Rotational performance and corneal astigmatism correction during cataract surgery: Aspheric toric intraocular lens versus aspheric nontoric intraocular lens with opposite clear corneal incision

2014 ◽  
Vol 40 (8) ◽  
pp. 1355-1362 ◽  
Author(s):  
Sophie Maedel ◽  
Nino Hirnschall ◽  
Yen-An Chen ◽  
Oliver Findl
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Toric Intraocular Lens ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Astigmatism Correction

scholarly journals Two Different Corneal Incision Designs for Correcting Corneal Astigmatism During Cataract Surgery With Multifocal Intraocular Lens Implantation

2021 ◽  
Author(s):  
Dan Liu ◽  
Cong Fan ◽  
Chunyan Li ◽  
Jian Jiang
Keyword(s):  
Cataract Surgery ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Corneal Incision ◽  
Multifocal Iol ◽  
Clear Corneal Incision ◽  
Corneal Aberrations ◽  
Multifocal Intraocular Lenses ◽  
Post Surgery ◽  
The Mean

Abstract Background: Multifocal intraocular lenses (IOLs) is very intolerant to residual corneal astigmatism and patients with more than 1.0 D of residual corneal astigmatism are not suitable candidates for implantation of multifocal IOLs. The purpose of this study was to evaluate the efficacy of a single clear corneal incision (CCI) or an opposite clear corneal incision (OCCI) made on a steep meridian for correction of low to moderate corneal astigmatism during implantation of multifocal IOLs.Methods: This is a retrospective cohort study. A total of 50 patients with pre-operative total corneal astigmatism, ranging between 0.5 and 2.0 diopters (D), who underwent cataract surgery and received multifocal IOLs were included. Correction of corneal astigmatism was done via single CCIs on steep meridians in patients with 0.5–1.2 D total corneal astigmatisms, and OCCIs in patients with 1.3–2.0 D total corneal astigmatisms. Visual acuity, corneal astigmatism, ocular aberrations, corneal aberrations, and subjective vision quality were evaluated after surgery.Results: At 12-weeks post-surgery, the mean uncorrected distance vision (UCDV) was 0.06±0.09 logarithm of the minimum angle of resolution (logMAR) and 0.03±0.09 logMAR, and the mean uncorrected near vision (UCNV) was 0.08±0.11 logMAR and 0.09±0.09 logMAR in the CCI and OCCI groups, respectively. The change in corneal astigmatism was 0.52 ± 0.22D and 1.06 ± 0.23D in the CCI and OCCI groups, respectively (P<0.001). Total corneal higher-order aberrations (HOAs) and trefoil increased in both groups (P<0.05); however, there was no difference in the change in total corneal HOAs between the two groups (P>0.05). Conclusions: CCI and OCCI made on a steep axis could be an option for correction of mild-to-moderate astigmatism during cataract surgery with multifocal IOL implantation.

scholarly journals Comparison of Astigmatism Correction in Cataract Surgery Between Simultaneous Femtosecond Laser-Assisted Intrastromal Arcuate Keratotomy and Toric Intraocular Lens Implantation

2020 ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Tertiary Care ◽  
Corneal Astigmatism ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Tertiary Care Medical Center ◽  
Significant Difference

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.

scholarly journals Long-term changes in the refractive effect of a toric intraocular lens on astigmatism correction

2021 ◽  
Author(s):  
Ken Hayashi ◽  
Motoaki Yoshida ◽  
Shunsuke Hayashi ◽  
Akira Hirata
Keyword(s):  
Intraocular Lens ◽  
Marked Change ◽  
Corneal Astigmatism ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Time Points ◽  
Astigmatism Correction ◽  
Ocular Residual Astigmatism ◽  
Long Term Changes

Abstract Purpose To examine the long-term changes in the astigmatism-correcting effect of a toric intraocular lens (IOL) after stabilization of surgically induced astigmatic changes due to cataract surgery. Methods Unilateral eyes of 120 patients that received a toric IOL for against-the-rule (ATR) or with-the-rule (WTR) astigmatism were enrolled. Manifest refractive and anterior corneal astigmatism, and ocular residual astigmatism which is mainly derived from internal optics were examined preoperatively, at approximately 2 months postoperatively (baseline) and at 5 ~ 10 years postbaseline. The astigmatism was decomposed to vertical/horizontal (Rx) and oblique components (Ry), which was compared between baseline and 5 ~ 10 years postbaseline. Results In the eyes having ATR astigmatism, the mean Rx and Ry of the manifest refractive and corneal astigmatism significantly changed toward ATR astigmatism between the baseline and 5 ~ 10 years postbaseline (p ≤ 0.0304), but those of ocular residual astigmatism did not change significantly between the 2 time points. In the eyes having WTR astigmatism, the Rx and Ry of refractive, corneal, and ocular residual astigmatism did not change significantly between the 2 time points. Double-angle plots revealed an ATR shift in refractive and corneal astigmatism and no marked change in the ocular residual astigmatism in the eyes with ATR astigmatism, and there is no change in this astigmatism in the eyes with WTR astigmatism. Conclusion The long-term changes with age in the effect of a toric IOL significantly deteriorated due to an ATR shift of corneal astigmatism in the eyes having ATR astigmatism, while it was maintained in eyes having WTR astigmatism, suggesting that ATR astigmatism should be overcorrected.

scholarly journals Changes in ocular astigmatism after superotemporal versus temporal clear corneal incision cataract surgery

2021 ◽  
Author(s):  
Qi Fan ◽  
Dongjin Qian ◽  
Zhennan Zhao ◽  
Yongxiang Jiang ◽  
Yi Lu
Keyword(s):  
Cataract Surgery ◽  
Anterior Segment ◽  
Corneal Astigmatism ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Ocular Residual Astigmatism ◽  
Age Related ◽  
Postoperative Astigmatism ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity

Abstract Background The incision site to choose to manage postoperative astigmatism during cataract surgery is still debated. This study investigated corneal and internal astigmatism changes after superotemporal versus temporal clear corneal incision cataract surgery. Methods Patients included were diagnosed between December 2019 and January 2020 with age-related cataract with corneal astigmatism < 1.5 diopters (D) and were divided into two groups: Right Eye Group (R Group, superotemporal incision) and Left Eye Group (L Group, temporal incision). Uncorrected visual acuity, manifest refraction, corneal topography, anterior segment optical coherence tomography were performed pre- and 6 months postoperatively. Total ocular astigmatism, corneal astigmatism, surgically induced corneal astigmatism (SICA), non-corneal ocular residual astigmatism (N-CORA), postoperative intraocular lens (IOL) decentration, and tilt were analysed. Results Thirty-eight subjects were included: 21, R Group; 17, L Group. After surgery, the N-CORA decreased significantly from 1.17 ± 0.72D to 0.73 ± 0.47D in all patients (P = 0.001), 1.03 ± 0.52D to 0.70 ± 0.40D in the R Group (P = 0.005), and 1.35 ± 0.90D to 0.78 ± 0.55D in the L Group (P = 0.033). Significant differences between the R and L groups were found in the postoperative meridian of anterior corneal astigmatism (75.95 ± 52.50 vs 116.79 ± 47.29; P = 0.017), total corneal astigmatism (51.65 ± 42.75 vs 95.20 ± 57.32; P = 0.011), J45 change vector of SICA in the anterior cornea (-0.10 ± 0.18 vs 0.00 ± 0.11; P = 0.048), and total cornea surface (-0.14 ± 0.17 vs 0.03 ± 0.12; P = 0.001). IOL decentration, tilt, and the meridian of IOL tilt were not significantly correlated with N-CORA. Conclusions The N-CORA significantly decreased after cataract surgery. Superotemporal and temporal incisions can cause differences in the meridian components of oblique astigmatism but will not have a significant effect on the magnitude of corneal astigmatism.

scholarly journals Minimizing Surgically Induced Astigmatism at the Time of Cataract Surgery Using a Square Posterior Limbal Incision

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Paul Ernest ◽  
Warren Hill ◽  
Richard Potvin
Keyword(s):  
Cataract Surgery ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Corneal Incision ◽  
Surgically Induced Astigmatism ◽  
Clear Corneal Incision ◽  
Refractive Outcomes ◽  
Induced Astigmatism ◽  
Surgically Induced ◽  
Corneal Incisions

Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery.Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2 mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size.Results. Preoperative corneal astigmatism averaged 1.0 D and was not significantly different between the incision types. Surgically induced astigmatism with the 2.2 mm posterior limbal incision averaged0.25±0.14 D, significantly lower in magnitude than the aggregate surgically induced astigmatism produced by the 2.2 mm clear corneal incision (0.68±0.49 D).Conclusion. The 2.2 mm square posterior limbal incision induced significantly less, and significantly less variable, surgically induced astigmatism relative to a similar-sized clear corneal incision. This is likely to improve refractive outcomes, particularly important with regard to premium intraocular lenses.

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