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Toric IOL implantation in the course of femtolaser-assisted and manual cataract surgery

Poster Details

First Author: A.Dunai HUNGARY

Co Author(s):    K. Kranitz   A. Gyenes   A. Takacs   Z. Nagy     

Abstract Details



Purpose:

To analyse the functional and refractive results of the implantation of a single-piece toric acrylic posterior chamber lens (PCL) following femtosecond laser assisted cataract surgery (FACS) and to compare them to the ones of the traditional manual phacoemulsification.

Setting:

Semmelweis University, Department of Ophthalmology, Budapest, Hungary

Methods:

10 eyes with age-related cataract were operated using FACS (Group A), another 25 of them with conventional phacoemulsification (Group B). All recieved the same type of toric PCL (Acrysof SN6ATx, Alcon). All of them had a preoperative corneal astigmatism 1.00 diopters or higher. Lenstar optical biometry and Pentacam Scheimpflug imaging was used during IOL calculation and keratometry. Digital retroilluminary images were taken 1 day, 1 week, 1 month and 6 months postoperatively. PCL rotation was examined with a standard software (Adobe Photoshop). Connecting characteristic points on the conjunctiva and on the PCL, referency lines were determined, and their angle was measured. Comparing the photograph sets, angle changes were evaluated. Refractometry, uncorrected (UCVA) and best corrected decimal visual acuity (BCVA) of the patients was checked per- and postoperatively.

Results:

Both UCVA and BCVA improved in the two groups alike (UCVA postop. (A): 0.75±0.24; (B): 0.80±0.24; BCVA (A): 0.93±0.15; (B): 0.98±0.09), though corneal astigmatism did not show a significant decrease (Kruskal-Wallis, p>0.05). The amount subjective refractive astigmatism was lowered from 1.35±0.41D to 0.43±0.31D in Group A, and from 1.53±0.51D to 0.48± 0.32D in Group B (paired t-test, p<0.001 both). The cylinrical correction accepted by the patients was 0.5D or less in 70.0 (A), and 68,0 percent (B) of the cases. Relatively low change values of the PCL position were measured in both groups, at all times. Average IOL rotation in the sixth month was 3.3±2.4º degrees in Group A, and 4.9±4.6º degrees in Group B, compared to the first-day state. Rotation less then 3 degrees measured on the 70.0% in Group A and 56.0% in Group B. Comparing the two cohorts, the FACS group (A) showed a trend to lower rotation values, but no significancy was found (paired t-test, p=0.15).

Conclusions:

Toric IOL implantation is a predictable and efficant method to correct high preoperative corneal astigmatism. Examining the PCL position in chronological sequence, excellent rotational stability was found after both cataract surgery techniques, so the implantation makes a persistent decrease of the patients' refractive astigmatism. Promising results following femtolaser assisted cataract surgery project, that this method will be useful for toric PCL implantation. FINANCIAL INTEREST: NONE

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