The Role Of Corneal Tomography In Preoperative Evaluation For Toric Iol Candidacy
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT644 | Type: Free paper | DOI: 10.82333/rbfb-1w56
Authors: Dr Tom Kozlovsky* 1 , Dr Olga Reitblat 2 , Mr Amit Ginsberg 3 , Dr Haggay Avizemer 1
1ophthalmology,Wolfson Medical Center,Holon,Israel, 2ophthalmology,Rabin Medical Center,Petah Tikva,Israel, 3medicine,ben gurion university,beer sea,Israel
Purpose
To assess the clinical value of incorporating corneal tomography into the preoperative evaluation of candidates for toric intraocular lens (IOL) implantation, and to determine whether reliance on biometry and automated keratometry alone provides sufficient diagnostic accuracy.
Setting
Methods
A retrospective review was conducted on patients referred for preoperative evaluation to determine suitability for toric IOL implantation. Demographics, ocular history, and diagnostic parameters were analyzed. Preoperative measurements included biometry, automated keratometry, and corneal tomography. The final decision regarding toric IOL implantation was compared with and without the added diagnostic input of corneal tomography, with emphasis on cases where tomography altered clinical decision‑making.
Results
Thirty‑six eyes were included. Twenty‑seven eyes (77.14%) ultimately underwent toric IOL implantation. Consistent keratometric measurements across biometry and automated keratometry were observed in 25 eyes (69.44%); in these cases, corneal tomography did not alter the surgical plan. Two eyes (5.56%) were excluded from toric IOL implantation based solely on tomography findings, both exhibited pre‑tomography keratometric variability and were later diagnosed with irregular astigmatism. Eight eyes (22.22%) demonstrated irregular astigmatism on mapping but with sufficient regularity to still justify toric IOL selection.
Conclusions
In patients without prior ocular pathology and with consistent keratometric values across devices, routine corneal tomography may not be essential for determining toric IOL eligibility. Tomography remains valuable and should be selectively employed in cases with inter‑device measurement inconsistencies, suspected irregular astigmatism, or a complex ocular history.