Clinical outcomes with toric intraocular lenses planned using an optical low coherence reflectometry ocular biometer with a new toric calculator

Abstract

PurposeTo prospectively evaluate postoperative clinical outcomes with implantation of toric intraocular lenses (IOLs) using preoperative keratometry from an optical low coherence reflectometry (OLCR) ocular biometer (Lenstar® LS900) and the built-in Barrett toric calculator.Patients and methodsA prospective observational study recruited one or both eyes of subjects who underwent uncomplicated cataract surgery with toric IOL implantation using OLCR biometery data and the Barrett toric IOL calculator for toric IOL planning. Data were collected at the preoperative, operative, 1-day and 2-month postoperative visits. The primary outcome measure was the manifest refractive astigmatism magnitude at 2 months. The secondary outcome measures included the manifest refraction, corneal keratometry, and distance visual acuity (corrected and uncorrected). The results obtained with the Barrett toric calculator were compared with simulated results based on the toric calculators designed for the IOLs being used.ResultsData from 98 eyes of 54 subjects were available for analysis. In the 74 eyes with postoperative lens orientation as planned, and sufficient IOL cylinder power to correct subjects’ measured astigmatism, 77% of eyes (57/74) had 0.5 diopter (D) or less refractive cylinder 2 months postoperatively, while 89% (66/74) had 0.75 D or less. Simulated results after adjusting actual IOL orientation to the planned orientation suggested that the Barrett calculator would result in postoperative residual astigmatism about 0.2 D lower than that expected with standard calculators.ConclusionUse of the Barrett toric calculator with biometry data from the Lenstar LS900 biometer for toric IOL planning in a clinical setting resulted in significantly lower levels of residual refractive cylinder than might be expected with standard calculators. Postoperative lens orientation and variability in the measurement of corneal astigmatism pre- and postoperatively appear to be important limiting factors in toric IOL outcomes.

Patient outcomes following implantation with a trifocal toric IOL: twelve-month prospective multicentre study

“…Höhn et al [12] obtained a mean UIVA of 0.00 logMAR at 12 months after the implantation of the AT LISA trifocal toric IOL. The data presented demonstrate the visual superiority at intermediate distances of the AT LISA tri toric 939MP IOL compared to bifocal toric IOLs [9, 17, 22]. Marques and colleagues [17] found, at 6 months post implantation of a diffractive bifocal IOL, a mean UIVA of 0.18 ± 0.09 logMAR and Shimoda et al [22] reported a mean UIVA of 0.20 ± 0.09 at 70 cm at 3 months post implantation of another bifocal diffractive toric IOL.…”

Face and content validation of Phacoemulsification Techniques Related To Surgically Induced Astigmatism questionnaire

“…SIA has been emphasized in previous studies as it leads to better visual performance and satis- (Gundersen and Potvin, 2016;Srivannaboon and Chirapapaisan, 2017;Clark, 2018) . The surgical technique is an established factor that in luences SIA (Kawahara et al, 2013;Kwon et al, 2014;Chang et al, 2015;Nikose et al, 2018) .…”

<p>Distribution and related factors of corneal regularity and posterior corneal astigmatism in cataract patients</p>

“…But facts show that although the value is small, it is not a fixed value, that is, the distribution of PCA cannot be inferred only by measuring the asphericity of the anterior corneal surface 21–23. Disregarding PCA potentially underestimates ATR astigmatism (ATRA) and overestimates WTR astigmatism (WTRA), and owing to the posterior surface’s predominant WTR shape that affects the ATRA power, thus correspondingly yield an under-corrected ATRA and over-corrected WTRA 7,10,24,25. The measurement errors of corneal refractive power and astigmatism before cataract surgery will lead to inaccurate IOL degree in surgery.…”

“…Koch et al found TCA value is affected by PCA (average-0.3D) 8. PCA potentially decreased TCA in with-the-rule (WTR) astigmatism cases or increased it, as observed in against-the-rule (ATR) cases1,8–10; discounting PCA could result in miscalculated astigmatism, as in WTR cases overestimated by 0.5–0.6D and ATR underestimated by about 0.2–0.3D 5. A 7.4°±10.3° axis error has also been documented, reportedly caused by ignoring PCA 11.…”