Results Of Toric Intraocular Lens Implantation In Patients With High Corneal Astigmatism
Published 2026 - 44th Congress of the ESCRS
Reference: PP17.10 | Type: Free paper | DOI: 10.82333/4xv2-3y65
Authors: Dr Ori Stern 1 , Dr Olga Reitblat 2 , Mrs Adi levy 3 , Dr Haggay Avizemer 1 , Prof. Ehud I Assia 4 , Prof. Guy Kleinmann* 5
1Ophthalmology,Wolfson Medical Center,Holon,Israel;Gray Faculty of Medicine, Tel Aviv University,Tel Aviv,Israel, 2Ophthalmology,Rabin Medical Center,Petach Tikva,Israel;Gray Faculty of Medicine, Tel Aviv University,Tel Aviv,Israel, 3Ein Tal Eye Center,Tel Aviv,Israel, 4Ein Tal Eye Center,Tel Aviv,Israel;Gray Faculty of Medicine, Tel Aviv University,Tel Aviv,Israel, 5Goldschleger Eye Institute,Sheba Medical Center,Ramat Gan,Israel;Ein Tal Eye Center,Holon,Israel;Gray Faculty of Medicine, Tel Aviv University,Tel Aviv,Israel
Purpose
To evaluate the efficacy and predictability of toric intraocular lens (IOL) implantation in patients with a high regular and irregular corneal astigmatism during cataract surgery and compare the results to patients that were implanted with toric IOLs for lower corneal astigmatism.
Setting
Multicenter study performed at two medical centers
Methods
Retrospective cohort study of toric IOL implantation in three groups defined by corneal astigmatism. Group 1 included eyes with corneal astigmatism greater than 4.0 diopters (D) and corneal pathology (keratoconus, pellucid marginal degeneration, corneal scar, or post-penetrating keratoplasty). Group 2 had corneal astigmatism greater than 4.0 D with normal corneas. Group 3 had corneal astigmatism greater than 1.5 and less than 4.0 D with normal corneas. All eyes underwent preoperative biometry and corneal tomography and a 1-month postoperative visit with a complete ophthalmic examination, refraction and toric IOL axis measurement.
Results
A total of 175 eyes were included (group 1=38, group 2=33, group 3=104). Residual astigmatism (RA) ≤1.0 D was achieved in 68.4%, 87.9%, and 90.4%, and RA ≤0.5 D in 39.5%, 51.5%, and 66.3% (overall p=0.004 and p=0.012, groups 1-3, respectively); pairwise differences were significant only for group 1 vs. 3. Within-group mean astigmatism decreased from 6.38±2.4 D to 0.89±1.03 D, 5.17±0.9 D to 0.59±0.49 D, and 2.7±0.73 D to 0.50±0.47 D in groups 1-3, respectively (all p<0.001). In eyes targeted for distance, postoperative uncorrected-distance visual acuity (logMAR) was 0.21±0.14, 0.17±0.12, and 0.12±0.12 (overall p<0.001; Holm-adjusted: group 1 vs 3, p=0.001; group 2 vs 3, p=0.027).
Conclusions
Toric IOL implantation was highly effective with respect to residual astigmatism and uncorrected distance visual acuity. These benefits extended to eyes with very high astigmatism, and selected eyes with irregular corneas may also derive meaningful improvement.