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Long-term refractive outcome and rotational stability of AcrySof Toric intraocular lens in an NHS hospital setting

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Session Details

Session Title: Toric IOLs

Session Date/Time: Sunday 14/09/2014 | 16:30-18:30

Paper Time: 17:27

Venue: Capital Hall B

First Author: : L.Ilari UK

Co Author(s): :    P. Udani              

Abstract Details


To evaluate the refractive stability and long term follow up of a Toric intraocular implant ( IOL) to correct corneal astigmatism at the time of cataract extraction.


Princess Royal University Hospital, King’s College NHS Foundation Trust, London, UK.


This was a retrospective non comparative case series of 24 eyes ( 19 patients , mean age: 73, range 53 to 84) who had cataract surgery with implantation of an AcrySof Toric IOL (Alcon Laboratories, Inc., Fort Worth, TX). Preoperative keratometric astigmatism was 3.02 D (SD 0.84, range: cylinder powers 1.95 D to 4.5 D). Measurements included unaided and corrected distance and near visual acuity, automated keratometry (Canon RK-F1,Tokyo, Japan), IOL Master (Carl Zeiss Meditec AG), Pentacam (Oculus GmbH). Patients were followed up at 2 weeks, 3 months, 6 months and 1 year. Average follow up was 12.1 months (range: 3 to 24 months). Rotational stability was also investigated after obtaining preoperative and postoperative dilated anterior segment digital photographs.


Mean postoperative residual refractive cylinder was 0.62 D (SD: 0.52 D, range from 0 D to 1.75 D) with a reduction of 79.5% from preoperative keratometric astigmatism. Postoperative refractive cylinder was ≤0.5 D in 76.9% of eyes and ≤ 1 D in 92.3%. Manifest spherical equivalent (SE) was -0.18 D ( SD: 0.53, range from -1.13 D to 0.5 D). Uncorrected distance visual acuity (UCVA) logMAR was 0.15 (SD: 0.15, range from -0.1 to 0.48) and corrected distance visual acuity (CDVA) logMAR was 0 (SD: 0.13, range from -0.1 to 0.18). UCVA was ≥ 0 logMAR (corresponding to 6/6 Snellen acuity or better) in 58.3% of eyes and ≥0.3 logMAR (corresponding to 6/12 Snellen acuity or better) in 91.7%. Mean early postoperative IOL rotation at 2 weeks was 3.08º (range 0º to 9º, p >0.05). Mean late postoperative rotation was 1.23º (range 0º to 3º, p >0.05). No IOL rotated more than 10º and 90.5% rotated 5º or less. No intraoperative complications were recorded. Two eyes (8.3%) developed a mild posterior capsule opacification at 12 and 14 months respectively which has not required laser capsulotomy.


The Acrysof Toric IOL is safe and effective in correcting moderate degrees of keratometric astigmatism. Long term follow up shows a stable refractive outcome and a very good rotational stability.

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