Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

Da Young Shin,Ho Sik Hwang,Eun Chul Kim,Man Soo Kim,Hyun Seung Kim

doi:10.1186/s12886-021-01966-8

Abstract

BackgroundThe aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D).Methods We performed a retrospective chart review for patients with corneal astigmatism > 1.5D who underwent cataract surgery and their target refraction is -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.ResultsThe near UCVA of the toric IOL group (0.26 ± 0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48 ± 0.32) (p = 0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). Best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465) did not show significant differences between the toric IOL group and the monofocal IOL group. In the toric IOL group, postoperative refractive astigmatism was − 0.80 ± 0.46D and postoperative corneal astigmatism was − 1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were − 1.65 ± 0.77D and − 1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications.ConclusionsWhen myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

Highlights

The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D)
Patients This study retrospectively reviewed 100 eyes (60 with monofocal IOL; 40 with toric IOL) of 100 patients who underwent cataract surgery with preoperative corneal astigmatism of > 1.5D in Bucheon St
uncorrected visual acuity (UCVA) at a distance improved in both groups after cataract surgery, reaching 0.55 ± 0.22 in the monofocal group and 0.38 ± 0.14 in the toric (Fig. 1)

Summary

Introduction

The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D). Studies conducted in China, Southwest Asia and Europe have reported that 22.1–26.2 % of the population have corneal astigmatism > 1.5 diopters (D) [2,3,4]. Various methods, such as arcuate incision using limbal relaxing incision (LRI) and femtosecond laser, toric intraocular lens (IOL) implantation, and photorefractive keratectomy, have been studied for correction of corneal astigmatism in cataract surgery [5]. It is difficult to simultaneously perform photorefractive keratectomy with cataract surgery, and expensive machines are needed for arcuate incision using femtosecond laser; LRI and toric IOL implantation are usually preferred. Toric lOLs has become the most recommended method for correcting astigmatism in cataract patients

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