J Korean Ophthalmol Soc.  2014 Nov;55(11):1636-1641. 10.3341/jkos.2014.55.11.1636.

Analysis of Miscorrection after Implantation of the Toric Intraocular Lens

• Jeon HM
• Lee KH

• KMID: 2216612
• DOI: http://doi.org/10.3341/jkos.2014.55.11.1636

Abstract

PURPOSE
To evaluate the efficacy and stability of AcrySof Toric intraocular lens (IOL) implants and to analyze the miscorrection that resulted after implantation.
METHODS
This retrospective study included 422 eyes of 348 patients who underwent cataract surgery with implantation of the AcrySof toric IOL between December 2011 and June 2013. We evaluated uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry and refraction preoperatively and 3 months postoperatively. The axis of implanted AcrySof Toric IOL was measured using the KR-1W aberrometer before mydriasis. At 3 months postoperatively, patients with a residual cylindrical power of 0.50 diopters (D) or more, and having an IOL rotation of 10 degrees (degrees) or more were considered having miscorrection.
RESULTS
UCVA (log MAR) improved from 0.58 +/- 0.35 to 0.18 +/- 0.26. Preoperative corneal astigmatism was 1.46 +/- 0.72 D and postoperative refractive cylindrical power was 0.45 +/- 0.30 D. The postoperative miscorrection was 50.5% in the T3 group, 35.7% in the T4 group, and 27.2% in the T5 group. The incidence of overcorrection was significantly higher in the T3 group than in the T4 and T5 group. In eyes with with-the-rule (WTR) astigmatism, overcorrection was found in 36.4% (32/88 eyes), while in eyes with against-the-rule (ATR) astigmatism, undercorrection was found in 37.6% of cases (44/117 eyes). There were five cases of IOL rotation at 3 months postoperatively.
CONCLUSIONS
AcrySof Toric IOL was effective in correcting corneal astigmatism and had good rotational stability. However, the incidence of miscorrection, especially for overcorrection, was higher with lower power toric IOL. Patients with WTR astigmatism tend to have overcorrection, while those with ATR show a tendency toward undercorrection, suggesting that these changes considered at the time of cataract surgery.

Keyword

Cataract surgery; Corneal astigmatism; Miscorrection; Toric intraocular lens

MeSH Terms

Astigmatism
Axis, Cervical Vertebra
Cataract
Humans
Incidence
Lenses, Intraocular*
Mydriasis
Retrospective Studies
Visual Acuity

Figure

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  Figure 1. Percentage of eyes with with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism in each decade.

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  Figure 2. Cumulative histogram of uncorrected visual acuity (UCVA) at 3 months postoperatively.

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  Figure 3. Bar chart of postoperative astigmatic results. The eyes with with-the-rule (WTR) tend to overcorrection, while those with against-the-rule (ATR) show tendency toward undercorrection.

Reference

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