J Korean Ophthalmol Soc.  2015 Oct;56(10):1544-1551. 10.3341/jkos.2015.56.10.1544.

Effect of Toric Intraocular Lens Implantation on Astigmatism in Cataract Surgery

Affiliations
  • 1Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. kmk9@snu.ac.kr
  • 2Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To evaluate the efficacy of Tecnis(R) toric intraocular lens (IOL) implantation for the correction of astigmatism and rotational stability during cataract surgery in patients with cataract and astigmatism.
METHODS
We prospectively analyzed 17 eyes of 14 patients with 1 to 4 diopters (D) of corneal astigmatism who underwent phacoemulsification and Tecnis(R) toric IOL implantation at Seoul National University Hospital from June 2013 to May 2014. Informed consent was obtained from all participants before the clinical trial. We evaluated the changes in visual acuity, refraction, astigmatism, IOL axis and higher order aberration for 3 months postoperatively. Power vector analysis was used to analyze astigmatism.
RESULTS
The mean uncorrected visual acuity (log MAR) significantly improved from 0.58 +/- 0.34 to 0.26 +/- 0.43 at 3 months postoperatively. The mean refractive astigmatism was significantly decreased by 77.9% from a mean value of -2.67 +/- 0.89 D to -0.59 +/- 0.48 D at 3 months postoperatively. According to power vector analysis, M, B, J0, and J45 were significantly reduced after the surgery. The mean difference between achieved and intended IOL axis was 3.26 degrees clockwise at postoperative 3 months, which was statistically insignificant. Most of the rotational changes were observed within a month after the surgery.
CONCLUSIONS
Phacoemulsification and Tecnis(R) toric IOL implantation in patients with cataracts and astigmatism showed efficacy for the correction of astigmatism and rotational stability.

Keyword

Astigmatism; Cataract; Tecnis(R) toric IOL; Vector analysis

MeSH Terms

Astigmatism*
Axis, Cervical Vertebra
Cataract*
Humans
Informed Consent
Lens Implantation, Intraocular*
Lenses, Intraocular*
Phacoemulsification
Prospective Studies
Seoul
Visual Acuity

Figure

  • Figure 1. Image analysis for the rotation of the cylindrical axis on the toric intraocular lens.

  • Figure 2. Changes in visual acuity. There were statistically significant improvements in visual acuity at postoperative 1 week, 1 month, and 3 months compared with pre-operative values. log MAR = logarithm of the minimum angle of reso-lution; Preop = preoperative.

  • Figure 3. Change in refractive astigmatism. There were stat-istically significant decreases in refractive astigmatism at post-operative 1 week, 1 month, and 3 months compared with pre- operative values. Preop = preoperative.

  • Figure 4. Changes in the corneal astigmatism between pre- and post- operation. There is no significant changes between the follow-ups. Preop = preoperation.

  • Figure 5. Changes in spherical equivalents between pre- and post- operation. Preop = preoperation.

  • Figure 6. Diagram showing refractive astigmatism in diopters measured before surgery and 1 week, 1 month, and 3 months after implanting a single-piece toric acrylic intraocular lens. Astigmatism is shown as vectors at J0 and J45. Each ring repre-sents 1 diopter.

  • Figure 7. Absolute amount of rotation of a single-piece toric acrylic intraocular lens (IOL) compared with preoperative IOL axis. There was significant rotation between 1 week and 1 month after surgery. However, axis was stable after 1 month.


Reference

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