Astigmatism Management with Astigmatism-Correcting Intraocular Lens Using Two Toric Calculators - A Comparative Case Series

Overview

Journal Clin Ophthalmol

Publisher Dove Medical Press

Specialty Ophthalmology

Date 2021 Aug 13

PMID 34385813

Citations 1

Authors

Yu-Te Huang

Chun-Ju Lin

Chun-Ting Lai

Ning-Yi Hsia

Peng-Tai Tien

Henry Bair

Huan-Sheng Chen

Chun-Chi Chiang

Jane-Ming Lin

Wen-Lu Chen

Wen-Chuan Wu

Yi-Yu Tsai

Affiliations

Soon will be listed here.

Abstract

Background: To compare refractive outcomes after phacoemulsification and toric IOL implantation using two different toric calculators for initial astigmatism assessment in a real-world setting.

Methods: This was a retrospective, comparative, interventional case series. Patients over 30-year-old who underwent phacoemulsification and toric IOL implantation (AcrySof Toric IOL) by the same surgeon between 2017 and 2018 were included. Eyes with irregular astigmatism, previous corneal refractive surgery, intraocular surgery, corneal pathology, macular pathology and pupil abnormalities were excluded. IOL toricity was determined by using a calculator provided by the AcrySof Toric calculator before 2018 and Barrett Toric Calculator after 2018. Patient demographics, corneal topography, vector and preoperative and postoperative refraction were collected and analyzed at three months postoperative.

Results: Thirty-two eyes of 32 patients were included in the final analysis. 0.1D for surgically induced astigmatism was used. Group 1 included 14 eyes assessed with the original (AcrySof) toric IOL calculator, and group 2 included 18 eyes assessed with the Barrett toric IOL calculator. In group 1, postoperative astigmatism less than -1.00D, -0.75 D, and -0.5D was achieved in 88.2%, 76.1% and 53.7% of eyes, respectively, while, in group 2, 89% eyes achieved postoperative residual astigmatism less than 0.5D and all eyes achieved postoperative residual astigmatism less than 0.75D. The proportion of patients with lower postoperative astigmatism was significantly higher in Group 2 (p< 0.05 by chi-square test), a pattern that still held when we divided patients into multiple groups. Vector analysis with the Alpins methods also supported better outcomes in the Barrett group (0.71 D vs 0.35 D).

Conclusion: The Barrett Toric calculator resulted in better results in the prediction of residual astigmatism than original (AcrySof) toric calculators.

Citing Articles

Astigmatism Management in Modern Cataract Surgery.

Park R, Aref A Vision (Basel). 2024; 8(1).

PMID: 38535758 PMC: 10975415. DOI: 10.3390/vision8010009.

References

Alpins N . Astigmatism analysis by the Alpins method. J Cataract Refract Surg. 2001; 27(1):31-49. DOI: 10.1016/s0886-3350(00)00798-7. View

Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J . Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery: A Systematic Review and Meta-analysis. Ophthalmology. 2015; 123(2):275-286. DOI: 10.1016/j.ophtha.2015.10.002. View

Ferreira T, Ribeiro P, Ribeiro F, ONeill J . Comparison of astigmatic prediction errors associated with new calculation methods for toric intraocular lenses. J Cataract Refract Surg. 2017; 43(3):340-347. DOI: 10.1016/j.jcrs.2016.12.031. View

Yeu E, Cheung A, Potvin R . Clinical Outcomes of Toric Intraocular Lenses: Differences in Expected Outcomes When Using a Calculator That Considers Effective Lens Position and the Posterior Cornea vs One That Does Not. Clin Ophthalmol. 2020; 14:815-822. PMC: 7083635. DOI: 10.2147/OPTH.S247800. View

Kaur M, Shaikh F, Falera R, Titiyal J . Optimizing outcomes with toric intraocular lenses. Indian J Ophthalmol. 2017; 65(12):1301-1313. PMC: 5742958. DOI: 10.4103/ijo.IJO_810_17. View

Yang J, Zhang H, Yang X, Tian F, Zhao S . Accuracy of corneal astigmatism correction with two Barrett Toric calculation methods. Int J Ophthalmol. 2019; 12(10):1561-1566. PMC: 6796096. DOI: 10.18240/ijo.2019.10.07. View

Gauvin M, Wallerstein A . AstigMATIC: an automatic tool for standard astigmatism vector analysis. BMC Ophthalmol. 2018; 18(1):255. PMC: 6151063. DOI: 10.1186/s12886-018-0920-1. View

Mohammad-Rabei H, Mohammad-Rabei E, Espandar G, Javadi M, Jafarinasab M, Hashemian S . Three Methods for Correction of Astigmatism during Phacoemulsification. J Ophthalmic Vis Res. 2016; 11(2):162-7. PMC: 4926563. DOI: 10.4103/2008-322X.183924. View

Clark K . Toric intraocular lens outcomes with a new protocol for IOL selection and implantation. J Fr Ophtalmol. 2018; 41(2):145-151. DOI: 10.1016/j.jfo.2017.08.007. View

10.

Visser N, Bauer N, Nuijts R . Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg. 2013; 39(4):624-37. DOI: 10.1016/j.jcrs.2013.02.020. View

11.

Goggin M, van Zyl L, Caputo S, Esterman A . Outcome of adjustment for posterior corneal curvature in toric intraocular lens calculation and selection. J Cataract Refract Surg. 2016; 42(10):1441-1448. DOI: 10.1016/j.jcrs.2016.10.004. View

12.

Nunez M, Henriquez M, Escaf L, Ventura B, Srur M, Newball L . Consensus on the management of astigmatism in cataract surgery. Clin Ophthalmol. 2019; 13:311-324. PMC: 6376888. DOI: 10.2147/OPTH.S178277. View

13.

Koch D, Ali S, Weikert M, Shirayama M, Jenkins R, Wang L . Contribution of posterior corneal astigmatism to total corneal astigmatism. J Cataract Refract Surg. 2012; 38(12):2080-7. DOI: 10.1016/j.jcrs.2012.08.036. View

14.

Hashemi H, Fotouhi A, Yekta A, Pakzad R, Ostadimoghaddam H, Khabazkhoob M . Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. J Curr Ophthalmol. 2018; 30(1):3-22. PMC: 5859285. DOI: 10.1016/j.joco.2017.08.009. View

15.

Kane J, Connell B . A Comparison of the Accuracy of 6 Modern Toric Intraocular Lens Formulas. Ophthalmology. 2020; 127(11):1472-1486. DOI: 10.1016/j.ophtha.2020.04.039. View

16.

Lake J, Victor G, Clare G, Porfirio G, Kernohan A, Evans J . Toric intraocular lens versus limbal relaxing incisions for corneal astigmatism after phacoemulsification. Cochrane Database Syst Rev. 2019; 12:CD012801. PMC: 6916141. DOI: 10.1002/14651858.CD012801.pub2. View

17.

Ventura B, Wang L, Weikert M, Robinson S, Koch D . Surgical management of astigmatism with toric intraocular lenses. Arq Bras Oftalmol. 2014; 77(2):125-31. DOI: 10.5935/0004-2749.20140032. View

18.

Pinero D, Caballero M, Nicolas-Albujer J, de Fez D, Camps V . A New Approach for the Calculation of Total Corneal Astigmatism Considering the Magnitude and Orientation of Posterior Corneal Astigmatism and Thickness. Cornea. 2018; 37(6):720-726. DOI: 10.1097/ICO.0000000000001577. View

19.

Davison J, Makari S, Potvin R . Clinically relevant differences in the selection of toric intraocular lens power in normal eyes: preoperative measurement vs intraoperative aberrometry. Clin Ophthalmol. 2019; 13:913-920. PMC: 6551590. DOI: 10.2147/OPTH.S205352. View

20.

Solomon K, Sandoval H, Potvin R . Correcting astigmatism at the time of cataract surgery: Toric IOLs and corneal relaxing incisions planned with an image-guidance system and intraoperative aberrometer versus manual planning and surgery. J Cataract Refract Surg. 2019; 45(5):569-575. DOI: 10.1016/j.jcrs.2018.12.002. View