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Routine use of 1 D toric vs spherical IOLs in phacoemulsification

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Session Details

Session Title: Rotational Stability & Outcomes

Session Date/Time: Monday 24/09/2018 | 14:30-16:00

Paper Time: 14:52

Venue: Room A4

First Author: : R.Bellucci ITALY

Co Author(s): :    A. Panico   M. Cargnoni                 

Abstract Details


Most of the eyes scheduled for cataract surgery have 0.5 D or more of corneal astigmatism, that is maintained after surgery. In addition, many eyes with corneal astigmatism do not receive toric IOLs because of the burden of this service in busy practices. This study investigates the possibility of using 1-D toric IOLs (Perfector, Hanita lenses) – that produce about 0.65 D of astigmatism at the spectacle plane - in every eye at cataract surgery, regardless the amount of corneal astigmatism. A group of patients implanted with spherical IOLs in the same period was used for comparison.


Vista Vision Cataract and Refractive Surgical Centre, Verona, Italy


Two groups of 30 patients/eyes were considered, of the same age, with no selection as for corneal astigmatism. To take care of posterior corneal astigmatism, the 2.2 mm main incision was located - and the toric IOL was aligned - vertically when 90° astigmatism was 0.75 D or higher, and horizontally when it was 0.5 D or lower. One month postoperatively we measured automated and clinical refraction, uncorrected and corrected visual acuity, and corneal topography. IOL alignment was assessed at the slit lamp under mydriasis.


Corneal astigmatism did not change with surgery. Postoperatively, refractive astigmatism was lower in the toric group (0.73±0.44 D vs. 1.12±0.61 D, P = 0.0062) with partial compensation of corneal astigmatism. Refractive astigmatism was higher than topographic astigmatism in 23% of toric implanted eyes and in 50% of spherical implanted eyes. In eyes with preoperative corneal astigmatism lower than 1 D, the postoperative refractive astigmatism was similar in the two groups. Uncorrected visual acuity was 0.16±0.07 LogMAR in the toric eyes, and was 0.21±0.08 LogMAR in the spherical eyes (P = 0.0126).


When properly aligned, intraocular lenses with 1 D of toricity were of advantage over spherical lenses in eyes with corneal astigmatism above 1 D, and caused no harm in eyes with corneal astigmatism lower than 1 D. A nomogram was obtained out of this preliminary study.

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