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

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.

Download Full-text

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

10.21203/rs.2.12464/v2 ◽

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.

Download Full-text

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

10.21203/rs.2.12464/v1 ◽

2019 ◽

Author(s):

Suhong He ◽

Xiang Chen ◽

Xingdi Wu ◽

Yajuan Ma ◽

Xuewen Yu ◽

...

Keyword(s):

Clinical Outcomes ◽

Early Stage ◽

Corneal Astigmatism ◽

Rotational Stability ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Pearson's R ◽

The Mean ◽

Pearson’S R

Abstract Background: A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with moderate to high myopia. In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long axial length（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) and sulcus-to-sulcus (STS). The 1- and 3-month clinical outcomes included visual acuity, manifest refraction, keratometry, postoperative toric IOL axis, the area of capsulorhexis, and the overlapped area between IOL optic and anterior capsulorhexis. 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 7.41±11.32 degree (°) and 7.48±11.19° (0°-79°), respectively. A positive correlation was found between IOL rotation and the area of capsulorhexis (Pearson’s r=0.297, P=0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (Pearson’s r=-0.020, P=0.876), ACD (Pearson’s r=-0.123, P=0.387), LT (Pearson’s r=0.083, P=0.523), VL (Pearson’s r=-0.082, P=0.546), ACV (Pearson’s r=-0.094, P=0.480), STS (Pearson’s r=0.019, P=0.884), or the overlapped area between capsulorhexis and optic (Pearson’s r=-0.191, P=0.131) . Conclusions: The area of capsulorhexis was a risk factor for toric IOL rotation. Implantation of TECNIS toric IOL in cataract cases with long AL was effective and safe.

Download Full-text

Rotational stability of modified toric intraocular lens

PLoS ONE ◽

10.1371/journal.pone.0247844 ◽

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.

Download Full-text

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

10.21203/rs.3.rs-54189/v1 ◽

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.

Download Full-text

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

10.21203/rs.3.rs-54189/v2 ◽

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.

Download Full-text

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

BMC Ophthalmology ◽

10.1186/s12886-020-01726-0 ◽

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).

Download Full-text

Toric Intraocular Lens Implantation in the Correction of Moderate-To-High Corneal Astigmatism in Cataract Patients: Clinical Efficacy and Safety

Journal of Ophthalmology ◽

10.1155/2021/5960328 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Xiaodi Qiu ◽

Yumeng Shi ◽

Xiaoyan Han ◽

Zhixiang Hua ◽

Yi Lu ◽

...

Keyword(s):

Visual Acuity ◽

Corneal Astigmatism ◽

Intraocular Lenses ◽

Rotational Stability ◽

Related Factors ◽

Toric Iol ◽

Iol Implantation ◽

Effective Option ◽

One Year ◽

Cataract Patients

Background/Aims. To investigate the long-term efficacy and rotational stability of toric intraocular lenses (IOLs) implanted for the correction of moderate-to-high corneal astigmatism. Methods. A total of 57 cataract patients (57 eyes) with regular corneal astigmatism (≥2.57 D) were enrolled in this retrospective cohort study. Phacoemulsification with toric IOL implantation was performed for all patients. The uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were recorded before and one year after surgery, and statistical analysis of preoperative corneal astigmatism, postoperative residual astigmatism, aberrations, IOL rotation, and related factors was performed to evaluate the efficacy, safety, and stability of toric IOLs in correcting moderate-to-high corneal astigmatism. Results. One year after surgery, visual acuity was significantly improved compared with that before surgery (preoperative log MAR 0.87 ± 0.34 vs. postoperative log MAR 0.31 ± 0.26, p < 0.001 ), and the self-reported spectacle independence rate was 68.42%. The total residual astigmatism was 1.18 ± 0.85 D, which was significantly less than the preoperative value (3.41 ± 0.99 D) ( p < 0.001 ). The degree of toric IOL rotation was 4.93 ± 3.02°, and 54.39% of patients had a lens rotation of less than 5°. The IOLs of 5.26% (3 eyes) of patients rotated more than 10°, and these patients received glasses instead of undergoing IOL repositioning. Conclusions. Toric IOL implantation provided optimal vision outcomes and low spectacle dependence during a one-year follow-up period. The results from our study show that toric IOL implantation is a safe and effective option for cataract patients with moderate-to-high corneal astigmatism.

Download Full-text

Comparative evaluation of rotational stability of toric IOLs with four-eyelet vs two-eyelet capsular tension rings in eyes with high myopia

International Journal of Ophthalmology ◽

10.18240/ijo.2021.03.07 ◽

2021 ◽

Vol 14 (3) ◽

pp. 378-382

Author(s):

Hui-Min Jiang ◽

◽

Li-Ming Tao ◽

Keyword(s):

Visual Acuity ◽

High Myopia ◽

Visual Outcome ◽

Corneal Astigmatism ◽

Rotational Stability ◽

Toric Iol ◽

Toric Iols ◽

Group A ◽

The Mean ◽

Group B

AIM: To compare the rotational stability of Toric intraocular lens (IOLs) implantation combined with four-eyelet or two-eyelet capsular tension rings (CTRs) in eyes with high myopia and cataract. METHODS: This prospective randomized controlled interventional study included 33 eyes which had preoperative corneal astigmatism ≥1.5 D and ocular axial length ≥25.5 mm. These eyes were randomly divided into two groups to undergo phacoemulsification and toric IOL implantation with either four-eyelet CTR implantation (group A, n=16) or two-eyelet CTR implantation (group B, n=17). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), phoropter examination results, and toric IOL rotation degrees were tested 6mo after the surgery. RESULTS: In both groups, the toric IOL was in the capsular sac 6mo after surgery. The difference between the two groups in terms of visual outcome was not found to be statistically significant (P>0.05) at a follow-up of 6mo. The mean residual astigmatism values were 0.56±0.22 D and 0.92±0.24 D in A and B groups, respectively (P<0.001). The mean rotation degree of IOL was 1.00°±0.73° in group A and 3.53°±1.46° in group B (P<0.001). CONCLUSION: In cataract patients with high myopia and astigmatism, four-eyelet CTR can effectively increase the rotation stability of toric IOLs, achieving the desired goal of correcting corneal astigmatism.

Download Full-text

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

BMC Ophthalmology ◽

10.1186/s12886-021-01966-8 ◽

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.

Download Full-text

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

10.21203/rs.3.rs-58747/v1 ◽

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.

Download Full-text