmatism correction at the time of cataract surgery. Standard phacoemulsification with toric IOL implantation achieves better visual outcome than combined FLACS and FS-AK at 6-month follow up.


2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
mohamed baz ◽  
Essam El Din Shoheib Ahmed ◽  
Ashraf El Shayeb ◽  
Walid Abbdelghaffar
Keyword(s):  

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Background: To analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.


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