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Arcuate incisions (AI) vs Toric lenses: a comparison of long-term results using the Quality Index Bellevue (QIB)

Poster Details

First Author: T.Herbst GERMANY

Co Author(s):    J. Foerster   D. Holland           

Abstract Details


Toric lenses are the main tool for treating astigmatism. Beside toric lenses, arcuate incisions (AI) are an alternative treatment method for correction of astigmatism, which were abandoned by most surgeons due to deficits in predictability and accuracy. With the introduction of the femtosecond laser in cataract surgery, accuracy and predictability of arcuate incisions were significantly improved. This study wants to compare the 6 months post-op medical outcome of arcuate incisions performed with a femtosecond laser to toric lenses with the help of the “Quality Index Bellevue” (QIB), a self-developed measurement index for medical outcome in cataract surgery.


The base for examinations is the “Quality Index Bellevue System”, which transfers each medical finding into a quality index and bases upon the German school grading system. Besides other outcome variables, patient satisfaction, visual acuity as well as refractive errors were compared pre- and postoperatively.


Our choice of statistical methods depends on the level of measurement: For examinations on aggregate levels, we used ANOVA test as well as ordinary t-test. For comparisons of single finding QiBs, we came back to Mann-Whitney-test and Kruskal-Wallis test respectively because of ordinal scale levels. Further possible examinations will be realized by appropriate statistical methods.


We found significant short-term differences for objective QiBs (QIB SEQ, QIB cylinder) in favor of AIs. Furthermore, “QIB cornea” showed slightly difference between both groups in favor of toric lenses. Nevertheless, differences were not found to be significant in the long term. Since our first results base on only 30 cases per group, further results may change due to the ongoing data collection.


Beside toric lenses, arcuate incisions (AI) are possible treatment options for astigmatism corrections. Due to the introduction of femtosecond lasers in cataract surgery, “AI” seem to be a serious alternative to toric lenses because of enhanced accuracy and predictability. The present study compares the medical outcome of toric lenses with those of LRI using the “Quality Index Bellevue”, a measurement index for medical outcome. First results showed significant differences for short-term results. However, corresponding long-term differences showed no significant differences. Since first results base on only 30 cases per group, further results may change due to the ongoing data collection. FINANCIAL DISCLOUSRE: NONE

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