Our experience in using the VERION system in calculation and implantation of toric IOLs in cataract surgery

Meticulous correction of astigmatism during cataract surgery is mandatory in cases of multifocal intraocular lens (IOL) implantation. Toric multifocal IOLs allow predictable astigmatic correction during cataract surgery. In this editorial, we review our investigation on the Tecnis ZMT IOL (Abbott Medical Optics, CA, US) as well as other recent developments in multifocal toric IOLs.

Download Full-text

Faculty Opinions recommendation of Should Artificial Tears Be Used During the Preoperative Assessment of Toric IOLs Before Age-Related Cataract Surgery? The TORIDE Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.741146465.793590214 ◽

2021 ◽

Author(s):

Arun Gulani ◽

Aaishwariya Gulani

Keyword(s):

Cataract Surgery ◽

Preoperative Assessment ◽

Artificial Tears ◽

Age Related ◽

Toric Iols

Download Full-text

Changes of anthropometric parameters of an eye during the implantation of toric intraocular lenses in children with congenital cataracts.

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-2-101-104 ◽

2021 ◽

pp. 101-104

Author(s):

A.I. Shilov ◽

◽

K.K. Shefer ◽

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lenses ◽

Pediatric Cataract ◽

Congenital Cataracts ◽

Positive Effects ◽

Postoperative Astigmatism ◽

Toric Iols ◽

Significant Difference ◽

Pediatric Cataract Surgery

Aim. The aim of the study is to examine changes in the anthropometric and refractive parameters of the eyeball in children with congenital cataracts who have been implanted with various types of IOLs (toric or classic monofocal). Materials and methods. In this work, we retrospectively studied the medical history of 34 children (42 eyes) aged 4 to 15 years, who underwent phacoemulsification of congenital cataracts with implantation of various types of IOLs: toric and simple monofocal. Further, in these groups, by statistical methods, the dynamics of refraction in the first three years after the operation, the incidence of postoperative astigmatism, and its dynamics were assessed. We also assessed the rate of change in the anteroposterior axis of the eyeball, the dynamics of refraction in terms of the total spheroequivalent and maximum visual acuity in 3 years after the operation. Results. According to the results of the study, it was shown that toric IOLs significantly better stimulate the process of emmetropization of the eyeball, and also have a significant tendency to completely eliminate postoperative astigmatism, within 3 years after surgery. However, there were no significant differences in maximally corrected visual acuity between the 2 compared groups. There were also no data showing a significant difference in the more frequent development of myopia in the group receiving the toric IOL. Conclusion. The correct choice and calculation of the IOL remains one of the most difficult tasks in pediatric cataract surgery. New technologies are introduced annually and require constant testing. In this study, we have shown the possibility of using toric IOLs and their positive effects in pediatric cataract surgery and in the prevention and treatment of obscuration amblyopia. Key words: pediatric cataract, intraocular lenses, myopia, refraction, phacoemulsification, amblyopia.

Download Full-text

Toric Intraocular Lenses in Cataract Surgery

US Ophthalmic Review ◽

10.17925/usor.2011.04.01.38 ◽

2011 ◽

Vol 04 (01) ◽

pp. 38

Author(s):

Rosa Braga Mele ◽

Keyword(s):

Cataract Surgery ◽

Contact Lenses ◽

Treatment Options ◽

Corneal Astigmatism ◽

Intraocular Lenses ◽

Rotational Stability ◽

Toric Iol ◽

Toric Iols ◽

High Prevalence ◽

Increasing Demand

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

Download Full-text

Cataract Surgery in Patients with Keratoconus: Pearls and Pitfalls

The Open Ophthalmology Journal ◽

10.2174/1874364101711010194 ◽

2017 ◽

Vol 11 (1) ◽

pp. 194-200 ◽

Cited By ~ 3

Author(s):

F. Aiello ◽

QJ Nasser ◽

C. Nucci ◽

R.I. Angunawela ◽

Z. Gatzioufas ◽

...

Keyword(s):

Cataract Surgery ◽

Outcome Prediction ◽

Low Grade ◽

Refractive Outcome ◽

Patient Counselling ◽

Number Of Factors ◽

Toric Iols ◽

Refractive Correction ◽

Good Patient Satisfaction ◽

Corneal Thinning

Background: Keratoconus (KC) is a common ectatic disorder resulting in progressive corneal thinning and irregular astigmatism. It has been observed that patients affected by KC are more likely to develop lens opacities earlier compared to non-keratoconic patients. Objective: Intraocular lens (IOL) selection and refractive outcome prediction are among a number of factors that can make cataract surgery in keratoconic patients challenging. Accurate biometry is often difficult to obtain due to unreliable K measurements and lack of dedicated biometric formulae. The use of toric IOLs has also been investigated. Conclusions: Determining the stage of KC, pre-operative patient counselling and the preferred method of refractive correction are all crucial to obtain successful postoperative outcomes and good patient satisfaction. The use of toric IOLs can achieve good results only in selected low-grade keratoconic eyes.

Download Full-text

PP137 Toric Intraocular Lenses and Spectacle Independence: A Systematic Review

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319002538 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 64-64

Author(s):

Derek O'Boyle ◽

Caridad Perez Vives ◽

Jan de Haan ◽

Frank Ender ◽

Rafael Busutil

Keyword(s):

Cataract Surgery ◽

Randomized Controlled Trials ◽

Intraocular Lenses ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled ◽

Number Of Patients ◽

Toric Iols ◽

Cataract Patients

IntroductionAstigmatism is a common ocular condition that causes reduced visual acuity. The condition is highly prevalent in cataract patients, with preoperative astigmatism of at least 0.5 diopters being present in 78 percent of cataractous eyes. Residual uncorrected astigmatism after cataract surgery is associated with significant costs, primarily driven by the lifetime cost of spectacles (estimated at EUR 1,608 to EUR 3,608 in Europe). Toric intraocular lenses (IOLs) are a safe and effective way of correcting astigmatism, while also reducing the need for spectacles after cataract surgery. The objective of this review was to assess the published evidence relating to spectacle independence in patients implanted with toric IOLs, compared with those receiving non-toric IOLs with or without astigmatism reducing surgical interventions (SI).MethodsA systematic literature search was conducted of the EMBASE, MEDLINE, and Cochrane Library databases. Articles were selected if they included adult patients undergoing phacoemulsification who had age-related cataracts and preoperative regular corneal astigmatism of at least 0.5 diopters, and assessed spectacle independence as an outcome.ResultsSeven studies met the inclusion criteria: four randomized controlled trials and one non-randomized comparative study comparing toric IOLs with non-toric IOLs, and two randomized controlled trials comparing toric IOLs with non-toric IOLs plus SI. Spectacle independence was evaluated as the number of patients who reported not requiring spectacles for distance viewing at 3 or 6 months. Figures for spectacle independence ranged from 60 to 100 percent for toric IOLs, 31 to 50 percent for non-toric IOLs, and 36 to 65 percent for non-toric IOLs plus SI. In each study, toric IOLs demonstrated superior spectacle independence compared with the control group.ConclusionsThe benefits of toric IOL implantation for astigmatic cataract patients included a higher rate of spectacle independence, compared with non-toric IOLs with or without SI. For this group of patients, the lifetime economic burden of spectacle acquisition costs can be reduced with the implantation of toric IOLs during cataract surgery.

Download Full-text

Correcting astigmatism at the time of cataract surgery: Toric IOLs and corneal relaxing incisions planned with an image-guidance system and intraoperative aberrometer versus manual planning and surgery

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2018.12.002 ◽

2019 ◽

Vol 45 (5) ◽

pp. 569-575 ◽

Cited By ~ 10

Author(s):

Kerry D. Solomon ◽

Helga P. Sandoval ◽

Richard Potvin

Keyword(s):

Cataract Surgery ◽

Image Guidance ◽

Guidance System ◽

Toric Iols ◽

Relaxing Incisions

Download Full-text

Prevalence of Corneal Astigmatism in Patients before Cataract Surgery in Northern China

Journal of Ophthalmology ◽

10.1155/2014/536412 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Xiaoyong Yuan ◽

Hui Song ◽

Gang Peng ◽

Xia Hua ◽

Xin Tang

Keyword(s):

Cataract Surgery ◽

Teaching Hospital ◽

Surgical Techniques ◽

Northern China ◽

Corneal Astigmatism ◽

Partial Coherence ◽

Visual Rehabilitation ◽

Partial Coherence Interferometry ◽

Toric Iols

Purpose. To analyze the prevalence and presentation patterns of corneal astigmatism in cataract surgery candidates in a teaching hospital in northern China.Methods. From May 1, 2012, to April 30, 2013, partial coherence interferometry (IOLMaster) measurements of all qualified cataract surgery candidates were retrospectively collected and analyzed.Results. The study evaluated 12,449 eyes from 6,908 patients with a mean age of69.80±11.15(SD) years. The corneal astigmatism was 0.5 diopters (D) or less in 20.76% of eyes, 1.0 D or more in 47.27% of eyes, 2.0 D or more in 13.16% of eyes, and 3.0 D or more in 3.75% of eyes. With-the-rule astigmatism was found in 30.36% of eyes, while against-the-rule was found in 52.41% of eyes. The percentage of against-the-rule astigmatism increased with age.Conclusion. Our study showed that almost one-half of preoperative eyes (47.27%) in northern China have a corneal astigmatism of 1.0 D or more, indicating that more surgical techniques or toric IOLs are needed to achieve better visual rehabilitation.

Download Full-text