scholarly journals Rotational stability of modified toric intraocular lens

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247844
Author(s):  
Ryoko Osawa ◽  
Tetsuro Oshika ◽  
Masahiko Sano ◽  
Takuma Yuguchi ◽  
Tadayoshi Kaiya
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Toric Iols ◽  
Corrected Distance Visual Acuity ◽  
One Way Anova

We evaluated the rotational stability of a new toric intraocular lens (IOL), HOYA XY-1 toric IOL that is an improved version of HOYA 355 toric IOL, with longer overall length (13.0 mm vs. 12.5 mm), shortened unfolding time, and texture processing of the surface of haptics. Data from 193 eyes of 165 patients (76.4 ± 8.3 years old) with preoperative corneal astigmatism exceeding 0.75 diopters who had undergone phacoemulsification and toric IOL implantation were collected and analyzed. Corneal astigmatism, refractive astigmatism, and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 1 day, 1 week, and 1 month after surgery. The degree of IOL decentration, IOL tilt, and toric axis misalignment was assessed at 1 day and 1 month postoperatively. Fifty eyes received AcrySof toric IOL, 51 eyes TECNIS toric IOL, 46 eyes HOYA 355 toric IOL, and 46 eyes HOYA XY-1 toric IOL. The amount of axis misalignment from the intended axis was significantly different among IOLs (p = 0.004, one-way ANOVA), and HOYA XY-1 showed significantly less amount of axis misalignment than TECNIS (p = 0.020, Tukey’s multiple comparison) and HOYA 355 (p = 0.010). The proportion of eyes that showed axis misalignment <10° at 1 month postoperatively was significantly higher with HOYA XY-1 toric IOL than with other toric IOLs (χ2 test, p = 0.020). HOYA XY-1 toric IOL, the modified version of HOYA 355 toric IOL, showed excellent rotational stability in comparison with other models of toric IOLs.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

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.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

Abstract Background: The aim of this study is 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). There were no postoperative complications and no adverse events were reported.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.

scholarly journals Clinical evaluation of toric intraocular lens implantation based on iTrace wavefront keratometric astigmatism

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhe Zhang ◽  
Hui Li ◽  
Jing Zhou ◽  
Yaqin Zhang ◽  
Suhua Zhang
Keyword(s):  
Intraocular Lens ◽  
Case Series ◽  
Standard Technique ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Intraocular Lens ◽  
Vector Method ◽  
Toric Iol ◽  
Iol Implantation ◽  
Wavefront Aberrometry

Abstract Background Currently, there is no standard technique for determining corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This aim of this study was to evaluate visual outcomes and rotational stability after toric intraocular lens (IOL) implantation using the wavefront aberrometry of the cornea with iTrace. Setting: Single site in China, Shanxi Eye Hospital, Shanxi, China. Design: Prospective case series. Methods The study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Astigmatic changes were assessed using Alpins vector method over a 3-month follow-up period. Results Preoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤0.50 D increased from 0 to 71.8% postoperatively. Conclusions This is the first study on evaluation of clinical outcomes of toric IOL implantation in corneal astigmatism patients using iTrace wavefront keratometric readings. The findings show that use of iTrace built-in toric calculator is safe and effective for planning toric IOL surgery for wavefront keratometric astigmatism. Trial registration Current Controlled Trials ISRCTN94956424, Retrospectively registered (Date of registration: 05 February 2020).

scholarly journals Early-stage clinical outcomes and rotational stability of TECNIS toric intraocular lens implantation in cataract cases with long axial length

2019 ◽  
Author(s):  
Suhong He ◽  
Xiang Chen ◽  
Xingdi Wu ◽  
Yajuan Ma ◽  
Xuewen Yu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Axial Length ◽  
Early Stage ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
The Mean

Abstract Background: A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with long axial length (AL). In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long AL and identify factors influencing their early-stage stability with preoperative corneal astigmatism. Methods: The study population consisted of 64 eyes from 52 cataract patients, and these patients had preoperative corneal astigmatism between 1.0 and 3.7 diopters (D) and underwent phacoemulsification and TECNIS toric IOL implantation. Ophthalmic biological measurements were carried out preoperatively, including AL, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), anterior chamber volume (ACV), sulcus-to-sulcus (STS) and keratometric value (K). Clinical examinations, including visual acuity, manifest refraction, keratometry, digital anterior segment photographs with pupillary dilation, were performed at 1 and 3 months after surgery. Results: The mean best corrected distance visual acuity (BCDVA) was improved from 0.93±0.35 logarithms of the minimal angle of resolution (logMAR) preoperatively to 0.07±0.10 logMAR postoperatively at 3 months after surgery. The mean residual astigmatism (RAS) was 0.91±0.74D at 3 months, which was significantly decreased compared with the preoperative corneal astigmatism of 1.71±0.55 D. The mean absolute rotation of TECNIS toric IOL at 1 and 3 months was 7.42±11.32 degree (°) (0°-79°) and 7.48±11.19°(0°-79°), respectively. The mean area of capsulorhexis and the overlapped area between capsulorhexis and optic intraoperatively was 21.04±3.30 mm2 and 7.40±2.87 mm2.A positive correlation was found between IOL rotation and the area of capsulorhexis (P=0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (P=0.876), ACD (P=0.387), LT (P=0.523), VL (P=0.546), ACV (P=0.480), STS (P=0.884), K1 (P=0.429)，K2 (P=0.644), average of K1 and K2 (P=0.520), intraoperative IOL axial direction (P=0.396), preoperative corneal astigmatism (P=0.269) or the overlapped area between capsulorhexis and optic intraoperatively (P=0.131) . Conclusions: The large CCC was a risk factor for toric IOL rotation. An appropriately smaller sized CCC was conducive to increase the rotational stability of TECNIS toric IOL implantation in cataract cases with long AL.

scholarly journals Early-stage clinical outcomes and rotational stability of TECNIS toric intraocular lens implantation in cataract cases with long axial length

2020 ◽  
Author(s):  
Suhong He ◽  
Xiang Chen ◽  
Xingdi Wu ◽  
Yajuan Ma ◽  
Xuewen Yu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Axial Length ◽  
Early Stage ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
The Mean

Abstract Background: A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with long axial length (AL). In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long AL and identify factors influencing their early-stage stability with preoperative corneal astigmatism.Methods: The study population consisted of 64 eyes from 52 cataract patients, and these patients had preoperative corneal astigmatism between 1.0 and 3.7 diopters (D) and underwent phacoemulsification and TECNIS toric IOL implantation. Ophthalmic biological measurements were carried out preoperatively, including AL, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), anterior chamber volume (ACV), sulcus-to-sulcus (STS) and keratometric value (K). Clinical examinations, including visual acuity, manifest refraction, keratometry, digital anterior segment photographs with pupillary dilation, were performed at 1 and 3 months after surgery. Results: The mean best corrected distance visual acuity (BCDVA) was improved from 0.93±0.35 logarithms of the minimal angle of resolution (logMAR) preoperatively to 0.07±0.10 logMAR postoperatively at 3 months after surgery. The mean residual astigmatism (RAS) was 0.91±0.74D at 3 months, which was significantly decreased compared with the preoperative corneal astigmatism of 1.71±0.55 D. The mean absolute rotation of TECNIS toric IOL at 1 and 3 months was 7.42±11.32 degree (°) (0-79°) and 7.48±11.19°(0-79°), respectively. The mean area of capsulorhexis and the overlapped area between capsulorhexis and optic intraoperatively was 21.04±3.30 mm2 and 7.40±2.87 mm2.A positive correlation was found between IOL rotation and the area of capsulorhexis (p=0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (p=0.876), ACD (p=0.387), LT (p=0.523), VL (p=0.546), ACV (p=0.480), STS (p=0.884), K1 (p=0.429)，K2 (p=0.644), average of K1 and K2 (p=0.520), intraoperative IOL axial direction (p=0.396), preoperative corneal astigmatism (p=0.269) or the overlapped area between capsulorhexis and optic intraoperatively (p=0.131) .Conclusions: The large CCC was a risk factor for toric IOL rotation. An appropriately smaller sized CCC was conducive to increase the rotational stability of TECNIS toric IOL implantation in cataract cases with long AL.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Da Young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

Abstract Background The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -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 -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). Best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465) did not show significant differences between the toric IOL group and the monofocal IOL group. 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). There were no postoperative complications. 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.

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 Management of Cataract in Patients with Irregular Astigmatism with Regular Central Component by Phacoemulsification Combined with Toric Intraocular Lens Implantation

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Yi Gao ◽  
Zi Ye ◽  
Wenqian Chen ◽  
Jinglan Li ◽  
Xinlin Yan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Quality ◽  
Central Component ◽  
Regular Component ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Corrective Effect ◽  
Irregular Astigmatism

Purpose. To evaluate visual acuity (VA) and refractive status in patients with cataract and irregular astigmatism with a regular central component after phacoemulsification with implantation of a toric intraocular lens (IOL). Methods. Patients with cataract associated with irregular astigmatism with a regular central component were enrolled. All patients underwent phacoemulsification and toric IOL implantation. Postoperative visual acuity, residual astigmatism, toric IOL rotation, higher-order aberration, and objective and subjective visual quality were measured 3 months after surgery. Results. Twenty-three eyes were included in the study. The logMAR corrected and uncorrected distance visual acuity values were decreased at 3 months postoperatively (p < 0.005). The preoperative average corneal astigmatism and postoperative residual astigmatism were 1.15–6.97 D (1.99 ± 1.26 D) and 0–2.75 D (0.65 ± 0.57 D), respectively. The average IOL rotation was 3.17 ± 2.01°. Some objective indicators of visual quality, including the modulation transfer function (p < 0.05), Strehl ratio (p < 0.005), 100% VA (p < 0.005), 20% VA (p < 0.005), and 9% VA (p < 0.005), were significantly higher than the corresponding preoperative values. The objective scatter index (p < 0.005) was significantly lower than that before surgery. The postoperative VF-14 scale score was 83.99 ± 14.58. Conclusion. Toric IOL implantation has a good corrective effect on certain specific types of corneal irregular astigmatism with cataract. This effect can be attributed to its ability to correct the regular component of irregular astigmatism. The indications for toric IOL implantation could be expanded to some extent, thereby bringing benefit to more patients.

scholarly journals Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

2020 ◽  
Author(s):  
Zhe Zhang ◽  
Hui Li ◽  
Jing Zhou ◽  
Yaqin Zhang ◽  
Suhua Zhang
Keyword(s):  
Intraocular Lens ◽  
Case Series ◽  
Standard Technique ◽  
Rotational Stability ◽  
Toric Intraocular Lens ◽  
Vector Method ◽  
Toric Iol ◽  
Iol Implantation ◽  
Wavefront Aberrometry ◽  
Prospective Case Series

Abstract Background: There was no standard technique for measuring corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This study evaluated visual outcomes, rotational stability after performing toric intraocular lens (IOL) implantation planning based on the wavefront aberrometry of the cornea with iTrace. Setting: Single site in China, Shanxi Eye Hospital, Shanxi, China.Design: Prospective case series.Methods: The study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Over a 3-month follow-up period, astigmatic changes were assessed using the Alpins vector method. Results: Preoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤ 0.50 D increased from 0 to 71.8% postoperatively.Conclusions: This is the first study evaluating the clinical outcomes of using iTrace wavefront keratometric readings to plan a toric IOL implantation. The findings show that the iTrace built-in toric calculator with wavefront keratometric astigmatism for toric IOL planning is safe and effective.Trial registration: Current Controlled Trials ISRCTN94956424, Retrospectively registered (Date of registration: 05 February 2020). http://www.isrctn.com/ISRCTN94956424.

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.

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