Clinical Outcomes Of Cataract Surgery With Monofocal Toric Lens Implants For Corneal Astigmatism

To report patients' selection criteria, clinical outcomes, complication rate and patient satisfaction after cataract surgery with Rayone monofocal toric intraocular lens (IOL) implants (Rayner®, UK) in cases with corneal astigmatism.

Ophthalmology Department of Spire Gatwick Park Hospital, Horley, Surrey, United Kingdom between January 2018 and August 2022.

We conducted a retrospective cohort study in patients undergoing cataract surgery and monofocal toric lens implants by a single surgeon in a single centre. Selection criteria included cataract with regular corneal astigmatism, good pupil dilation, no previous corneal pathology, normal macula and  optic nerve. The IOL data were retrieved using the Raytrace  software for toric IOL calculation. Clinical records were reviewed collecting demographic data of patients, visual acuity (VA) before and after surgery, refraction before and after surgery, ocular biometry data, IOL calculation, expected refractive outcome, returns to theatre and complication rate. Cases with incomplete preoperative and/or postoperative clinical data were excluded.

56 patients, 28 right eyes and 28 left eyes, (35 F; 21 M), age 44 to 93 years (average 75 years) underwent cataract surgery with monofocal toric IOLs. The mean axial length was 24.3mm (range 21.5-29.3mm), the average selected sphere was 17D (range 3-24.8D), average selected cylinder was 2.8 cyl D (range 1-6.0 cyl D). The VA changed from a mean 0.5 LogMAR preoperative to a mean 0.2 LogMAR postoperative VA. The average postoperative spherical refraction was +0.5 sphere D and the average postoperative residual astigmatism was 0.25. The VA showed a statistically significant improvement of 2 lines LogMAR with a high level of satisfaction. There were no intraoperative complications, no adverse effects, no endophthalmitis, no return to theatre.

The outcomes of our cohort of cataract surgery with Rayone monofocal toric IOLs show that patients achieve quick visual rehabilitation and excellent unaided visual acuity with very low residual postoperative astigmatism (<0.6 cyl). The Rayone monofocal toric lens demonstrated excellent rotational stability and a high level of postoperative patients' satisfaction with no cases requiring a return to theatre for IOL repositioning.