Toric IOL in Combined DMEK and Cataract Surgery

Trindade, Bruno Lovaglio Cançado; Garcia, Julia Costa; Nogueira, Laila Rahme

doi:10.2147/opth.s293086

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…The results of this study are consistent with those of short-term clinical studies of Toric IOL [15][16][17] .…”

Section: Discussionsupporting

confidence: 90%

Long-term rotationalstability of AcrySof IQ Toric intraocular lens in cataract patients with myopia: a retrospective case series study

Luo

Liu

2023

Preprint

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Purpose To investigate the long-term rotational stability of AcrySof IQ Toric intraocular lens (IOL) in cataract patients with myopia. Methods Retrospective case series study. In total, 120 eyes of 78 cataract patients with axial length (AL) 24–30 mm, corneal astigmatism ≥ 1.50 D and implantation of AcrySof IQ Toric IOL guided by the Version navigation system were collected. According to the AL, they were assigned to two groups: group A, 60 eyes with high myopia (AL ≥ 26 mm); group B, 60 eyes with low to moderate myopia (24 mm ≤ AL < 26 mm). The preoperative eye axis, best-corrected distance visual acuity (BCDVA), corneal astigmatism, IOL rotation at 24–48 months after operation, the proportion of eyes with IOL rotation less than 5° and 10°, rotation direction and residual astigmatism were recorded. Results The mean follow-up period was 34.27 ± 4.98 months and the mean rotation degree was 2.73 ± 1.29°. The rotation degree of Group A (2.87 ± 1.31°) was slightly higher than that of Group B (2.59 ± 1.27°), with no statistical significance (P > 0.05). There was no significant difference in IOL rotation between the two groups at 24–36 months or 36–48 months postoperation (P > 0.05). The ratio of rotation ≤ 5° was 98.22%, with no patients with a rotation > 10°. The postoperative BCDVA was 0.13 ± 0.03 LogMAR, which was significantly higher than that preoperation (X2 = 76.79, P < 0.05). The mean corneal astigmatism preoperation was 2.17 ± 1.08 D, while the residual astigmatism postoperation was 0.41 ± 0.26 D, which was statistically significantly lower (t = 4.281, P < 0.05). Conclusion AcrySof Toric IOL can effectively correct corneal astigmatism in cataract patients with myopia and has good long-term rotational stability.

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“…The results of this study are consistent with those of short-term clinical studies of Toric IOL [15][16][17] .…”

Section: Discussionsupporting

confidence: 90%

Long-term rotationalstability of AcrySof IQ Toric intraocular lens in cataract patients with myopia: a retrospective case series study

Luo

Liu

2023

Preprint

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“…However, the degree of rotation was not significantly different between the two groups at 24-36 months and 36-48 months post-surgery (P > 0.05). The findings of this research aligned with the outcomes of the brief-term clinical investigation on Toric IOL [18][19][20] .…”

Section: Discussionsupporting

confidence: 71%

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

Luo,

Liu,

Wang

et al. 2024

JCNR

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Objective: To analyze the enduring rotational steadiness of AcrySof IQ Toric intraocular lens (IOL) in cataract patients suffering from myopia in a long-term study. Methods: A retrospective study was conducted on a case series involving 78 patients. A total of 120 eyes with an axial length (AL) ranging from 24–30 mm and corneal astigmatism ≥ 1.50 D underwent implantation of AcrySof IQ Toric IOL guided by the version navigation system. The eyes were divided into two groups based on AL. Group A included 60 eyes with high myopia (AL ≥ 26 mm), while Group B consisted of eyes with low to moderate myopia (24 mm ≤ AL < 26 mm). Data on the preoperative AL were collected. Measurements were taken for residual astigmatism, the best corrected visual acuity (BCDVA), corneal astigmatism, and IOL rotation occurring between 24- and 48-months post-surgery. The percentage of eyes with an IOL rotation of under 5° and 10° was analyzed. Results: The mean length of follow-up times was recorded as 34.27 ± 4.98, and the average rotation was 2.73 ± 1.29°. Group A exhibited a slightly higher average rotation of 2.87 ± 1.31°, compared to the rotation of 2.59 ± 1.27° observed in Group B. At both the 24–36 month and 26–48 month post-operation marks, the degree of IOL rotation did not show a statistically significant difference between the two groups, with none of the patients experiencing a rotation exceeding 10° (P > 0.05). The percentage of rotation degrees under 5° was recorded as 98.22%. After the procedure, the BCDVA was 0.13 ± 0.03 LogMAR. There was a substantial increase in the χ2 value after the operation as compared to the pre-operative χ2 value (χ2 = 76.79). The standard deviation of preoperative corneal astigmatism was statistically significant (P < 0.05) at 2.17 ± 1.08 D. Following the surgical procedure, the remaining astigmatism was measured at 0.41 ± 0.26 D. The data showed a notable gap in statistical significance (t = 4.281, P < 0.05). Conclusion: The AcrySof Toric IOL was a reliable solution for managing corneal astigmatism in cataract patients with myopia, demonstrating excellent long-term rotational stability.

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“…Die charakteristischen Trübungen auf der Linsenvorderfläche, die nicht durch eine YAG-Laser-Behandlung entfernt werden können, können in seltenen Fällen zu einer deutli-chen Sehminderung führen, die einen Linsenaustausch notwendig werden lassen kann. Im Hinblick auf die Verwendung von torischen [40] oder Presbyopie-korrigierenden Linsen [41] gibt es bisher in der Literatur nur wenige Machbarkeits-Fallberichte. Grundsätzlich sollte der Einsatz derartiger Kunstlinsen wohl überlegt werden, da es im Falle einer kombinierten Operation beim Einsatz von torischen Linsen durch die Manipulationen während der Transplantation zu einer Rotation der Kunstlinse im Kapselsack kommen kann, die unter der Luftfüllung der Vorderkammer oft nur schlecht korrigiert werden kann.…”

Section: Perioperative üBerlegungenkombinierte Operationunclassified

“…In rare cases, characteristic opacities on the anterior surface of the lens which cannot be removed by YAG laser treatment can lead to significantly reduced visual acuity, making it necessary to replace the lens. With regard to the use of toric lenses [40] or presbyopia-correcting lenses [41], there are very few feasibility case studies in the literature. In principle the use of such artificial lenses should be carefully considered, because in a combined surgery using a toric lens, manipulation during transplantation can cause the artificial lens to become rotated inside the lens capsule, which is often difficult to correct when the anterior chamber is filled with air.…”

Section: Perioperative Considerationscombined Surgerymentioning

confidence: 99%

Kataraktoperation beim Vorliegen einer Fuchs-Endotheldystrophie

Maier

Reinhard

2022

Klin Monbl Augenheilkd

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ZusammenfassungBei Betroffenen mit einer Fuchs-Endotheldystrophie beginnen die Probleme mit den Augen häufig in einem Alter, in dem sich auch schon erste Anzeichen einer Katarakt zeigen. Und umgekehrt findet man in der augenärztlichen Praxis immer wieder Patient*innen mit einer deutlichen Katarakt und einer Cornea guttata als Nebenbefund. In beiden Situationen stellt sich dann die Frage, ob zunächst nur eine posteriore lamelläre Keratoplastik (in Deutschland meist als DMEK) bzw. nur eine Kataraktoperation erfolgen oder ob gleich ein kombiniertes Vorgehen (sog. Triple-Operation) angestrebt werden sollte. Nur bei jungen Betroffenen mit einer fortgeschrittenen Fuchs-Endotheldystrophie ohne jeglichen Hinweis auf eine Katarakt und gut erhaltener Akkommodation kann, je nach individuellen Gegebenheiten, eine alleinige DMEK sinnvoll sein, in allen anderen Fällen erscheint eine Triple-Operation geeigneter. Dabei erscheint ein sequenzielles Vorgehen in diesen Situationen weniger angebracht, da sich in zahlreichen Studien zeigte, dass der Verlauf und die Ergebnisse nach einer Triple-Operation mit denen nach einem sequenziellen Vorgehen vergleichbar sind. Beim Vorliegen einer signifikanten Katarakt und einer Cornea guttata fällt die Entscheidung im Hinblick auf das operative Vorgehen deutlich schwerer. Hierbei gibt es unterschiedliche Aspekte in der Anamnese sowie den ophthalmologischen Untersuchungen (z. B. zentrale Hornhautdicke, Endothelzelldichte), die einem bei der Entscheidung helfen können. Soll dann zunächst nur eine Kataraktoperation erfolgen, sollten geeignete Maßnahmen ergriffen werden, um ein möglichst optimales Ergebnis trotz Vorliegen der Cornea guttata zu erreichen. Im folgenden Beitrag soll auf die wichtigsten prä-, peri- und postoperativen Aspekte im Hinblick auf die bestmögliche operative Versorgung von Betroffenen mit Fuchs-Endotheldystrophie und Katarakt eingegangen werden.

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Toric IOL in Combined DMEK and Cataract Surgery

Cited by 7 publications

References 19 publications

Long-term rotationalstability of AcrySof IQ Toric intraocular lens in cataract patients with myopia: a retrospective case series study

Long-term rotationalstability of AcrySof IQ Toric intraocular lens in cataract patients with myopia: a retrospective case series study

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

Kataraktoperation beim Vorliegen einer Fuchs-Endotheldystrophie

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