Official ESCRS | European Society of Cataract & Refractive Surgeons
Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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Making cataract surgery refractive: eliminating postoperative astigmatism

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Session Details

Session Title: Phakic IOLs

Session Date/Time: Sunday 23/09/2018 | 08:00-10:00

Paper Time: 09:44

Venue: Room A3, Podium 1

First Author: : M.Tetz GERMANY

Co Author(s): :    I. Fischinger                    

Abstract Details


To minimize astigmatism after cataract surgery by means of a new IOL calculator, optimized incision placement and implantation of low diopter toric IOL’s.


Augentagesklinik-Spreebogen, Berlin, Germany


100 eyes with preoperative astigmatism of 1.14±0.51 diopter underwent cataract surgery with implantation of a toric IOL performed by a single experienced surgeon. 50 operations were planned using the new I-O-W-A®-calculator. Personalized surgically induced astigmatism was taken into consideration and intraoperative aberrometry was measured using the intraoperative wavefront analyzer I-O-W-A®(Eyesight&Vision GmbH, Germany) to check accurate IOL positioning and residual astigmatism. Subjective refraction was checked 6 weeks postoperatively. 50 eyes were planed due to a conventional protocol and industry calculator (J&J toric calculator, Envista toric calculator) and served as control group.


Postoperative astigmatism in the group planned using the I-O-W-A® calculator and the I-O-W-A®-wavefront analyzer for intraoperative fine tuning of astigmatism the resulting residual astigmatism was 0.38±0.21 diopter and 0.60±0.44 diopter in the control group which implies a significant improvement as compared to standard industry toric calculators. 90% showed a postoperative astigmatism <0.5 diopter and 100% <0.75 diopter in the I-O-W-A®-group compared to a postoperative astigmatism of 60% <0.5 and 80% <0.75 diopter in the control group. Only 10% of the IOL’s in the I-O-W-A®-group had an intraoperative residual astigmatism > 0.75 D. In such a case the IOL was readjusted.


The presented procedure using this novel personalized IOL calculator and the intraoperative wavefront analyzer I-O-W-A® is practicable and enables the surgeon to check the position of toric IOL’s what allows an accurate elimination of astigmatism. The results are much better than recently published data on toric IOL’s.

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