Toric intraocular lens implantation in cataract patients with corneal opacity

Abstract

Background: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism.Methods: Thirty-one eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) were statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P < 0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P < 0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R = 0.91 P < 0.05 and R = 0.92 P < 0.05, respectively). Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.

Retrospective Case Series on The Enduring Rotational Stability of The AcrySof IQ Toric Intraocular Lens in Cataract Patients Suffering from Myopia

“…The optical component measures 6 units in diameter, with a total length of 12.0 mm, a spherical power of +6.0-+34.0 D, and a cylindrical power of +1.0-+6.0 D. Due to its hydrophobic acrylate composition, it exhibits durable bonding, thereby improving the structural integrity of the capsular bag. The blue light-blocking effect on the macular of the fundus helps safeguard the macular region of the fundus [12,14] .…”

Toric intraocular lenses: Expanding indications and preoperative and surgical considerations to improve outcomes

“…[ 41 42 ] Stable, non-progressive peripheral corneal scars following etiology such as post-microbial keratitis, post-corneal laceration repair (sparing the central visual axis), post-pterygium excision are other indications where these IOLs have been used. [ 43 ] Pediatric cataract surgery: the use in pediatric cataracts is more an exception rather than a routine recommendation. Phakic toric lenses have been tried in children with high astigmatism with acceptable outcomes to reduce the risk of anisometropic amblyopia.…”

“…Stable, non-progressive peripheral corneal scars following etiology such as post-microbial keratitis, post-corneal laceration repair (sparing the central visual axis), post-pterygium excision are other indications where these IOLs have been used. [ 43 ]…”

Cumulative dissipated energy in eyes with and without corneal opacity

“…This procedure cannot be considered a standard approach for all patients due to the risk of inaccuracy in IOL power calculation, inadequate cortical cleaning, and expulsive haemorrhage [ 2 ]. Additionally, this procedure carries some keratoplasty associated problems including long waiting time for suitable cornea, astigmatism induction, expulsive choroidal haemorrhage, or graft failure [ 3 , 4 ]. Phacoemulsification and IOL implantation may be better options for some cataract patients with corneal opacity depending on localization, size, and severity of the opacity [ 5 , 6 ].…”