Surgical and refractive outcomes of cataract surgery with toric intraocular lens implantation at a resident-teaching institution

Abstract

To evaluate the refractive and surgical outcomes of cataract surgery with toric intraocular lens (IOL) implantation performed at a teaching institution. Miami Veterans Affairs Medical Center, Miami, Florida, USA. Retrospective case series. All data were obtained by a retrospective chart review and entered into a standard computerized database for analysis. Main outcome measures included refractive and surgical outcomes after Acrysof toric IOL placement, including the deviation from the expected spherical and cylindrical correction and the incidence of ocular complications. The study comprised 94 eyes (80 patients). The mean deviation from the anticipated spherical correction (94 eyes) was +0.06 diopter (D) ± 0.8 (range -2.6 D to +3.6 D), with 80% of eyes achieving a spherical equivalent within ±1.00 D of the target refraction. The postoperative refractive cylinder was significantly reduced from baseline, with 79% of eyes having at least a 0.50 D improvement in astigmatism after surgery (P<.0005). The mean deviation from the anticipated refractive cylinder (85 eyes) was -0.48 ± 1.2 D (range -5.0 to +2.8 D). The IOL was placed in an incorrect position in 2 patients, requiring a reoperation with IOL rotation into the proper axis. The mean follow-up was 7 months (range 1 to 28 months). The added complexity associated with toric IOL placement resulted in spherical and astigmatic improvements without compromising patient safety beyond a level inherent in resident-based cataract surgery.