scholarly journals Toric Intraocular Lenses for the Management of Corneal Astigmatism at the Time of Cataract Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Colm McAlinden ◽  
David Janicek
Keyword(s):  
Cataract Surgery ◽  
Human Error ◽  
Data Entry ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Vector Analysis ◽  
Corneal Incision ◽  
Toric Iol ◽  
Iol Power ◽  
The Mean

Aims/Background. To assess astigmatic outcomes with the use of toric intraocular lenses (IOLs) for patients with significant amounts of corneal astigmatism undergoing cataract surgery. Methods. This audit was conducted in a UK ophthalmology department and included 48 eyes of 42 patients. Surgery was performed during 2019 in patients with 2.50 diopters (D) or more corneal astigmatism. Anterior keratometry readings were used to determine the toric IOL power. Vector analysis using the Alpins method was used to assess changes in astigmatism pre to postoperatively. Results. There were 18 right and 26 left eyes included. In terms of gender, 61% of patients were female and 39% were male. The mean (±standard deviation (SD)) age was 70 (±11) years. The mean (±SD) axial length, K1, K2, and delta K was 23.55 (±1.4) mm, 42.71 (±1.39) D, 45.78 (±1.60) D, and 3.01 (±0.89) D, respectively. Postoperatively, the median spherical, cylinder, and spherical equivalent refraction was 0.00 D, −1.00 D, and 0.00 D, respectively. Postoperatively, 41% of the eyes had ≤0.50 D of spectacle astigmatism and 80% had ≤1.00 D. No patient required a secondary procedure to reposition the IOL from rotation. In vector analysis with the use of polar diagrams, there was a tendency for overcorrection of with-the-rule astigmatism and undercorrection of against-the-rule astigmatism. Conclusions. Significant reductions in astigmatism can be achieved with the use of toric IOLs in patients undergoing cataract surgery. Further improvements may be possible with surgeon-specific determination of their surgically induced astigmatism and flattening effect from the main corneal incision. Furthermore, the use of an optical biometer that directly measures the posterior corneal curvature and permits automatic toric IOL power determination with modern formulas avoiding the need for manual data entry may reduce the risk of human error and improve visual and refractive outcomes.

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 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 80 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 acuity (UDVA) 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 acuity(UNVA) 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 Mobile App for Pre- and Intraoperative Assessment of Astigmatism Correction with Toric Intraocular Lenses in Cataract Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Francisco Aecio Fernandes Dias ◽  
Vinicius Jose Fernandes Dias ◽  
Barbara de Araujo Lima Dutra ◽  
Anna Christina Siqueira Marques ◽  
Edgar Marçal ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Case Series ◽  
Mobile App ◽  
Mean Difference ◽  
Ease Of Use ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Astigmatism Correction ◽  
Case Series Study ◽  
The Mean

Purpose. To develop a mobile app that allows capturing and editing of photographs, performs image transposition and projection of a protractor with 360° axis markings, and permits accurate visualization of programmed alignment for the positioning of toric intraocular lenses (IOLs). Methods. In this prospective case series study, a codesign methodology was chosen to develop the Eye Axis Check application. After app development, measurements were obtained and comparisons were made between manual marks and toric IOL alignment without and with the app in 30 eyes that had undergone cataract surgery with toric IOLs. The mobile app was made available to 15 ophthalmic surgeons in different cities to assess its usability. Results. The users approved the developed application for its ease of use and utility. The mean difference between the markings made manually and those made with the app was 1° (±2°; range: 0°–5°), and the mean difference between the IOL position and the assessment made by the app was 3° (±3°; range: 0°–12°). Upon comparison of the agreement between the app measurements and the manual measurements for the IOL angle, no significant differences were found, and an excellent concordance (0.997) and a strong positive linear correlation (0.995) were observed. Conclusion. A mobile app for preoperative planning and intraoperative toric IOL alignment was developed and revealed to be useful and easy to use.

scholarly journals Treatment of Corneal Astigmatism at the Time of Cataract Surgery, What Can Be Promised

2015 ◽  
Vol 09 (02) ◽  
pp. 102
Author(s):  
George Beiko ◽  
Keyword(s):  
Cataract Surgery ◽  
Treatment Options ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Technological Advances ◽  
Made In

The treatment of corneal astigmatism at the time of cataract surgery is commonplace. Corneal incisional surgery and toric intraocular lenses (IOLs) are routinely utilised; the role of each modality is understood and defined. Although technological advances have been made in the assessment of the cornea and in the execution of the treatment options, recent innovations in toric IOL designs may be more significant for the comprehensive ophthalmologist.

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.

scholarly journals Refractive Status in Eyes Implanted with Toric and Nontoric Intraocular Lenses during Combined Cataract Surgery and Microhook Ab Interno Trabeculotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yasuyuki Takai ◽  
Kazunobu Sugihara ◽  
Mihoko Mochiji ◽  
Kaoru Manabe ◽  
Aika Tsutsui ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Absolute Residual ◽  
Refractive Status ◽  
The Mean ◽  
Better Than ◽  
Ab Interno

Purpose. To compare the refractive status between eyes implanted with toric and nontoric intraocular lenses (IOLs) during combined cataract surgery and microhook ab interno trabeculotomy (μLOT), a minimally invasive glaucoma surgery (MIGS). Methods. Twenty eyes of 20 patients who had open-angle glaucoma, cataract, and preexisting regular corneal astigmatism exceeding 1.5 diopters (D) and underwent combined μLOT and phacoemulsification were recruited retrospectively. Ten eyes were implanted with a toric IOL and 10 eyes with a nontoric IOL. The primary outcomes were the uncorrected visual acuity (UCVA) and refractive cylinder at 3 months postoperatively. Results. The mean UCVA of the toric IOL group (logarithm of the minimum angle of resolution (logMAR), 0.23 ± 0.25) was significantly better than that of the nontoric IOL group (logMAR, 0.45 ± 0.26) at 3 months postoperatively ( p < 0.05 ). The mean absolute residual refractive cylinder of the nontoric IOL group (2.25 ± 0.62 D) was significantly greater than that of the toric IOL group (1.30 ± 0.68 D) ( p < 0.05 ). Postoperatively, 60% of eyes in the toric IOL group and 10% in the nontoric IOL group had an absolute refractive astigmatism level of 1.5 D or less. Surgically induced astigmatism (0.77 ± 0.43 D for toric group and 0.60 ± 0.32 D for nontoric group) and IOP reduction (33.9 ± 15.6% for toric group and 29.4 ± 11.7% for nontoric group) were not different between groups. Conclusions. Use of toric IOL during combined cataract surgery and μLOT is possible and better than not, but physician should prevent their patient of persisting residual astigmatism. The study was registered at https://www.umin.ac.jp/, and the clinical trial accession number is https://clinicaltrials.gov/ct2/show/UMIN000043141.

scholarly journals Astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus Toric intraocular Lens Impantation with conventional phacoemulsification

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah. Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Retrospective Chart Review ◽  
Corneal Astigmatism ◽  
Vector Analysis ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Significant Difference

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.

scholarly journals Toric Intraocular Lenses in Cataract Surgery

2011 ◽  
Vol 04 (01) ◽  
pp. 38
Author(s):  
Rosa Braga Mele ◽  
Keyword(s):  
Cataract Surgery ◽  
Contact Lenses ◽  
Treatment Options ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Rotational Stability ◽  
Toric Iol ◽  
Toric Iols ◽  
High Prevalence ◽  
Increasing Demand

Cylindrical deficits in patients with corneal astigmatism of 0.50 diopter (D) to 1.00D may influence visual acuity. Increasing age and cataract surgery are correlated with greater prevalence and extent of corneal astigmatism. Conventionally, spectacles and contact lenses have been used to improve or correct corneal astigmatism. However, increasing demand for freedom from spectacles for distance vision and high prevalence of pre-existing corneal astigmatism in cataract patients have forced cataract surgery for the correction of aphakia and pre-existing corneal astigmatism to become common practice. However, implantation of toric intraocular contact lenses (IOLs) into the eye during cataract surgery may be a more predictable, powerful, and stable way of correcting pre-operative corneal astigmatism and may provide an adjunct or alternative to spectacles or relaxing incisions. Early toric IOLs were associated with post-operative rotational stability, lens misalignment, and safety concerns. The use of the new AcrySof® IQ Toric IOL for the correction of aphakia and pre-existing corneal astigmatism has largely mitigated these concerns. In addition, the AcrySof® IQ Toric IOL may also replace other treatment options for correcting pre-existing corneal astigmatism in patients undergoing cataract surgery.

scholarly journals Management of Dislocated Intraocular Lenses with Iris Suture

2016 ◽  
Vol 27 (1) ◽  
pp. 45-48 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Mario Canastro
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Signs ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Pigment Dispersion ◽  
Corneal Incision ◽  
The Mean

Purpose Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. Methods In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. Results A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of logMAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. Conclusions Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.

scholarly journals ASTIGMATISM;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
MOHAMMAD Alam
Keyword(s):  
Cataract Surgery ◽  
Analytical Study ◽  
Intraocular Lenses ◽  
Slit Lamp ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Age Related ◽  
Iol Power ◽  
Age Range ◽  
Study Setting

Objectives: To evaluate the management of pre-existing astigmatism with 3.2 mm corneal incision on steeper axis during phacoemulsification cataract surgery. Study Design: Analytical study. Setting: Patients undergoing cataract surgery with phacoemulsification in K.D.A Teaching Hospital KMU-IMS Kohat. Period: January, 2016 to July, 2016. Materials and Methods: 50 patients with age related cataract were selected. Out of them 23 (46%) were male and 27 (54%) were female. All the patients were in age range from 49 to 76 years with mean age of 63.2% years. Proper examination with slit lamp was done. Informed consent was obtained from each patient. Proper proforma was made for documentation. Biometry was done for IOL power. Preoperative keratometry was done with Topcon autoref-keratometer. Patients with traumatic eyes, previously operated eyes, vascularised and opacified cornea were excluded from the study. Pupils of patients were dilated properly with tropicamide eye drop.  Phacoemulsification with 3.2 mm clear corneal incision at steeper axis with intraocular lenses implantation was carried out on all patients by single surgeon under topical anesthesia. Postoperative keratometry was done on the same keratometer and observer to avoid bias at the end of two months. Results: Preoperative astigmatism was present in range of 0.12 diopter cylinder to 3.71 diopter cylinder with mean 1.56 diopter cylinder. At the end of two months mean astigmatism of 0.98 diopter cylinder with range 0.2 diopter cylinder to 2.0 diopter cylinder was noted postoperatively with mean reduction of 0.58 diopter cylinder. Conclusion: Phacoemulsification with 3.2 mm clear corneal incision at steeper axis can correct astigmatism significantly with good emmetropic results.

Sign in / Sign up

Export Citation Format

Share Document