Injectable 1-piece hydrophilic acrylic toric intraocular lens for cataract surgery: efficacy and stability.
ABSTRACT To evaluate the efficacy and rotational stability of an injectable 1-piece hydrophilic acrylic toric intraocular lens (IOL).
Department of Ophthalmology, Hillingdon Hospital, Uxbridge, Middlesex, United Kingdom.
This study enrolled consecutive patients who had 2.00 diopters (D) or more of preexisting corneal astigmatism. Patients had phacoemulsification with implantation of a T-flex 623T toric IOL through a 2.8 mm astigmatically neutral incision. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities (logMAR), refraction, keratometry, and the cylinder axis of the toric IOL were measured.
Thirty-three eyes of 25 patients were evaluated. The mean preoperative refractive astigmatism was 3.35 D ± 1.20 (SD) and the mean keratometric astigmatism, 3.98 ± 1.89 D, respectively. Four months postoperatively, the mean UDVA was 0.28 ± 0.23 D logMAR, improving to 0.19 ± 0.23 D logMAR CDVA. The mean refractive astigmatism was 0.95 D ± 0.66 D; vector analysis using the Holladay-Cravy-Koch method showed that the mean reduction in refractive astigmatism was 2.94 ± 0.89 D. The mean difference between the intended and the actual final IOL cylinder axis was 3.44 degrees (range 0 to 12).
The toric IOL reduced visually significant keratometric astigmatism and increased spectacle independence after cataract surgery. There were no cases of significant IOL rotation in the capsular bag 4 months postoperatively.
Article: Vector analysis of corneal and refractive astigmatism changes following toric pseudophakic and toric phakic IOL implantation.[show abstract] [hide abstract]
ABSTRACT: To determine the efficacy of the astigmatism correction following toric intraocular lens (IOL) and toric phakic IOL (pIOL) implantation in eyes with no previous ocular surgery and in postkeratoplasty (PKP) eyes. In addition, changes in corneal astigmatism were determined. Astigmatism was analyzed in 35 eyes with an AcrySof toric IOL, 35 eyes with an Artiflex toric pIOL, 50 eyes with an Artisan toric pIOL, and 40 PKP eyes with an Artisan toric pIOL. Refractive astigmatism was analyzed by using Alpins method. Surgically induced corneal astigmatism (SICA) was determined following a superior 2.2-mm, 3.4-mm, or 5.4-mm incision. Follow-up was 12 months. Following toric IOL implantation, the index of success was 0.14 and overall residual astigmatism, 0.37 diopter (D). Following toric pIOL implantation, the index of success was 0.32 (Artiflex) and 0.18 (Artisan), and overall residual astigmatism was approximately 0.60 D. In PKP eyes, Artisan pIOLs resulted in an index of success of 0.28 and overall residual astigmatism of 1.56 D. The SICA, following 2.2-mm, 3.4-mm, 5.4-mm (normal eyes), and 5.4-mm (PKP eyes) incisions, was -0.25 ± 0.42 D (P = 0.108), -0.31 ± 0.43 D (P < 0.001), -0.48 ± 0.55 D (P < 0.001), and -0.49 ± 1.48 D (P = 0.035), respectively. Toric IOLs and pIOLs provide an effective astigmatism correction. Incorporating the SICA into the toric IOL power calculation may further increase their effectiveness. Therefore, incorporation of 0 D, -0.30 D, or -0.50 D of SICA for a 2.2-, 3.4-, or 5.4-mm superior incision, respectively, is recommended.Investigative ophthalmology & visual science 03/2012; 53(4):1865-73. · 3.43 Impact Factor