Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery

Mendicute, Javier; Irigoyen, Cristina; Ruiz, Miguel Fernández; Illarramendi, Igor; Ferrer-Blasco, Teresa; Montés‐Micó, Robert

doi:10.1016/j.jcrs.2008.11.043

Cited by 155 publications

(132 citation statements)

References 43 publications

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“…Likewise, our results in terms of predictability of refractive correction were also comparable to those reported for other modalities of toric IOLs [5][6][7][8] and in some cases even better. 9,10 Visser et al 9 found that residual refractive astigmatism of -1.00 D or less was achieved in approximately 90% of samples of eyes implanted with a toric multifocal IOL.…”

Section: Discussionsupporting

confidence: 90%

Clinical Outcomes and Capsular Bag Stability of a Four-Point Haptic Bitoric Intraocular Lens

Kretz¹,

Breyer²,

Klabe³

et al. 2015

J Refract Surg

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PURPOSE: To evaluate the visual, refractive, and aberrometric outcomes of a bitoric intraocular lens (IOL) and its stability and alignment within the capsular bag. METHODS:A retrospective study including 41 eyes of 24 patients with preexisting corneal astigmatism of 0.75 diopters or greater undergoing cataract surgery with implantation of the bitoric IOL AT TORBI 709M (Carl Zeiss Meditec, Jena, Germany). Visual and refractive outcomes were evaluated during a 3-month follow-up period. The misalignment between intended and real axis and the levels of corneal, internal, and ocular aberrations (KR-1W; Topcon, Tokyo, Japan) were also evaluated. RESULTS:A total of 76% and 97% of eyes had a postoperative spherical equivalent within ±0.50 and ±1.00 diopters of emmetropia, respectively. Likewise, a total of 86% and 95% of eyes had a postoperative absolute value of refractive cylinder of 0.50 or less and 1.00 or less diopters, respectively. Mean postoperative corrected distance visual acuity was 0.00 logMAR (20/20 Snellen). Mean values of postoperative monocular and binocular uncorrected distance visual acuity were 0.10 and 0.00 logMAR (20/25 and 20/20 Snellen), respectively. The aberrometric analysis confirmed that the magnitude of ocular higher-order aberrations was mainly due to corneal optics and that the corneal astigmatism correction was sufficient with the toric IOL. Mean absolute IOL misalignment was 3.5º with values ranging from 0º to 10º. CONCLUSIONS:The bitoric IOL AT TORBI 709M is able to provide a predictable correction of corneal astigmatism with low postoperative levels of ocular higher-order aberrations.[J Refract Surg. 2015;31(7): 431-436.] new concept of toric intraocular lens (IOL) has been recently developed and released, the bitoric IOL. This type of IOL distributes cylinder power symmetrically on the front and back surface of the IOL, and not only on one surface as with toric IOLs currently available.1 This optical design has the theoretical advantage of obtaining IOLs of better optical quality when high cylinders should be corrected.2 One example of this type of toric IOL is the AT TORBI 709M (Carl Zeiss Meditec, Jena, Germany), which uses bitoric, monofocal, and aspheric (aberration neutral) optics.1 Previous studies have shown excellent visual and refractive outcomes after cataract surgery with implantation of this specific model of IOL.

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Section: Discussionsupporting

confidence: 90%

Clinical Outcomes and Capsular Bag Stability of a Four-Point Haptic Bitoric Intraocular Lens

Kretz¹,

Breyer²,

Klabe³

et al. 2015

J Refract Surg

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“…Alternatively, treatments like selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy (PRK), and laser-assisted in situ keratomileusis (LASIK) all serve as feasible options in correcting astigmatism. [2][3][4][5] There is emerging evidence advocating the use of customized toric intraocular lens (IOL) as a novel approach to correct high post-PK astigmatism. 6,7 Not uncommonly, patients with post-PK astigmatism can also develop cataract in the previously operated eye at the later stage of their lives.…”

Section: Introductionmentioning

confidence: 99%

Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism

Srinivasan

Ting

Lyall

2013

Eye

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Purpose To report visual and refractive outcomes, and endothelial cell loss following primary and secondary 'piggyback' toric intraocular lens (IOL) implantation in patients with high post-penetrating keratoplasty (PK) astigmatism. Methods Prospective case series. Nine eyes of nine patients with post-PK astigmatism were consecutively recruited for implantation of a customized toric IOL. Six underwent simultaneous phacoemulsification (PE) and three pseudophakic eyes had a secondary 'piggyback' toric IOL implanted in the ciliary sulcus. Mean follow-up time was 17.2 ± 7.7 months. Pre-and post-operative uncorrected (UDVA) and best-corrected (BDVA) distance visual acuities and refractive errors were collected for comparison. Cartesian astigmatic vectors were calculated to identify a change in the magnitude of astigmatism precompared to postoperatively. Pre-and postoperative endothelial cell counts were also collected for analysis. Results UDVA (logMAR) improved from 1.13 ± 0.51 preoperatively to 0.48 ± 0.24 postoperatively (P-value ¼ 0.003). There was no significant change in BDVA (P-value ¼ 0.905) from 0.31 ± 0.27 to 0.26 ± 0.19. Corneal astigmatism preoperatively was 6.57 ± 4.40 diopters (D). Post-operative refractive cylinder was 0.83 ± 1.09 D compared to 3.89 ± 4.01 D preoperatively (P ¼ 0.039). Analysis of astigmatic Cartesian x and y coordinates found a significant reduction postoperatively compared to preoperatively (P ¼ 0.005 and P ¼ 0.002), respectively. Mean endothelial cell loss was 9.9%. Conclusion: Implantation of a customized primary or secondary 'piggyback' toric IOL serves as an effective modality in treating patients with high post-PK astigmatism.

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“…Each degree of rotation causes an average loss of cylinder power of approximately 3%; thus, when an IOL rotates 30 degrees there is no astigmatic correction, although there is a change of axis (44,(46)(47)(48)(49)(50)(51)(52)(53)(54)(55) . Articles comparing the use of toric IOL to other astigmatism reducing techniques, such as opposed clear corneal incisions (56) or LRI (57) , are still scanty in number on literature. Slightly advantageous outcomes, favoring toric IOL have been reported (56,57) , but debate on which technique unequivocally offers better results is just at the beginning.…”

Section: B) Non-incisional Approachmentioning

confidence: 99%

“…Articles comparing the use of toric IOL to other astigmatism reducing techniques, such as opposed clear corneal incisions (56) or LRI (57) , are still scanty in number on literature. Slightly advantageous outcomes, favoring toric IOL have been reported (56,57) , but debate on which technique unequivocally offers better results is just at the beginning. Toric IOL may also be employed in conjunction to such techniques aiming further refractive improvements (38) .…”

Section: B) Non-incisional Approachmentioning

confidence: 99%

Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

Freitas¹,

Boteon²,

Carvalho³

et al. 2013

Rev. bras.oftalmol.

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Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery

Abstract: Toric IOL implantation achieved a slight enhanced effect over OCCIs in treating preexisting astigmatism.

Cited by 155 publications

References 43 publications

Clinical Outcomes and Capsular Bag Stability of a Four-Point Haptic Bitoric Intraocular Lens

Clinical Outcomes and Capsular Bag Stability of a Four-Point Haptic Bitoric Intraocular Lens

Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism

Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

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