Comparing Visual Acuity, Low Contrast Acuity and Refractive Error After Implantation of a Low Cylinder Power Toric Intraocular Lens or a Non-Toric Intraocular Lens

Purpose: To evaluate the clinical outcomes and quality of life following implantation of PanOptix toric intraocular lens (IOL) and to compare the outcomes following femtosecond laser assisted cataract surgery (FLACS) and standard cataract surgery (SCS). Methods: This comparative retrospective study included 79 eyes of 55 patients underwent cataract or refractive lens exchange surgery between April 2017 and January 2020 in Bayindir Hospital and Kaskaloglu Eye Hospital. Corneal (CA) and refractive astigmatism (RA), uncorrected visual acuities for distant, intermediate, and near (UDVA, UIVA, and UNVA), low contrast distance visual acuity, rotational stability, defocus curves, photopic and mesopic contrast sensitivity (CS), visual function-14 (VF-14) test, presence of dysphotopsia, and need for spectacles were evaluated at postoperative third month. Outcomes were compared between FLACS and SCS group. Results: The mean UDVA, UIVA, and UNVA were 0.05 ± 0.07, 0.08 ± 0.08, and 0.06 ± 0.07 logMAR, respectively. All patients achieved ⩾0.3 logMAR uncorrected visual acuity for all distances. UDVA was found significantly better in FLACS group ( p = 0.03). All eyes had ⩽1 D of subjective postoperative RA. Defocus curve had two peaks at 0 and −1.50 D. Spectacle independence was achieved in 88.7% of patients. Photopic and mesopic CS was within normal range in all patients. The mean VF-14 score was 98 ± 2. The mean IOL axis rotation was 2.1° ± 2.3°. Only one patient reported seeing disturbing halos. Conclusions: This trifocal toric IOL effectively reduced refractive astigmatism and provided excellent visual outcomes with high spectacle independence, patients’ satisfaction, and good rotational stability. FLACS might have an impact on optimal postoperative results.

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Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1024 ◽

2012 ◽

Vol 1 (2) ◽

pp. 128-130

Author(s):

Tova Lifshitz ◽

Jaime Levy ◽

Anry Pitchkhadze

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

Uncorrected Visual Acuity ◽

Cylinder Power ◽

Best Corrected Visual Acuity

ABSTRACT We present the case of a 73-year-old patient who underwent successful phacoemulsification and toric intraocular lens (IOL) implantation to correct high stable astigmatism due to keratoconus and cataract. Preoperative refraction was −3.25 −4.0 × 98°. A toric IOL (Acrysof SN60T6) with a spherical power of 16.5 D and a cylinder power of 3.75 D at the IOL plane and 2.57 D at the corneal plane was implanted and aligned at an axis of 0°. Uncorrected visual acuity improved from 6/60 to 6/10. Postoperative best corrected visual acuity was 6/6, 6 months after the operation. In conclusion, phacoemulsification with toric IOL implantation can be performed in eyes with keratoconus and cataract. How to cite this article Levy J, Pitchkhadze A, Lifshitz T. Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation. Int J Kerat Ect Cor Dis 2012;1(2):128-130.

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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.

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Supplementary toric intraocular lens implantation for pseudophakic refractive error in Chinese eyes

JCRS Online Case Reports ◽

10.1016/j.jcro.2015.06.001 ◽

2015 ◽

Vol 3 (3) ◽

pp. 68-73

Author(s):

Leonard Yuen ◽

Jennifer Hung

Keyword(s):

Intraocular Lens ◽

Refractive Error ◽

Intraocular Lens Implantation ◽

Toric Intraocular Lens ◽

Lens Implantation

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Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2018/7342917 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Takayuki Baba ◽

Tomohiro Nizawa ◽

Toshiyuki Oshitari ◽

Shuichi Yamamoto

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Intraocular Lens ◽

Refractive Error ◽

Surgical Outcomes ◽

Case Series ◽

Cell Loss ◽

Significant Difference ◽

Group A ◽

Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

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Correction of High Corneal Astigmatism during Cataract Surgery

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-4-405-410 ◽

2019 ◽

Vol 15 (4) ◽

pp. 405-410 ◽

Cited By ~ 1

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.

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Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity

10.21203/rs.2.16507/v5 ◽

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.

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Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity.

10.21203/rs.2.16507/v2 ◽

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.

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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.

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