Clinical Outcomes And Tomographic Corneal Changes Following Toric Intraocular Lens Implantation
Published 2025 - 43rd Congress of the ESCRS
Reference: FP13.02 | Type: Free paper | DOI: 10.82333/h6wa-dw10
Authors: Devendra Venkatramani* 1 , Tanvi Haldipurkar 2 , Suhas Haldipurkar 3 , Shruti Choudhari 4
1Laxmi Eye Hospital,Navi Mumbai ,India, 2Cataract and Refractive Surgery,Laxmi Eye Hospital,Navi Mumbai ,India, 3Cataract Surgery,Laxmi Eye Hospital,Navi Mumbai ,India, 4Vitreoretina,Laxmi Eye Hospital,Navi Mumbai ,India
Purpose
To evaluate the clinical outcomes, corneal tomographic changes, and biometric alterations following cataract surgery with toric intraocular lens (IOL) implantation.
Setting
Kaplan Medical Center, Rehovot, Israel
Methods
This single-center retrospective study included patients who underwent cataract surgery with toric IOL implantation. Outcome measures encompassed a comparison of pre- and post-operative clinical data, including refraction, uncorrected and best-corrected distance visual acuity (UCDVA and BCDVA), biometry (using IOL MASTER 700), and Scheimpflug tomography (using Pentacam). The study examined the influence of the main incision axis, as performed by various surgeons, on corneal tomography and postoperative refraction. Additional clinical outcomes assessed included postoperative toric IOL axis alignment. The follow-up period ranged from one month to one year
Results
Thirty patients underwent cataract surgery with toric IOL implantation by 9 surgeons. Mean change in corneal astigmatism was 0.4 diopters (D) (p = 0.6). Mean change in steep axis was 7 degrees (p = 0.8). Posterior corneal curvature remained the same, regardless of main incision location. Postoperative UCDVA was 0.08 + 0.08 (logMAR). The change between planned and measured axis was not significant (p = 0.5). Mean IOL misalignment was 3.8 + 6.5 degrees. In 20 % of eyes, residual astigmatism was more than 0.75 D. BCDVA of those patients improved by 1 line (6/7.5>6/6). Mean residual astigmatism was 0.4 D (ranged 0-1.5). No statistically significant difference was observed between left and right handed surgeons on astigmatism and axis changes.
Conclusions
Cataract surgery with toric IOL implantation resulted in favorable uncorrected distance visual acuity outcomes. Notably, corneal tomographic measurements remained stable post-operatively, irrespective of the main incision location or surgeon handedness. This finding suggests that the position of the main incision has minimal impact on postoperative residual astigmatism. Moreover, these results support the efficacy of toric IOLs in managing corneal astigmatism during cataract surgery and indicate that surgeon-specific variations in incision placement may not significantly affect tomographic outcomes.