Efficacy of toric intraocular lens and prevention of axis misalignment by optic capture in pediatric cataract surgery

Abstract

Purpose: To compare the outcomes of intraocular lens (IOL) implantation using toric (T)-IOL and nontoric (N)-IOL in pediatric cataract patients with astigmatism and to examine the effect of optic capture (OC) on the axis misalignment (AM) of the T-IOLs. Setting: Department of Ophthalmology, Kindai University Hospital, Osaka, Japan. Design: Interventional, comparative case study. Methods: Consecutive pediatric patients implanted with T-IOLs or N-IOLs were retrospectively reviewed. In the T-IOL group, the preoperative and postoperative corrected distance visual acuity (CDVA) and AM were compared in patients with and without OC. Results: The T-IOL group included 14 eyes of 11 patients, whereas the N-IOL group included 22 eyes of 15 patients. One year postoperatively, the mean ocular cylinder (1.38 ± 0.80 diopters [D]) was significantly smaller than the mean corneal cylinder (3.33 ± 1.24 D) in the T-IOL group (P = .00012, Wilcoxon signed-rank test). The mean preoperative and 1-year postoperative CDVA (logMAR) were 0.57 and 0.003 (T-IOL) and 0.71 and 0.09 (N-IOL), respectively. The AM at 1 week and 1 year postoperatively was 2.6 ± 3.7 degrees and 4.4 ± 3.1 degrees for the OC group, and 13.3 ± 8.8 degrees and 18.5 ± 14.8 degrees, for the non-OC group, respectively. The AM was significantly smaller in the OC group than that in the non-OC group (P = .009, Mann-Whitney U test) at postoperative 1 week. Conclusions: T-IOL implantation is effective in correcting astigmatism in pediatric cataract patients with astigmatism, and the OC technique is likely to achieve lower AM of the T-IOL.