Efficacy Of Toric Intraocular Lenses In Pediatric Cataract Patients With Preexisting Corneal Astigmatism

To evaluate visual and refractive outcomes as well as rotational stability of a toric intraocular lens (IOL) in pediatric cataract patients with preexisting corneal astigmatism and to compare them between patients with or without posterior capsulorhexis and between different IOLs.

Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.

A retrospective analysis was performed, and all patients operated on by the same surgeon for pediatric cataract with a primary toric IOL implantation at the age of 6 years or later were included in the study and followed up. Data was collected and the rotational stability of a toric IOL was evaluated during the follow-up visit using the slit lamp beam angle. Eyes were grouped based on the IOL model (8 eyes with Alcon Acrysof IQ toric and 9 eyes with Tecnis toric IOL) and whether a posterior capsulorhexis was (3 eyes) or was not performed (14 eyes) during the surgery. Alpins method was used for the vector analyses of astigmatism (target-induced astigmatism (TIA), surgically induced astigmatism (SIA), and correction index (CI) (SIA/TIA)).

10 children(17eyes)with a 12.5yr.(6.0–17.5)mean age,were followed up for 30.0mo(4.0–65.0)on average.After surgery,uncorrected decimal distance visual acuity improved from 0.22±0.17 to 0.54±0.32(p=0.005)and the best corrected from 0.45±0.17 to 0.91±0.20(p<0.001),with a mean -0.96±2.61 spherical and -0.69±0.68 cylindrical correction.Mean axial length and corneal astigmatism increased, but mean refractive astigmatism decreased from -2.28±1.64 to -0.94±0.59(p=0.003).Mean TIA was 2.98±1.23,SIA 2.58±1.35,and CI 0.85±0.22.The mean IOL rotation was insignificant at 3.76±3.39°(p=0.806). IOL rotation did not differ between IOLs(Alcon Acrysof IQ 4.13±2.42°;Tecnis 3.44±4.03°) and those with posterior capsulorhexis(0.67±1.94°)or without(4.43±3.62°).

Primary toric IOL implantation in pediatric cataract patients over 6 years old reduces refractive astigmatism and restores excellent distance visual acuity. The toric IOL remains stable in patients with or without posterior capsulorhexis, with no differences between Alcon Acrysof IQ toric or Tecnis toric IOL.