Corneal Astigmatism Correction In Cataract Surgery With Toric Intraocular Lenses, Their Rotational Stability, Clinical Outcomes, And Spectacle Independence

To assess the significance of toric intraocular lens (IOL) implantation on visual acuity after cataract surgery in subjects with preexisting corneal astigmatism, to evaluate their rotational stability, and to compare the clinical performance of subjects with toric IOL and subjects with implanted spherical IOL.

NeoVize Eye Clinic, Brno, Czech Republic

The study of 50 eyes of 36 patients (mean age of 74,42±6,30 years) with AcrySof ® IQ Toric IOL implanted during cataract surgery. Toric IOLs were implanted using a markerless system Callisto Eye (Carl Zeiss Meditec, Germany) to guide the intra-operative alignment of the toric IOL. 50 eyes of 50 patients (mean age of 73,82±9,57 years) served as a control group with implanted Clareon® spherical IOL. The evaluated parameters: postoperative uncorrected and corrected distance visual acuity (UDVA, DCVA), residual astigmatism, rotational stability of the toric IOL, and patient dependence on spectacle correction 12 months postoperatively in the toric IOL group and two months after surgery in the spherical IOL group.

The mean postoperative residual astigmatism of the toric group was (-0.63 ± 0.40 D), significantly lower than the preoperative (p < 0.001). The mean postoperative residual astigmatism in the control group (-0.73±0.38 D) was significantly lower than the preoperative (p = 0.014). The level of residual postoperative astigmatism did not differ significantly between the groups (p = 0.214). The mean postoperative UDVA of the toric group was 0.93±0.21, and the mean UDVA of the control group was 0.85±0.19, the difference between both groups was not significant (p = 0,274). The mean axis rotation of the toric IOL 6-12 months after surgery was 2.73° from the planned axis. Patients in the toric group did not need spectacle correction for distance.

Favorable efficacy, rotational stability, distance vision spectacle freedom, and safety results support using the AcrySof ® IQ Toric IOL for patients with cataracts and corneal astigmatism.