Comparison of Toric Intraocular Lenses and Arcuate Corneal Relaxing Incisions to Correct Moderate to High Astigmatism in Cataract Surgery.

Abstract

To compare toric intraocular lens (IOL) implantation with arcuate corneal relaxing incisions for moderate to high corneal astigmatism during cataract surgery. A retrospective comparison study. This 12-month single-surgeon study compared eyes with cataract and preexisting astigmatism of 1.75 diopters (D) or greater (range, 1.75-5.25 D) receiving corneal arcuate relaxing incisions or toric IOL implantation. Main outcome measures were visual acuity, refractive results, and IOL axis determination. There were 45 and 20 eyes in the toric IOL and arcuate incision groups, respectively. Preoperative data were not significantly different between the 2 groups; the mean preoperative astigmatism was 2.16 ± 0.93 D in the toric IOL group and 2.41 ± 0.76 D in the incisional group. At 6 months postoperatively, the mean residual astigmatism was 0.75 and 1.33 D (P = 0.000), respectively; 82.2% and 44.4% of eyes were 1.00 D or less (P = 0.000), and 35.7% and 16.7% of eyes were 0.50 D or less (P = 0.000), respectively. Uncorrected distance visual acuity improved in both groups; eyes in the toric IOL group were more likely to be 20/30 or better (87% vs 29%, P = 0.008). Following surgery, all eyes had best corrected visual acuity of 20/40 or greater, and no eye lost a line of vision. The mean toric IOL rotation was 2.6 ± 1.7 degrees (range, 0-6 degrees). Both toric IOLs and arcuate corneal incisions reduce moderate to high preexisting corneal astigmatism during cataract surgery; however, toric IOL implantation was more effective and predictable.