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First Author: K.Khripun RUSSIA
Co Author(s): S. Astakhov
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To compare the efficacy and safety of implanting a supplementary intraocular lens (IOL) in the ciliary sulcus in one eye and the toric IOL on another eye to correct astigmatism in highly hyperopic patients.
Department of Ophthalmology, Saint Petersburg State Medical University, Saint-Petersburg, Russia.
This study included highly hyperopic patients (axial length 21.3-22.0 mm) with regular astigmatism. Supplementary IOL (Sulcoflex Toric 653T) was implanted in the ciliary sulcus in the pseudophakic eye 1 month after the phacoemulsification and the toric IOL(AcrySof IQ Toric) was implanted in another. We made laser iridotomy in all cases with supplementary IOLs to minimize the risk of pupillary block. Visual and refractive outcomes were evaluated. The position and rotation of the IOLs were documented at all control visits. In all cases UBM images were taken, with the regular control of the intraocular pressure (IOP). We used the aberrometry for comparing the results. Postoperative follow-up was at 1 week, 1 month and 6 months.
The ten eyes of 5 patients were evaluated. All the patients had improved UDVA (uncorrected distance visual acuity) postoperatively; the mean Snellen UDVA 1 month postoperatively was 0,8 +- 0.1 in the group with Sulcoflex Toric and 0.7+/-0.1 in the group with AcrySof IQ Toric IOL. Visual acuity remained stable throughout the study. In the group with supplementary IOL the final value of spherical equivalent was more exact. The IOL position was stable in both groups. There are no cases of IOP increasing. Higher level of high- and low- order aberrations was defined in the AcrySof IQ Toric group. There were no significant intraoperative or postoperative complications.
Using different types of IOLs for correcting astigmatism in highly hyperopic patients is justified and allows us to receive good visual results. The ḋshort eyeṠ is not a contraindication for supplementary IOL implantation, but it is necessary to make laser iridotomy to minimize the risk of pupillary block. Lower visual acuity (UDVA) in the eyes with AcrySof IQ Toric IOL is connected with errors in IOL calculation, that often happens on ḋshortṠ eyes. We observed similar spherical equivalent deviations in the eyes where we planned to implant Sulcoflex Toric IOL, but we corrected them at the expense of supplementary IOL implantation. There were no cases of IOL rotation or tilt in either group within 6 months of supervision.