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Is it absolutely necessary to advise toric IOL in case of moderate regular astigmatism of +1.50dcyl during phaco?

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Session Details

Session Title: Pseudophakic IOLs Toric

Session Date/Time: Sunday 06/09/2015 | 16:30-18:30

Paper Time: 17:54

Venue: Room 16

First Author: : J.Agrawal INDIA

Co Author(s): :                        

Abstract Details


To evaluate surgical outcome in my routine practice adopting clear corneal incision(CCI) & opposite clear corneal incision(OCCI) at one group and Toric IOL at another group for moderate regular astigmatism of +1.50dcyl during phaco.


The study was conducted at my private hospital , Agrawal Eye Care, Patna, India


236 cases were given either CCI or CCI+OCCI depending upon amount of moderate astigmatism; 73 cases were treated by Toric IOL. All cases were examined by autokeratometry, orbscan, slitlamp, BUVA both pre & postoperatively. Out of 236 cases,152 cases with astigmatism < 0.75Dcyl were given only CCI at steep meridian. Rest 84 cases with astigmatism > 0.75 & < 1.50 were given CCI + OCCI at steep meridian. Another group with 73 cases were treated by Toric IOL. All post operative records were evaluated on 3rd day, 2nd week ,1st month,2nd month & 6th month.


For 152 cases with astigmatism < 0.75Dcyl given only CCI at steep meridian, postoperative astigmatism in 124 cases remained between 0.26 to 0.54Dcyl; while 18 cases gave 0.78 to 1.12Dcyl, 10 cases remained to be evaluated. For 84 cases who were given CCI+ OCCI, only 76 cases could be followed upto 6 months,post operative astigmatism were between 0.56 to 0.96Dcyl.Out of 73 cases for Toric IOL, 69 followed for 6 months; result in post operative astigmatism between 0.43 to 0.69Dcyl and in 21 cases gave either 1.47+/- 0.49Dcyl or irregular astigmatism due to rotation, split changes or oblique changes.


For CCI or CCI+OCCI, both uncorrected and corrected Visual acuity show statistically significant improvement (P=0.0004,P=0.0006 respectively).Toric IOL gives more stable results, but significant no of pts results in post operative surprises. Thus for moderate regular astigmatism, both Toric IOL and CCI + OCCI are almost equally comparable—So advise of Toic IOL in moderate astigmatism is not absolutely necessary; CCI + OCCI can be the alternative and cost effective.

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