AcrySof Toric Intraocular Lens Implantation Research Articles

AcrySof Toric IOL Implantation in Phacosurgery in Keratoconus Patient With Cataract

Abstract A 75-year-old diabetic man presented with cataract and keratoconus in both eyes. Ocular examination revealed visual acuity of 6/12 in both eyes through pinhole. The patient was scheduled for phacoemulsification with posterior chamber intraocular lens (IOL) implantation in his right eye. Biometry (IOL Master) of the right eye showed K1 as 46.68 diopters (D) at 82 degrees and K2 as 51 D at 172 degrees (average K, 48.87 D) with an IOL power of +19.5 D. The IOL power was calculated by accessing the following Web site: http://www.acrysoftoriccalculator.com/. The AcrySof Toric IOL recommended was SN60T8 with a spherical equivalent of 19.5 D and a residual astigmatism of +0.26 D at 173 degrees. Owing to nonavailability of T8 Toric IOL, it was converted by the Toric IOL calculator to T5 Toric IOL as SN60T5 (spherical equivalent of +19.5 D and a residual astigmatism of +1.8 D at 173 degrees). The IOL selected was Alcon SN60T5 with +19.5 D and +3.00 D cylinder. The steep axis was 170 degrees, and the location of the incision recommended was 135 degrees. Phacoemulsification was uneventful. At 4 weeks of follow-up, the uncorrected visual acuity and best corrected visual acuity in the right eye were 6/6 partial and 6/6, respectively. No rotation of the IOL was noticed.

Refractive Lens Exchange with Foldable Toric Intraocular Lens

To assess visual and refractive outcomes, and rotational stability after refractive lens exchange (RLE) with toric intraocular lens (IOL) implantation to correct ametropia and preexisting astigmatism. Prospective, nonrandomized, observational case series (self-controlled). This prospective, nonrandomized, and self-controlled study included 32 eyes of 19 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having RLE with AcrySof Toric IOL implantation (Alcon Laboratories Inc, Fort Worth, Texas, USA). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refractive sphere, and keratometric and refractive cylinder were recorded preoperatively and 6 months after surgery. Toric IOL axis shift was also measured. A patient satisfaction, visual phenomena, and spectacle dependency questionnaire was also carried out. At 6 months postoperatively, UCVA was 20/32 or better in 100% of the eyes, with 84.3% achieving 20/25 or better. One hundred percent of eyes achieved 20/25 or better BCVA. No eye lost >or=2 lines, 1 eye lost 1 line, 16 eyes did not change, 4 eyes gained 1 line, and 11 eyes gained >or=2 lines of BCVA after the surgery. Mean refractive cylinder was reduced significantly after surgery from -2.46 +/- 0.99 D to -0.53 +/- 0.30 D (P < .001). Vector analysis to compare attempted vs achieved correction showed that 100% of eyes were within +/- 1.00 D for the spherical equivalent, and 100% of eyes were within +/-0.50 D for the astigmatic components (J(0) and J(45)). Mean toric IOL axis rotation was 0.90 +/- 1.76 degrees, being <or= 5 degrees in 96.8% of eyes evaluated. Patients were satisfied with their vision without reporting severe visual phenomena (from none to moderate). RLE with toric IOL implantation showed good visual and refractive outcomes for correcting spherical and cylindrical refractive errors.

Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery

To compare toric intraocular lens (IOL) implantation with paired opposite clear corneal incisions (OCCIs) for astigmatism correction in patients having cataract surgery. Ophthalmology Service, Donostia Hospital, San Sebastián, Spain. This randomized prospective clinical study comprised eyes with more than 1.00 diopter (D) of preexisting corneal astigmatism. One group had AcrySof toric IOL implantation and the other, paired 2.75 mm/3.20 mm OCCIs in the steep axis with spherical IOL implantation. Uncorrected (UCVA) and best corrected (BCVA) visual acuity, refraction, corneal and total higher-order aberrations (HOAs), photopic and mesopic contrast sensitivity, and toric IOL axis were measured 3 months postoperatively. Forty eyes (40 patients) were evaluated. In the toric group, 95% of eyes achieved 20/40 or better UCVA and 70%, 20/25 or better. In the OCCI group, 80% of eyes achieved 20/40 or better UCVA and 50%, 20/25 or better. All eyes achieved 20/25 or better BCVA. Mean refractive cylinder decreased significantly from preoperatively to postoperatively (-1.75 +/- 0.71 to -0.62 +/- 0.46 D, toric group; -1.61 +/- 0.67 to -0.97 +/- 0.51 D, OCCI group) (P<.01). In the toric group, 95% and 100% of eyes were within +/-0.50 D for J(0) and J(45), respectively. In the OCCI group, the percentages were 70% and 100%, respectively. No significant differences in HOA were found between groups (P>.1). Contrast sensitivity was similar except at the highest spatial frequency, being better in the toric group (P<.01). Toric IOL implantation achieved a slight enhanced effect over OCCIs in treating preexisting astigmatism.

The Clinical Result of AcrySof Toric Intraocular Lens Implantation

Purpose: To evaluate the short-term efficacy of astigmatism correction and rotational stability of AcrySof Toric Intraocular lens (IOL) implants. Method: We analyzed 27 eyes of 23 patients who underwent microcoaxial cataract surgery (MCCS) and AcrySof Toric IOL implantation between March 2008 and July 2008. We evaluated visual acuity, keratometry, and refraction. Slit-lamp retroillumination photographs were obtained in all patients on 1 day, 1 month and 3 months postoperatively. The change of postoperative IOL axis alignment and the presence of anterior capsular shrinkage were analyzed. Result: The mean unaided visual acuity (LogMAR) improved from 1.020.38 to 0.100.12. Although postoperative manual keratometric value was not different from the preoperative value, post-operative astigmatism decreased from a mean value of 1.660.42D to 0.610.38D at 3 months postoperatively. The mean difference between achieved and intended lens axis was 1.632.83 degrees at the first post-operative day, and 1.912.92 degrees on the first postoperative month, with all cases within 10 degrees. There were two cases of IOL rotation between one day and one month postoperative follow-up, and severe anterior capsule contractions were found in them. Conclusions: AcrySof Toric IOL is effective for correction of astigmatism and it has good post-operative rotational stability. Because most of misalignments were found at the postoperative day 1, the precise implantation of IOL, according to the intended axis, can be important during operation and immediately after the operation.

The Use of NIDEK OPD Scan II Wavefront Aberrometry in Toric Intraocular Lens Implantation

To present case examples outlining the use of wavefront aberrometry for toric intraocular lens (IOL) implantation pre- and postoperatively. Twelve eyes that underwent AcrySof Toric IOL (Alcon Inc Laboratories) implantation were assessed pre- and postoperatively using the NIDEK OPD Scan II (NIDEK Co Ltd). Wavefront aberrometry, corneal topography, and objective visual quality were measured using the OPD Scan II with OPD-Station software. The internal and corneal aberrations were evaluated separately to determine whether the source of astigmatism was corneal, internal, or a combination of both. All IOLs were implanted using a 2.75-mm incision. Wavefront aberrometry was used to determine the position of the incision to minimize postoperative astigmatism. The postoperative objective visual quality and wavefront maps were used to determine the effect of residual irregular or regular astigmatism. The OPD Scan II determines whether irregular or regular astigmatism is due to the corneal surface or to the internal aberrations of the eye. The magnitude, type, and location of astigmatism can guide the proper placement of toric IOLs.

Foldable toric intraocular lens for astigmatism correction in cataract patients

To evaluate the results of AcrySof toric intraocular lens (IOL) (Alcon) implantation to correct preexisting astigmatism in patients having cataract surgery. Ophthalmology Service, Donostia Hospital, San Sebastián, Spain. This prospective observational study included 30 eyes of 15 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having cataract surgery. Bilateral implantation of the AcrySof toric IOL was performed after phacoemulsification. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere, residual keratometric and refractive cylinders, and toric IOL axis were measured. The UCVA was 20/40 or better in 93.3% of eyes and 20/25 or better in 66.6%. All eyes achieved 20/25 or better BCVA. The mean refractive cylinder decreased significantly after surgery from -2.34 D +/- 1.28 (SD) to -0.72 +/- 0.43 D (P<.01). Vector analysis of attempted versus achieved correction showed that 100% of eyes were within +/-1.00 D and 80% and 93.9% were within +/-0.50 D for J(0) and J(45), respectively. The mean toric IOL axis rotation was 3.63 +/- 3.11 degrees, with rotation less than 10 degrees in 96.7% of eyes. The results indicate that phacoemulsification and posterior chamber AcrySof toric IOL implantation is an effective option to correct preexisting astigmatism in cataract surgery. The AcrySof toric IOL showed good rotational stability.