ESCRS - POCAT657 - Refractive Accuracy Of Routine Toric Iol Implantation In Clinical Practice: A Retrospective Single-Center Study

Refractive Accuracy Of Routine Toric Iol Implantation In Clinical Practice: A Retrospective Single-Center Study

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT657 | Type: Poster | DOI: 10.82333/sgve-9808

Authors: Mr Daniel Wallinger* 1 , Dr Leon Pomberger 1 , Dr Sophia Reifeltshammer 1 , Dr Klaus Straßmair 1 , Prof. Matthias Bolz 1 , Prof. Nino Hirnschall 1

1Kepler University Clinic,Linz,Austria;Johannes Kepler University,Linz,Austria

Purpose

Cataract surgery has evolved into a refractive procedure aimed at achieving spectacle independence. As regular astigmatism is one of the most common refractive error next to myopia and hyperopia, its correction during cataract surgery is essential. Although toric intraocular lenses represent the most effective available option, clinically relevant residual postoperative astigmatism remains common. This study evaluates real-world outcomes of routine toric intraocular lens implantation in a clinical setting.

Setting

Retrospective, monocentric study

Methods

This retrospective study included 110 right eyes undergoing toric intraocular lens implantation. Preoperative measurements included optical biometry (IOLMaster 700, CZM, Germany) and anterior segment optical coherence tomography (OCT) (CASIA2, Tomey, Japan). Intraocular lens (IOL) power was calculated using the Barrett Universal II formula and the Tecnis Toric Calculator. All surgeries were performed by ten experienced surgeons using superior corneal incisions, manual phacoemulsification, and image-guided axis marking (Callisto eye, CZM, Germany). 4 weeks postoperatively, biometry and anterior segment OCT were repeated, manifest refraction was obtained, and IOL axis alignment was assessed using at the slit lamp using the slit-lamp beam.

Results

Mean preoperative corneal astigmatism was 2.12 ± 0.71 D, decreasing to a mean postoperative refractive astigmatism of 0.50 ± 0.36 D at 4 weeks. Residual refractive astigmatism ≤0.50 D was achieved in 66% of eyes, and ≤1.00 D in 95% of eyes. Postoperative uncorrected distance visual acuity (UDVA) improved to 0.22 ± 0.18 logMAR. Mean absolute intraocular lens rotation at 4 weeks compared to the intended axis was 4.01 ± 4.05 °.

Conclusions

Astigmatic outcomes were within the range of previous studies for modern toric IOLs. These findings confirm the effectiveness of toric IOL implantation while emphasizing the importance of rotational control, accurate alignment assessment, and individualized calculation parameters. Optimization of these factors may further improve refractive outcomes of toric IOL implantation in routine cataract surgery.