Managing low corneal astigmatism in patients with presbyopia correcting intraocular lenses: a narrative review

Rocha‐de‐Lossada, Carlos; Rodríguez‐Vallejo, Manuel; Rodríguez‐Calvo‐de‐Mora, Marina; Ribeiro, Filomena; Fernández, Joaquín

doi:10.1186/s12886-023-03003-2

Cited by 5 publications

(1 citation statement)

References 124 publications

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“…EDOF IOLs have also long been considered advantageous over trifocal IOLs in the setting of preexisting eye conditions. They may be indicated over diffractive trifocal IOLs for patients with low (0.5-1 D) astigmatism [23]. Another study found that patients implanted with EDOF IOLs in the setting of preperimetric glaucoma also report good patient satisfaction and favorable visual outcomes, though it did not directly compare EDOFs to multifocals [24,25].…”

Section: Ocular Comorbiditiesmentioning

confidence: 99%

Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation

De la Paz,

Tsai

2023

Current Opinion in Ophthalmology

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Purpose of review Options for addressing presbyopia with intraocular lens (IOL) implantation have become more varied and sophisticated. We reviewed recent literature on multifocal and extended depth of focus (EDOF) IOLs in order to provide insight on their respective advantages, with emphasis on the visual outcomes of each design. Recent findings Increased patient age, spectral domain optical coherence tomography (SD-OCT) abnormalities, abnormal optical axis measurements, and better preoperative visual acuity have been implicated as predictors of worse postoperative vision or visual quality in multifocal IOLs. Despite differences in objective outcomes, patient-reported outcomes such as satisfaction are consistently similar between multifocal and EDOF IOLs. EDOFs may have slightly lower rates of spectacle independence than trifocals, but there is more support for their use in the setting of with other ocular conditions. Summary Multifocal and EDOF IOLs are both viable options for patients who wish to preserve near vision. Given their similar objective performance in many aspects, enabling patients to make informed decisions based on their expectations and visual requirements is critical to postoperative satisfaction. Evidence for advanced technology IOL implantation in pediatric patients remains inconclusive.

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Section: Ocular Comorbiditiesmentioning

confidence: 99%

Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation

De la Paz,

Tsai

2023

Current Opinion in Ophthalmology

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Cost-effectiveness of low-astigmatism correction with toric or spherical intraocular lenses combined with corneal incisions: an economic evaluation

Ginel,

Rodríguez-Vallejo,

Piñero

et al. 2024

J Cataract Refract Surg

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Purpose: To assess the cost-effectiveness of the treatment of low corneal astigmatism (≤1.5 D) at the moment of the cataract surgery. Setting: (“Masked by journal requirement”) Design: Economic Evaluation. Methods: A decision tree was used to assess the cost-effectiveness of implanting spherical versus toric intraocular lenses (IOLs) or the spherical lens combined with the following corneal incisions: limbal relaxing incisions conducted manually (M-LRI) or assisted by femtosecond laser (F-LRI), arcuate keratotomies conducted manually (M-AK) or assisted by femtosecond (F-AK), and intrastromal arcuate keratotomies (F-iAK). Outcomes of cost were selected from a patient’s perspective considering the gross cost of each one of the surgeries at European centers, and the effectiveness variable was the probability of achieving a visual acuity of 20/20 after surgery. A sensitivity analysis was conducted to assess the uncertainty considering the evidence retrieved from the transition probabilities of the model, the effectiveness, and the cost. Results: F-AK or Toric IOLs were the most effective treatments, increasing an 16% or 9%, respectively, in the percentage of eyes attaining 20/20 vision. The M-LRI, F-iAK, and F-LRI procedures were strongly dominated, while the M-AK and toric IOL were weakly dominated by the F-AK. A patient with low corneal astigmatism would need to be willing to pay 360€ [CI 95%: 231-1224] with F-AK and 472€ [CI 95%: 149-4490] with toric IOLs for a 10% increase in the probability of achieving 20/20 vision. Conclusions: From the patient’s perspective, F-AK was generally the most cost-effective treatment, even though toric IOLs can dominate in some countries.

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A comparison of operating room toric placement tools: CALLISTO eye vs. e Wavetec AnalyzOR (CORTCO)

Scott

2024

BMC Ophthalmol

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Background To evaluate procedure times for two cataract planning systems (ZEISS CALLISTO eye and the Wavetec AnalyzOR) in predicting residual astigmatism (prediction error) and other visual outcomes in patients with corneal astigmatism (maximum allowable up to 3.0D) at postoperative month 1. Methods This was a prospective, single center, parallel treatment group, bilateral and unilateral, randomized, 1-month study on patients scheduled to undergo routine, small-incision cataract surgery with a toric intraocular lens implantation. Both groups underwent preop measurements with the IOLMaster 700 (Zeiss, Jena, Germany) and surgery with the LenSx device (Alcon). Lens selection in the CALLISTO eye group was based on Zeiss VERACITY Surgery Planner (a web-based tool) and on the Wavetec AnalyzOR component of the ORA system (a real-time intraoperative aberrometer) for those eyes in the ORA group. All procedure and intraoperative times were measured with a stopwatch. Postoperative visual outcomes were evaluated between 1 and 2 months after surgery. Results There were 23 eyes in the CALLISTO group and 28 eyes in the ORA group. The mean surgical time for the CALLISTO group was 28.09 ± 1.72 min compared to 34.41 ± 1.52 min for the ORA group (P = 0.01). Toric lens placement mean time in the CALLISTO group was 2.47 ± 0.34 min compared to 3.88 ± 0.29 min in the ORA group (P = 0.0034). At month 1 postoperatively, the manifest refractive spherical error (MRSE) in the CALLISTO eye group 0.022 ± 0.388 diopters (D) compared to -0.174 ± 0.322 D in the ORA group; these were not statistically different. There was a higher percentage (75%) of eyes with an MRSE within 0.25D in the ORA group compared to the CALLISTO eye group (56.5%); at all other levels outcomes were numerically higher in the CALLISTO eye group. Conclusions Less surgical time was needed when using the CALLISTO eye than the ORA when performing cataract surgery with toric lens implantation. There were similar visual outcomes between the groups and no statistical differences.

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Managing low corneal astigmatism in patients with presbyopia correcting intraocular lenses: a narrative review

Cited by 5 publications

References 124 publications

Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation

Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation

Cost-effectiveness of low-astigmatism correction with toric or spherical intraocular lenses combined with corneal incisions: an economic evaluation

A comparison of operating room toric placement tools: CALLISTO eye vs. e Wavetec AnalyzOR (CORTCO)

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