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Toric intraocular lens implants in correction of corneal astigmatism during cataract surgery: a case series

Poster Details

First Author: S.Moolani INDIA

Co Author(s):    A. Moolani                    

Abstract Details

Purpose:

The purpose of our study was to evaluate the visual outcomes, accuracy and patient satisfaction after the implantation of Aspheric Toric intraocular lenses (IOL) in 35 eyes. Almost 20 percent of the patients presenting in our OPD for cataract surgery have a cylinder more than 0.75 which warrants the use of a Toric IOL to achieve a post operative state of emmetropia and freedom from spectacle use. We earlier have tried limbal relaxing incisions and Corneal laser correction to eliminate cylindrical component however toric IOLs have given the most predictable and safe outcome.

Setting:

Moolani's Eye Care Centre, Pune Maharashtra INDIA

Methods:

All cases were planned as topical phacoemulsification with a temporal incision and toric aspheric IOL implantation by a single surgeon. We used the online calculators available for the lenses in the first 8 cases and for the remaining used Barrett�â�€�™s Online toric calculator. Axis was marked on the slit lamp microscope, and the IOL was implanted in line with the marking. Outcomes were assessed in the individual eyes as quality of vision, unaided vision and residual cylinder. Intra-operative difficulties with the lens implantation, axis positioning, post operative axis and need for lens dialing if any was noted.

Results:

89 percent of patients achieved a cylinder of -0.50 or less with 20/20 or 20/30 uncorrected vision. The few patients who had a higher cylinder -0.75 or -1.00 were patients who had a pre op cylinder of 3.75 or more. 2 patients needed lens repositioning as the axis was misaligned postoperatively and both were high myopes of more than -6.

Conclusions:

Compared to previous techniques to correct astigmatism in cataract patients like corneal laser correction of the residual cylinder or limbal relaxing incisions which were unpredictable and limited in scope we find a more favourable refractive outcome and patient satisfaction with toric lenses. Toric IOLs are the need in this day of refractive cataract surgery. Although more expensive to the patient, they eliminate the need for any secondary surgery or procedure to eliminate remnant cylindrical power. Done in the right hands with a consistent clear corneal incision with knowledge about ones surgically induced astigmatism one can achieve predictable outcomes.

Financial Disclosure:

NONE

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