ESCRS - PO468 - Comparasion Of Toric Intraocular Lenses And Intra Surgical Opposite Incisions Placed At The Steeper Corneal Meridian To Correct Small To Moderate Astigmatism In Lens Surgery

Comparasion Of Toric Intraocular Lenses And Intra Surgical Opposite Incisions Placed At The Steeper Corneal Meridian To Correct Small To Moderate Astigmatism In Lens Surgery

Published 2025 - 43rd Congress of the ESCRS

Reference: PO468 | Type: Free paper | DOI: 10.82333/v8nh-bs81

Authors: Andrea Pastor Asensio* 1 , Inmaculada Ayús Such 1 , Claudia Andino Angulo 1 , Clara Pons-Talaya 1 , Salma El Masnaoui 1 , Miriam Barbany Rodríguez 2

1Centro de Oftalmología Barraquer,Barcelona,Spain, 2Cornea,Centro de Oftalmología Barraquer,Barcelona,Spain;Cornea,2Hospital Universitari MútuaTerrassa,Barcelona,Spain

Purpose

To compare the efficacy, predictability, safety, stability and accuracy of  astigmatism correction in lens surgery using toric intraocular lens implantation and the use of opposite incisions at the steeper corneal meridian during lens surgery.

Setting

CLINICAS BAVIERA, SPAIN

Methods

Non-randomized clinical study of 9,653 eyes of patients who underwent lens surgery between 2017 and 2023. Preop keratometric astigmatisms between -1.25 and -2.25 diopters, BCVA equal to or greater than 0.8 with no previous refractive surgery. Two groups were analyzed; Group A: patients who underwent toric intraocular lens implantation, group B: patients who underwent opposite (paired) corneal incisions during surgery. Main values ​​evaluated were postop spherical refractive error, astigmatism, spherical equivalent, safety and efficacy of each procedure.Vector decomposition using vector power analysis was used to evaluate the results. Bioptics (correction of residual refractive error after surgery) performed in each group was also evaluated.

Results

Postoperatively results; Group A: Spherical equivalent (SE) between -4.50 to + 3.38, mean -0.13(0.47 SD). Group B:SE between -3.00 to +3.38, mean -0.10 (55 SD). Safety indices: Group A:between 0.02 to 1.28, mean 1.01(0.10SD); Group B:between 0.34 to 1.47, mean 0.99(0.12 SD). Efficacy indices in Group A between 0.03 to 1.30, mean 0.90(0.19 SD) and in Group B between 0.10 to 1.50, mean 0.90(0.19 SD). Using power vector analysis, the spherical equivalent (M) pre op in group A is 1.57D (+-2.77) while post op is -0.17D (+-0.49) and the overall blur (B) is 2.75D (+-1.79) preop and 0.31D (+-0.37) postop. In group B the preop M value is 0.7D (+-3.44) being -0.14D(+-0.59) post op while the preop B value was 3.02D(+-2.02) being 0.58D(+-0.39) post op.

Conclusions

When comparing the two methods used for the correction of astigmatism in lens surgery, it can be conclude that both methods; intraoperative paired incisions and implantation of toric IOL´s are safe and effective procedures. In group A, 82.8% of eyes had an SE of +-0.50 postop, while in group B it was 76.1%, not being statistically significant different. Bioptics (correction of the residual refractive defect), however, was greater when incisions were used (group A), being statistically significant different when compared with group B. When evaluating the results using power vector analysis, the spherical equivalent (M) and the general defocus (B) postoperatively were no statistically significant different when comparing both groups.