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Evaluation of visual acuity and quality of vision in patients implanted with toric IOLs: influence of preoperative corneal astigmatism

Poster Details

First Author: D.Tognetto ITALY

Co Author(s):    S. Trainiti   M. Zanello   A. Cuna   Z. Andrea   M. Pastore   P. Leon

Abstract Details



Purpose:

The aim of this study was to evaluate visual acuity and quality of vision in relation to the preoperative corneal astigmatism in patients implanted with toric IOLs.

Setting:

University Eye Clinic of Trieste

Methods:

We conducted a prospective study of 133 eyes (66 right eyes, 67 left eyes) of 102 patients (mean age: 73,7 ± 9,9 years) with a visually significant cataract and from moderate to high astigmatism (1,5-4,5 diopters) undergoing cataract surgery (phacoemulsification with MICS technique) with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics). The preoperative evaluation was conducted with IOL Master (Carl Zeiss Meditec, Germany), Corneal Map Analysis System (CSO), Scheimpflug Camera (Sirius, CSO), Kona Cell Check-7000 (CSO). The axis and the power of the toric IOL were calculated with AMO IOL Calculator Platform, Tecnis® Abbott Medical Optics. The toric IOL rotation was evaluated by OPD Scan III (Nidek). Best corrected and uncorrected visual acuity (BCVA, UCVA), Total aberrations, Higher Order Aberrations (HOA), Point Spread Function (PSF) and Modulated Transfer Function (MTF) were evaluated during a 6-month follow-up. Eyes were grouped depending on preoperative degree corneal astigmatism (moderate and high), on preoperative axis corneal astigmatism (with the rule, against the rule) and on preoperative posterior axis corneal astigmatism (concordant, discordant with preoperative anterior axis corneal astigmatism).

Results:

In the total group the postoperative UCVA improved significantly (p<0.01). The postoperative BCVA, in the total group, improved significantly from 0,526 ± 0,158 to 0,258 ± 0,150 logMAR (p<0,01). No significant differences of visual acuity, optical aberrations and quality of vision were found in the different groups during the 6-month follow-up. The mean IOL rotation was 6° ± 3°. This parameter did not correlate with total aberrations (p=0,297) and with higher order aberration (p=0,535). The IOLs rotation is correlated with the UCVA (Pearson's index = -0,277; p < 0,01) and with BCVA (Pearson's index = -0,325; p < 0,00).

Conclusions:

Cataract surgery with toric IOLs is a predictable and effective procedure for visual rehabilitation in eyes with cataract and moderate to high corneal astigmatism, providing an excellent postoperative ocular visual acuity and optical quality. The preoperative corneal astigmatism characteristics did not influence the visual, functional and aberrometrics outcomes. FINANCIAL INTEREST: NONE

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