Effectiveness Of Toric Intraocular Lens Implantation For Correcting Irregular Corneal Astigmatism In Cataract Eyes

To observe the correction effect of Toric intraocular lens (IOL) implantation in cataract eyes with specific types of irregular corneal astigmatism.

Retrospective cohort study.

Cataract eyes that underwent phacoemulsification combined with Toric IOL implantation and had irregular corneal astigmatism with either the "asymmetric bow-tie" pattern (Type I) or the "angled bow-tie" pattern (Type II) were included. Corneal topography was assessed using Pentacam HR. Changes in preoperative corneal astigmatism, pre- and postoperative visual acuity, manifest refraction, and objective visual quality were measured and compared. Subgroup analysis was performed between Type I and Type II.

34 eyes from 34 patients were included in the analysis. The average visual acuity improved from 0.29 logMAR to 0.11 logMAR. Preoperative mean corneal astigmatism of 2.05±0.90 D (range: 1.08 to 5.24 D) was corrected to a postoperative residual astigmatism of 0.78±0.57 D (range: 0 to 2.43 D) (P < 0.001), with 56% of eyes within 0.75 D. The residual astigmatism prediction errors in Type I and Type II cases were (0.97±0.68 D) and (0.66±0.37 D), respectively (P = 0.100). The mean spherical equivalent prediction error in Type II cases (0.07±0.36 D) was significantly smaller than that in Type I cases (-0.29±0.52 D) (P = 0.030).

Toric IOL implantation can effectively correct specific types of irregular corneal astigmatism in cataract surgery. Eyes with the "angled bow-tie" pattern show higher accuracy in refractive predictions compared to eyes with the "asymmetric bow-tie" pattern.