scholarly journals Correction of High Corneal Astigmatism during Cataract Surgery

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Experience ◽  
Intraocular Lens ◽  
Surgical Intervention ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Surgical Interventions ◽  
Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

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 Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity

2020 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Opacity ◽  
Corneal Astigmatism ◽  
Intraocular Lens Implantation ◽  
Toric Intraocular Lens ◽  
Cataract Patient ◽  
Lens Implantation ◽  
Cataract Patients ◽  
Total Corneal Astigmatism

Abstract Background: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) were statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively)Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.

scholarly journals Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity.

2019 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Opacity ◽  
Corneal Astigmatism ◽  
Intraocular Lens Implantation ◽  
Toric Intraocular Lens ◽  
Cataract Patient ◽  
Lens Implantation ◽  
Cataract Patients ◽  
Total Corneal Astigmatism

Abstract Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively). Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.

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 Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity.

2019 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Opacity ◽  
Corneal Astigmatism ◽  
Intraocular Lens Implantation ◽  
Toric Intraocular Lens ◽  
Cataract Patient ◽  
Lens Implantation ◽  
Cataract Patients ◽  
Total Corneal Astigmatism

Abstract Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All cases achieved visual acuity were as good as or better than that preoperatively. The percentage of corneal opacity covering pupillary area had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=-0.88 P<0.00001 and R=-0.87 P<0.00001, respectively) Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The percentage of central corneal opacity covering pupillary area is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.

scholarly journals Relation Between Corneal Astigmatism and Uncorrected Visual Acuity in Eyes Implanted With Multifocal Intraocular Lens

2015 ◽  
Vol 44 (0) ◽  
pp. 111-120
Author(s):  
Eri Hiruta ◽  
Chikako Suto ◽  
Emiko Shimamura ◽  
Itsumi Watanabe ◽  
Chihiro Kobayashi
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Multifocal Intraocular Lens ◽  
Uncorrected Visual Acuity

scholarly journals Instillation Anesthesia in Refractive Surgery in Children

2018 ◽  
Vol 15 (2S) ◽  
pp. 82-88
Author(s):  
A. G. Shchuko ◽  
L. C. Khlebnikova ◽  
I. G. Oleshenko ◽  
T. N. Iureva ◽  
O. V. Pisarevskaya ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Refractive Surgery ◽  
Surgical Intervention ◽  
Functional Result ◽  
Topical Anesthesia ◽  
Comfort Level ◽  
Uncorrected Visual Acuity ◽  
Reactive Anxiety ◽  
History Of

Purpose: to evaluate the safety and clinical efficacy of the Femto-LASIK refractive surgery performed under local (topical) anesthesia in children and adolescents with anisometropic and refractive amblyopia against a background of mixed astigmatism, medium and high hypermetropia with hypermetropic astigmatism.Patients and methods: 28 children (28 eyes) aged from 7 to 16 years (av. age — 13.6 ± 2.1 years old) were operated under local anesthesia by the FemtoLASIK method. The degree of anisometropy was from 3.25 to 5.21 (average — 4.27 ± 0.53 D). Uncorrected visual acuity averaged 0.21 ± 0.07, corrected one — 0.41 ± 0.1. Psychological history of patients and readiness for operative treatment of the disease were found out during the diagnostic examination. Based on the Spielberger-Khanin technique, the level of personal and reactive anxiety was determined, allowing identifying patients for surgical intervention under topical anesthesia. The surgeon assessed the comfort of the operation. During the first postoperative examination, the developed questionnaire was used to assess the comfort level of the patient during surgical treatment.Results. During the surgical intervention and in the postoperative period there were no complications. The behavior of all patients during the operation can be considered adequate. The duration of the operation slightly exceeded the duration of FemtoLASIC in adults. Uncorrected visual acuity in the first day after the operation averaged 0.39 ± 0.08, in 6 months — 0.61 ± 0.1, which is 80% higher than the baseline indices. After 6 months, the equivalent of anisometropia was 0.69 ± 0.12 D, that is, the refraction of the operated eye approached the value of the paired eye. In 60.8% of patients, the sensations during the operation corresponded to the level of “comfortable”. The surgeon’s assessment of the conditions for performing operations as ‘satisfactory” was noted in 92.9%.Conclusion. The use of topical anesthesia in refractive surgery in children with an initially low level of anxiety is an effective, safe and predictable method of anesthesia, allowing to conduct surgery in comfortable conditions for both the patient and the surgeon, with a high functional result. 

scholarly journals Toric Intraocular Lens Implants for Astigmatism

2012 ◽  
Vol 06 (03) ◽  
pp. 164
Author(s):  
Irene C Kuo ◽  
Victor E Reviglio ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Refractive Lens Exchange ◽  
Astigmatism Correction ◽  
Uncorrected Visual Acuity ◽  
Refractive Lens ◽  
Multifocal Lens ◽  
High Level

Toric intraocular lenses are available in our surgical armamentarium for use in cataract surgery, refractive lens exchange, phakic lens procedures and multifocal lens procedures. These lens implants enjoy a high level of success in terms of post-operative uncorrected visual acuity, astigmatism correction and safety. With time, toric phakic lens implants, not available worldwide, may gain popularity as more surgeons gain comfort and confidence in offering and performing an elective intraocular procedure.

Toric intraocular lens for correction of high corneal astigmatism in cataract patients

2020 ◽  
Vol 1 (2) ◽  
pp. 83-88
Author(s):  
Irene Simo ◽  
◽  
Laura Remón ◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Medical Engineering ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Before And After ◽  
The Mean ◽  
Axis Rotation

AIM: To evaluate the efficacy of Bi-Flex toric intraocular lens (T-IOL; Medicontur, Medical Engineering, Ltd., Inc.) implantation to correct preexisting astigmatism in patients having cataract surgery. METHODS: This retrospective consecutive study included 22 eyes of 16 patients with more than 2.50 diopters (D) of corneal preexisting astigmatism having cataract. Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective and subjective refraction and keratometric and topographic cylinder were measured. Postoperative the toric IOL axis was evaluated using vector analysis. RESULTS: Postoperatively, subjective refractive cylinder was reduced significant (P<0.05) from 4.05±1.53 D to 1.35±0.86 D. The component J0 reduced in magnitude from -0.81±2.02 D to -0.12±0.62 D (P<0.05). Both, UCVA and BCVA improved significantly at 1mo after surgery (P<0.05 in both cases). After the surgery, the UCVA and BCVA were 0.24±0.19 and 0.06±0.08, respectively. The mean toric IOL axis rotation was 2.95±5.25 degree, with rotation less than 10 degrees in 86.36% of eyes. No differences in mean keratometric values obtained before and after surgery were found (P>0.05 for J0 and J45). CONCLUSION: Implantation of the Bi-Flex toric IOL is a safe and effective method to correct the preexisting regular astigmatism (greater than 2.50D).

scholarly journals Analysis of the surgical treatment of posterior lenticonus associated with congenital cataract

2016 ◽  
Vol 11 (3) ◽  
pp. 138-143
Author(s):  
K. B Pershin ◽  
N. F Pashinova ◽  
Alina Vasil’evna Cherkashina ◽  
A. Yu Tsygankov
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Intraocular Lens ◽  
Congenital Cataract ◽  
Intraocular Lenses ◽  
Entire Group ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Best Corrected Visual Acuity

Aim. The objective of the present study was to analyze the results of the surgical treatment of the children presenting with posterior lenticonus associated with congenital cataract. Materials and methods. The total of 8 children (8 eyes) with posterior lenticonus enrolled in this study accounted for 6.5% of all cases of congenital cataract treated at the “Excimer” Eye Center during the period from 2003 to 2015. The age of the patients varied from 0.2 to 15 (mean 8.1±3.8) years. Preoperatively, the uncorrected visual acuity was estimated to be 0.11±0.1 (0.01 - 0.3), with the best corrected visual acuity being 0.15±0.13 (range: 0.01 - 0.4). Lensectomy was performed under general anesthesia by means of the incision technology (1.8 and 2.2 mm) with the use of the Millenium, Stellaris microsurgical system (Bausch and Lomb, USA) and the Infinity system (Alcon, USA). In all the cases, different IOL models (Alcon, USA) were implanted; in four cases, the toric intraocular lenses were used. Results. In all the patients with posterior lenticonus and congenital cataract, the “dry” aspiration of the lens was performed. The distinctive features of posterior capsulorhexis included the use of two viscoelastic materials, viz. heavy Healon GV applied over the intraocular lens and ProVisc applied under the intraocular lens in the form of a “layer cake”. Thereafter, posterior capsulorhexis and vitrectomy were done. The lens was implanted into the capsular bag (n = 6) and into the ciliary sulcus (n = 2) with the anterior and posterior “optic capture”; the edges of the optical hole were placed behind the capsulorhexis hole. In the cases of the initial posterior capsular defect (n = 3), we performed vitreorhexis and vitrectomy followed by intraocular lens implantation. The best corrected visual acuity increased from 0.15 before the operation to 0.72 after surgery, with astigmatism being reduced from 2.3±0.9 to 1.6±065 diopters (overall astigmatism for the entire group) and from 1.81±0.46 to 0.56±0.56 diopters for the subgroup treated by means of toric IOL implantation. The patients remained under the observation during the follow-up period of more than 36 months. Conclusion. Lensectomy followed by intraocular lens implantation used for the treatment of the children presenting with posterior lenticonus and congenital cataract is the efficient method for the management of this combined pathology. Such features of the surgical technique as “dry” aspiration of the lens mass, posterior capsulorhexis, anterior vitrectomy, and optical capture taken together make it possible to achieve the favourable and stable functional outcome of the treatment.

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