Abstract

BackgroundA major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with long axial length (AL). In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long AL and identify factors influencing their early-stage stability with preoperative corneal astigmatism.MethodsThe study population consisted of 64 eyes from 52 cataract patients, and these patients had preoperative corneal astigmatism between 1.0 and 3.7 diopters (D) and underwent phacoemulsification and TECNIS toric IOL implantation. Ophthalmic biological measurements were carried out preoperatively, including AL, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), anterior chamber volume (ACV), sulcus-to-sulcus (STS) and keratometric value (K). Clinical examinations, including visual acuity, manifest refraction, keratometry, digital anterior segment photographs with pupillary dilation, were performed at 1 and 3 months after surgery.ResultsThe mean best corrected distance visual acuity (BCDVA) was improved from 0.93 ± 0.35 logarithms of the minimal angle of resolution (logMAR) preoperatively to 0.07 ± 0.10 logMAR postoperatively at 3 months after surgery. The mean residual astigmatism (RAS) was 0.91 ± 0.74D at 3 months, which was significantly decreased compared with the preoperative corneal astigmatism of 1.71 ± 0.55 D. The mean absolute rotation of TECNIS toric IOL at 1 and 3 months was 7.42 ± 11.32 degree (°) (0–79°) and 7.48 ± 11.19°(0–79°), respectively. The mean area of capsulorhexis and the overlapped area between capsulorhexis and IOL optic intraoperatively was 21.04 ± 3.30 mm2 and 7.40 ± 2.87 mm2.A positive correlation was found between IOL rotation and the area of capsulorhexis (p = 0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (p = 0.876), ACD (p = 0.387), LT (p = 0.523), VL (p = 0.546), ACV (p = 0.480), STS (p = 0.884), K1 (p = 0.429), K2 (p = 0.644), average of K1 and K2 (p = 0.520), intraoperative IOL axial direction (p = 0.396), preoperative corneal astigmatism (p = 0.269) or the overlapped area between capsulorhexis and IOL optic intraoperatively (p = 0.131) .ConclusionsThe large CCC was a risk factor for toric IOL rotation. An appropriately smaller sized CCC was conducive to increase the rotational stability of TECNIS toric IOL implantation in cataract cases with long AL.

Highlights

  • A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with long axial length (AL)

  • Patients with longer AL tend to have bigger capsular bags than those with emmetropia or hypermetropia [5, 6]. It indicates that larger capsular bags may reduce the equatorial friction for a given IOL, and thinner IOL may increase the gap between the optical component and the posterior capsule [7], leading to decreased IOL stability

  • We focused the toric IOL rotation of cataract patients with long AL eye and aimed to assess the correlation between boimetric measurements and rotational stability of TECNIS toric IOL implantation in cataracts with long AL

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Summary

Introduction

A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with long axial length (AL). We aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long AL and identify factors influencing their early-stage stability with preoperative corneal astigmatism. Patients with long axial length (AL) who have undergone cataract surgery and had IOL implantation may be willing to decrease myopia and residual astigmatism (RAS). We focused the toric IOL rotation of cataract patients with long AL eye and aimed to assess the correlation between boimetric measurements and rotational stability of TECNIS toric IOL implantation in cataracts with long AL. We attempted to identify the potential factors influencing the rotational stability at early stage after surgery

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