Korean J Ophthalmol.  2011 Feb;25(1):22-28. 10.3341/kjo.2011.25.1.22.

Postoperative Astigmatic Outcomes Based on the Haptic Axis of Intraocular Lenses Inserted in Cataract Surgery

• Kim IT
• Park HY
• Kim HS

• KMID: 994407
• DOI: http://doi.org/10.3341/kjo.2011.25.1.22

Abstract

PURPOSE
This study was conducted to compare post-operative astigmatic outcomes of two groups, with-the-rule (WTR) and against-the-rule (ATR) astigmatism patients, according to the haptic axis of intraocular lenses (IOLs) inserted in cataract surgery.
METHODS
Seventy-two eyes with WTR astigmatism and 79 eyes with ATR astigmatism had cataract surgery through a clear corneal temporal incision. These two groups of eyes were then each divided into 2 groups based on whether the haptic axis of the inserted IOL was at 180degrees or 90degrees. For ATR patients, the outcomes were analyzed according to the three types of IOLs.
RESULTS
There was no difference in corneal astigmatism, but WTR patients with a 180degrees haptic axis of the inserted IOL and ATR patients with a 90degrees hepatic axis of the inserted IOL had a significant decrease in postoperative refractive astigmatism (p < 0.05). The changes in ATR astigmatism according to the IOL type were more effective in single-piece acrylic IOLs than in the three-piece polymethylmethacrylate haptic IOL group.
CONCLUSIONS
Insertion of the IOL at the 180degrees haptic axis in WTR patients and at 90degrees in ATR patients during cataract surgery may have an effect in reducing pre-existing astigmatism. This observed effect was not consistent among the different types of IOLs.

Keyword

Cataract; Clear corneal temporal incision; Haptic axis of inserted intraocular lens; Ocular residual astigmatism

MeSH Terms

Astigmatism/classification/*etiology/*physiopathology
Cataract Extraction/*adverse effects
Equipment Design
Humans
Lens Implantation, Intraocular/*methods
*Lenses, Intraocular
*Postoperative Complications
Treatment Outcome

Figure

• 

  Fig. 1 Scheme of the axis of the inserted intraocular lens (IOL) in the patient's right eye. (A) An imaginary line of the haptic-optic-haptic laying horizontally is defined as the insertion of the IOL at the 180° haptic axis. (B) The vertical line is defined as the insertion of the IOL at the 90° haptic axis.

• 

  Fig. 2 The changes in mean astigmatism by intraocular lens (IOL) axis insertion. In the with-the-rule (WTR) astigmatism group by refraction (A), topography measurement (B), and in the against-the-rule (ATR) astigmatism group by refraction measurement (C), and topography measurement (D) (*p <0.05 indicates p-value compared with the preoperative values).D=diopters.

• 

  Fig. 3 The changes in mean astigmatism by intraocular lens (IOL) axis in against-the-rule (ATR) astigmatic patients. Single-piece hydrophobic acrylic IOL group by refraction (A) and topography (B). Single-piece hydrophilic acrylic IOL group by refraction (C) and topography (D). Three-piece acrylic optic with polymethylmethacrylate (PMMA) haptic group by refraction (E) and topography (F) (*p < 0.05 indicates p-value compared with the preoperative values).D = diopters.

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