AcrySof Toric Intraocular Lens Research Articles

Retrospective Case Series on The Enduring Rotational Stability of The AcrySof IQ Toric Intraocular Lens in Cataract Patients Suffering from Myopia

Objective: To analyze the enduring rotational steadiness of AcrySof IQ Toric intraocular lens (IOL) in cataract patients suffering from myopia in a long-term study. Methods: A retrospective study was conducted on a case series involving 78 patients. A total of 120 eyes with an axial length (AL) ranging from 24–30 mm and corneal astigmatism ≥ 1.50 D underwent implantation of AcrySof IQ Toric IOL guided by the version navigation system. The eyes were divided into two groups based on AL. Group A included 60 eyes with high myopia (AL ≥ 26 mm), while Group B consisted of eyes with low to moderate myopia (24 mm ≤ AL < 26 mm). Data on the preoperative AL were collected. Measurements were taken for residual astigmatism, the best corrected visual acuity (BCDVA), corneal astigmatism, and IOL rotation occurring between 24- and 48-months post-surgery. The percentage of eyes with an IOL rotation of under 5° and 10° was analyzed. Results: The mean length of follow-up times was recorded as 34.27 ± 4.98, and the average rotation was 2.73 ± 1.29°. Group A exhibited a slightly higher average rotation of 2.87 ± 1.31°, compared to the rotation of 2.59 ± 1.27° observed in Group B. At both the 24–36 month and 26–48 month post-operation marks, the degree of IOL rotation did not show a statistically significant difference between the two groups, with none of the patients experiencing a rotation exceeding 10° (P > 0.05). The percentage of rotation degrees under 5° was recorded as 98.22%. After the procedure, the BCDVA was 0.13 ± 0.03 LogMAR. There was a substantial increase in the χ2 value after the operation as compared to the pre-operative χ2 value (χ2 = 76.79). The standard deviation of preoperative corneal astigmatism was statistically significant (P < 0.05) at 2.17 ± 1.08 D. Following the surgical procedure, the remaining astigmatism was measured at 0.41 ± 0.26 D. The data showed a notable gap in statistical significance (t = 4.281, P < 0.05). Conclusion: The AcrySof Toric IOL was a reliable solution for managing corneal astigmatism in cataract patients with myopia, demonstrating excellent long-term rotational stability.

Scleral Fixation of a Single-Piece AcrySof Toric Intraocular Lens: A Case Report

Purpose: To describe a simple and least invasive surgical method of transscleral fixation of a dislocated single-piece AcrySof® toric intraocular lens (IOL).Case summary: A 62-year-old male was referred with dislocated toric IOL (SN6AT4, AcrySof® IQ Toric; Alcon Laboratories, Fort Worth, TX, USA) in his right eye after an uneventful cataract surgery. Scleral fixation using the toric IOL was performed by placing the suture knot at the optic-haptic junction right beside the toric axis markings which easily achieved the desired positioning of the axis. The preoperative uncorrected distance visual acuity was 20/400 and it improved to 20/60 at 1 week after repositioning of the IOL and the IOL was well-centered with its toric alignment within 5 degrees of the intended axis.Conclusions: Transscleral fixation of single-piece AcrySof toric IOLs is easy to learn technique, which reduces surgical time with minimal manipulation and enables IOL stability with good postoperative toric axis alignment.

Simple Technique for Stabilizing Toric Intraocular Lens during Removal of Ophthalmic Viscosurgical Device

Introduction: The aim of this study was to describe a simple technique for the implantation of toric intraocular lenses (IOLs) with increased stability during ophthalmic viscosurgical device (OVD) removal. Methods: The technique was performed on 20 eyes with 20 patients (mean age: 77.9 ± 9.21 years). The patients had cataract surgery with implantation of a single-piece, acrylic IOL (AcrySof Toric IOL, SN6A; Alcon Laboratories, Inc.). The intraoperative IOL rotation during OVD removal, rotational error of toric IOL axis at 30 min and 24 h after surgery, and mean preoperative and postoperative IOP were evaluated. Images were captured before and after removal of OVD from surgical video, and used to evaluate intraoperative IOL rotation. Results: The mean amount of IOL rotation during OVD removal with the current technique was 0.88 ± 0.93°, which was less than the 10.25 ± 5.50° previously reported for the conventional technique. The rotational error of toric IOL axis at 30 min and 24 h were 3.90 ± 3.71 and 3.05 ± 3.22°, respectively. The mean preoperative IOP and postoperative IOP were 13.84 ± 2.39 and 14.15 ± 4.68 mm Hg, respectively. Conclusions: With the current technique, the toric IOL is stable during OVD removal and repositioning of the IOL during surgery is less likely to be required.

Comparison of Visual Outcomes Between Toric Intraocular Lenses and Clear Corneal Incisions to Correct Astigmatism in Image-Guided Cataract Surgery.

PurposeTo compare the astigmatism correction effects of toric intraocular lenses (IOL) and clear corneal incisions during image-guided cataract surgery.MethodsAll patients with regular corneal astigmatism of 0.75–1.5 D underwent cataract surgery and astigmatism correction using the Callisto eye image-guided system. One group had implantation of an AcrySof toric IOL. Another group had implantation of aspheric IOL with 3.0 mm single clear corneal incision (SCCI) on the steep axis. Uncorrected and best-corrected spectacle visual acuity, refraction, and toric IOL axis were evaluated at 1, 4, and 12 weeks postoperatively.ResultsSixty-eight eyes of 68 patients were included. The mean residual refractive cylinder was 0.34 ± 0.40 D in the toric group and 0.64 ± 0.57 D in the SCCI group. There were no significant differences in residual refractive cylinder, spherical equivalent, uncorrected distance visual acuity (UDVA), and best-corrected spectacle visual acuity (BCSVA) between groups. The percentage of the residual cylinder within ± 0.50 D was 75 and 56% for toric and SCCI cases, respectively (p > 0.1). The mean surgical induced astigmatism vector was 0.61 ± 0.29 D in the SCCI group and 1.04 ± 0.38 D in the toric group. The mean magnitude of error was negative (−0.54 ± 0.48 D) and the correction index was <1.0 (p < 0.05) in SCCI group. At 3 months, all toric IOL alignment errors were within 5 degrees from the intended axis.ConclusionsBoth toric IOL and SCCI can correct low and medium astigmatism effectively with the help of a precise image-guided system.

Comparison of clinical outcomes of astigmatic correction using toric intraocular lens

AIM: To compare the clinical effects of two brands of Toric intraocular lens used in surgical correction of cataract with corneal astigmatism. METHODS: Totally 35 patients (50 eyes) with corneal astigmatism who underwent ophthalmic surgery from April 2019 to July 2019 were retrospectively analyzed. Among them, 25 eyes of 20 patients were implanted with Rayner 623T, while 25 eyes of 15 patients with Alcon AcrySof Toric intraocular lens (IOL). Three months after surgery, the uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), residual astigmatism, rotational degree of intraocular lens, contrast sensitivity, objective visual quality and the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) scale score were compared. Vector analysis was performed using the Alpins method. RESULTS: The mean postoperative UCDVA and BCDVA (logMAR) in the Rayner group were 0.17±0.20 and 0.08±0.15, respectively (P&gt;0.05), while those in the Alcon group were 0.21±0.16 and 0.10±0.11, respectively (P&gt;0.05). The mean residual astigmatism in the Rayner group was -0.57±0.24 D while that in the Alcon group was -0.50±0.28 D (P&gt;0.05). There was no statistically significant difference between the two groups in IOL rotational stability, vector analysis parameters, contrast sensitivity and objective visual quality (P&gt;0.05). The NEI VFQ-25 scale score was 85.16±5.91 in the Rayner group while it was 82.08±6.16 in the Alcon group (P&gt;0.05). CONCLUSION: The two brands of toric intraocular lens-Rayner 623T and Alcon AcrySof toric show no significant difference in their clinical outcomes.

Comparison of rotational stability and repositioning rates of 2 presbyopia-correcting and 2 monofocal toric intraocular lenses.

To compare the rotational stability of 2 commonly used toric presbyopia-correcting (PC) intraocular lenses (IOLs) and their monofocal toric counterparts. Single 2-surgeon private practice. Retrospective study. This study included 2 cohorts: (1) all eyes receiving a toric ReSTOR (n = 61 eyes, 49 patients) or toric Symfony (n = 779 eyes, 520 patients) IOL from September 2016 to January 2019; and (2) all eyes receiving an AcrySof (n = 2 393) or TECNIS (n = 731) monofocal toric IOL (TIOL) from April 2015 to January 2019. Eyes were only excluded if digital marking could not be used. All patients had image-guided digital marking to verify TIOL position at the conclusion of surgery. Postoperative rotation was determined by dilated examination performed later on the day of surgery or the following morning. The toric ReSTOR IOL was more likely to rotate 5 degrees or less than the toric Symfony IOL, 91.8% vs 79.0% (P = .01). This remained true for rotation of 10 degrees or less (100% vs 89.5%, P < 0.003). The mean rotation was 2.3 degrees for toric ReSTOR IOL compared with 4.5 for toric Symfony IOL (P = .01). Statistically significantly more eyes with toric Symfony IOL required a return to the operating room for repositioning (6.9% vs 0%, P < .03). More TECNIS monofocal TIOL eyes required surgical repositioning than AcrySof monofocal TIOL eyes (3.5% vs 1.2%, P < .001). Between these PC-TIOLs, the Symfony IOL was more likely to rotate and to require surgical repositioning than the ReSTOR IOL. The TECNIS TIOL built on the same platform as the Symfony IOL was more likely to require surgical repositioning than that by the AcrySof TIOL. Despite comparable rotational stability between the Symfony and TECNIS monofocal TIOLs, the Symfony was twice as likely to require surgical repositioning.

Rotational stability of modified toric intraocular lens.

We evaluated the rotational stability of a new toric intraocular lens (IOL), HOYA XY-1 toric IOL that is an improved version of HOYA 355 toric IOL, with longer overall length (13.0 mm vs. 12.5 mm), shortened unfolding time, and texture processing of the surface of haptics. Data from 193 eyes of 165 patients (76.4 ± 8.3 years old) with preoperative corneal astigmatism exceeding 0.75 diopters who had undergone phacoemulsification and toric IOL implantation were collected and analyzed. Corneal astigmatism, refractive astigmatism, and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 1 day, 1 week, and 1 month after surgery. The degree of IOL decentration, IOL tilt, and toric axis misalignment was assessed at 1 day and 1 month postoperatively. Fifty eyes received AcrySof toric IOL, 51 eyes TECNIS toric IOL, 46 eyes HOYA 355 toric IOL, and 46 eyes HOYA XY-1 toric IOL. The amount of axis misalignment from the intended axis was significantly different among IOLs (p = 0.004, one-way ANOVA), and HOYA XY-1 showed significantly less amount of axis misalignment than TECNIS (p = 0.020, Tukey’s multiple comparison) and HOYA 355 (p = 0.010). The proportion of eyes that showed axis misalignment <10° at 1 month postoperatively was significantly higher with HOYA XY-1 toric IOL than with other toric IOLs (χ2 test, p = 0.020). HOYA XY-1 toric IOL, the modified version of HOYA 355 toric IOL, showed excellent rotational stability in comparison with other models of toric IOLs.

Comparison of the rotational stability between plate-haptic toric and C-loop haptic toric IOLs in myopic eyes.

To compare the rotational stability of a plate-haptic toric intraocular lens (IOL) vs a C-loop haptic toric IOL in myopic cataract eyes. Eye and Ear, Nose, and Throat Hospital of Fudan University, China. Prospective, randomized, controlled study. Cataract eyes with axial length (AL) more than 24.5 mm were randomly assigned to receive implantation of a C-loop haptic toric IOL (AcrySof Toric IOL) (Group A) or a plate-haptic toric IOL (AT TORBI 709M IOL) (Group B). IOL rotation, residual astigmatism, visual acuity, and higher-order aberrations (HOAs) evaluated with OPD-Scan III aberrometer were compared at 3 months postoperatively. In total, 62 eyes of 62 patients were eligible for analysis: 31 in Group A and 31 in Group B. The mean rotation of toric IOLs was greater in Group A than that in Group B (8.00 ± 3.60 degrees vs 4.42 ± 3.24 degrees, respectively, P < .001), especially when IOLs were vertically placed. IOL rotation was positively correlated with AL in Group A, whereas no such correlations were found in Group B. Residual astigmatism in Group A was greater than that in Group B (-0.76 ± 0.30 diopter [D] vs -0.51 ± 0.29 D, respectively, P = .001). Fewer eyes achieved residual astigmatism of 0.50 D or less in Group A than in Group B (38.71% vs 64.52%). Group A had worse postoperative uncorrected visual acuity and higher total HOAs and coma for a 6.0 mm pupil than Group B, whereas postoperative corrected visual acuity was not different between the 2 groups. The plate-haptic toric IOL might be a better choice for myopic cataract eyes with corneal astigmatism because of reduced postoperative rotation.

A study on evaluation of acrysof toric intraocular lens implantation to correct pre-existing corneal astigmatism in patients undergoing cataract surgery- At a tertiary care hospital

The current study evaluates the results of acrysof toric intraocular lens implantation to correct pre-existing corneal astigmatism in patients undergoing cataract surgery. This study was done on Prospective interventional at Osmania Medical College, Sarojini Devi Eye Hospital, Hyderabad. The sample of the study is included 40 eyes of 38 consecutive patients with 1.5 D or more of pre-existing astigmatism consists of cataract surgery with toric open-loop IOL implantation (Alcon, Fort Worth, TX, USA). The pre-operative markings for the position of incisions and IOL placement were being done under the slit lamp. The visual acuity, residual keratometric and refractive cylinders, and toric IOL axis were being measured. 54.71 years was the mean age of the patients. All the 40 eyes at the final check-up had post-operative unaided visual acuity of 6/12 or better. 10 patients (25 %) had an unaided visual acuity of 6/6.37 eyes (92.5%) had best corrected post-operative visual acuity of 6/9 or better. The mean pre-operative refractive astigmatism in 40 eyes was 2.34D. 22 eyes had the Refractive astigmatism of &amp;#62;2D. No eyes had refractive astigmatism of &amp;#60;1.5D. The mean axial length was 24.22mmOut of 40 eyes in which Toric IOL was implanted, the post-operative residual refractive sphere was seen in 4 eyes. Out of 40 eyes in whom Toric IOL was implanted, a post-operative residual refractive cylinder was seen in 30 eyes. 10 patients had No post-operative refractive cylinder. The mean post-operative residual refractive cylinder was 0.58D. The mean Post-operative Keratometric cylinder was 2.24D. The mean post-operative Keratometric cylinder was 2.34D. In comparison, both pre-operative and post-operative keratometric astigmatism, it was found that there was no statistically significant difference between them.The misalignment of Toric IOL was 10 degrees or less in 36 patients (94.73%) and less than 5 degrees in 22 patients (57.89%). Misalignment of &amp;#62;10 degrees (11 degrees and 13 degrees) was seen in 2 patients. The mean IOL rotation among 38 patients was 4.55 degrees (Range 0-13 degrees, SD 3.43). None of the eyes required repositioning. The results of this study show that implantation of AcrysofTor ic IOL is a good surgical method to evaluate pre-existing corneal astigmatism in cataract surgery. Acrysoftoric IOL has shown good rotational stability.

The rotational stability of Toric intraocular lenses and influencing factors in cataract patients with different axial length

Objective: To evaluate the rotational stability of the Toric intraocular lens (TIOL) and influencing factors in cataract patients with different axial length. Methods: This retrospective cohort study consecutively enrolled patients who had phacoemulsification and AcrySof TIOL implantation in Peking University Third Hospital from May 2018 to January 2019. Based on axial length, patients were divided into two groups. Group A consisted of patients whose axial length was ≤ 24 mm. Patients whose axial length was >24 mm were included in group B. Data at three months postoperatively were used to evaluate the rotational stability of TIOL and its correlation with axial length, corneal white to white distance, lens thickness and TIOL spherical power. And t test, nonparametric test, chi-square test and Spearman test were used for statistical analysis. Results: Group A enrolled 39 patients (17 males and 22 females), with a median age of 74 years (range, 36-86 years). Group B enrolled 26 patients (11 males and 15 females), with a median age of 68 years (range, 36-86 years). For the efficacy of TIOL, in group A, the best corrected distance visual acuity (BCDVA, logarithm of the minimum angle of resolution) was 0.30 (0.10, 1.00) preoperatively and 0.10 (0.00, 0.60) postoperatively, and the astigmatism was 2.11 (0.95, 5.10) D preoperatively and 1.00 (0.00, 1.75) D postoperatively. In group B, the BCDVA was 0.36 (0.05, 1.00) preoperatively and 0.05 (0.00, 0.40) postoperatively, and the astigmatism was 2.00 (0.78, 3.76) D preoperatively and 0.75 (0.00, 2.25) D postoperatively. Between group A and group B, there were no significant differences in BCDVA (P=0.604) and astigmatism (P=0.789) preoperatively.In these two groups, postoperative BCDVA and astigmatism both significantly improved compared to preoperative parameters (both P<0.01). Between group A and group B, there were no significant differences in BCDVA (P=0.536) and astigmatism (P=0.076) postoperatively. In terms of rotational stability, the rotation in group A was 5.15°±3.62°, and that in group B was 6.50°±4.66°. There was no statistical difference between two groups (P=0.195). As for predictability, the percentage of eyes with rotation ≤5° was 59.0% (23 eyes) in group A and 50.0% (13 eyes) in group B. There was no statistical difference between the two groups (P=0.647). There was no significant correlation between the rotational stability of TIOL and axial length, corneal white to white distance, lens thickness or TIOL spherical power (P=0.836, 0.568, 0.170, 0.365). Conclusions: The rotational stability of TIOL at three months postoperatively in patients whose axial length >24 mm is of no difference with patients whose axial length ≤ 24 mm. It has no correlation with axial length, corneal white to white distance, lens thickness and TIOL spherical power. (Chin J Ophthalmol, 2020, 56: 41-46).

Comparison of two techniques for toric intraocular lens implantation: hydroimplantation versus ophthalmic viscosurgical devices

BackgroundTo compare the results between hydroimplantation of a single-piece, acrylic foldable toric intraocular lens (IOLs) and conventional implantation using an ophthalmic viscosurgical device (OVD).MethodsIn this study, 60 eyes with cataract and preexisting regular corneal astigmatism of 1.0 to 3.0 diopters (D) underwent the implantation of the AcrySof toric IOLs (Alcon Laboratories, Inc.). The patients were randomly assigned to a conventional implantation technique with an OVD or a hydroimplantation technique. Comparison of preoperative and postoperative parameters was performed using paired Student t tests, and independent Student t test was used to compare between the two groups.ResultsThree months postoperatively, the mean subjective astigmatism was 0.45 D ± 0.24 (SD) in the OVD group and 0.49 ± 0.29 D in the hydroimplantation group (P = 0.492). The mean endothelial cell density (ECD) loss was 7.54% ± 0.82% and 7.32% ± 0.59%, respectively (P = 0.117). The mean absolute IOL rotation was 4.77 ± 2.32 degrees and 4.70 ± 1.95 degrees, respectively (P = 0.334). The mean time for IOL implantation was 71.50 ± 8.10 s and 37.60 ± 3.90 s, respectively (P < 0.001). Two hours, 1 day, 1 week, 1 month, and 3 months postoperatively, there was no significant difference in IOP between the two groups (P > 0.05), although IOP two hours postoperatively seemed to be a little higher in the OVD group.ConclusionsCompared with the use of OVDs for toric IOLs implantation, the hydroimplantation technique provided advantages of increased efficiency, reduced surgical time and cost, and no concerns of OVD-induced elevated IOP.Trial registrationCurrent Controlled Trials ISRCTN55696872, Retrospectively registered (Date of registration: 25 March 2018).

Comparison of the Rotational Stability of Two Toric Intraocular Lenses in 1273 Consecutive Eyes

To compare the rotational stability of the 2 most commonly used toric intraocular lenses (TIOLs). Retrospective cohort study in a single private practice. The study included all patients receiving an Acrysof (n= 626) or Tecnis TIOL (n= 647) over an 18-month period from April 2015 to September 2016. Patients were only excluded if their surgery could not be performed using a digital marking system. All patients had cataract surgery performed in the same surgical center with a similar technique. A digital marking system with limbal vessel registration was used to record the axis of the TIOL at the conclusion of surgery. A dilated examination was performed either later on the day of surgery or the next morning, and the postoperative rotation of the 2 TIOL models was compared. Patients who required a return to the operating room for TIOL repositioning were examined to determine risk factors for reoperation and subsequent outcomes. The primary outcome measure was the percentage of eyes with TIOL rotation >5 and >10 degrees. The second main outcome was likelihood of requiring return to the operating room to reposition a rotated TIOL. The Acrysof TIOL was less likely to rotate postoperatively, with 91.9% of eyes rotated ≤5 degrees at the first postoperative check compared with 81.8% of Tecnis TIOL eyes (P < 0.0001). This difference persisted for rotation ≤10 degrees (97.8% Acrysof vs. 93.2% Tecnis, P= 0.0002) and ≤15 degrees (98.6% Acrysof vs. 96.4% Tecnis, P= 0.02). The mean rotation was 2.72 degrees (95% confidence interval 2.35-3.08 degrees) for Acrysof and 3.79 degrees (95% confidence interval 3.36-4.22 degrees) for Tecnis TIOLs (P < 0.05). The Tecnis TIOL showed a strong predisposition to rotate counterclockwise, unlike the Acrysof. More Tecnis TIOL patients required repositioning (3.1% vs. 1.6%), but this did not reach statistical significance (P= 0.10). Refractive outcomes were similar between the 2 groups. The Acrysof TIOL showed significantly greater rotational stability than the Tecnis TIOL.

Toric Intraocular Lens for Astigmatism Correction in Cataract Patients.

Background:To assess the clinical consequences of AcrySof toric intraocular lens (IOL) and Hoya toric IOL implantation to correct preexisting corneal astigmatism in patients undergoing cataract surgery.Materials and Methods:In this study, we examined 55 eyes of 45 patients with at least 1.00 D corneal astigmatism who were scheduled for cataract surgery. After phacoemulsification, toric IOL was inserted and axis was aligned. We observed the patients, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, manifest refraction, and IOL axis alignment 6 months after surgery.Results:After 6 months, the UDVA was 0.17 ± 0.17 logMAR in the AcrySof group and 0.17 ± 0.18 logMar in the Hoya group. More than 78% of eyes in the AcrySof group and 80% of eyes in the Hoya toric IOL achieved a UDVA of 20/40 or better. In the AcrySof group, the mean preoperative corneal astigmatism was 2.73 ± 0.92 D. The mean postoperative refractive astigmatism was 0.84 ± 0.63 D. In the Hoya group, the preoperative corneal astigmatism was 2.58 ± 0.76 D and the postoperative refractive astigmatism was 0.87 ± 0.66 D (P < 0.05). The mean AcrySof IOL axis rotation was 1.88° ± 3.05°. In the Hoya group, the mean axis rotation was 1.53° ± 3.66°. All changes in visual and refractive data before and after surgery were statistically significant (P < 0.05). There was no significant difference between the two groups regarding refractive and visual outcome after surgery (P > 0.05 for all).Conclusion:Implantation of AcrySof toric IOL and Hoya toric IOL was an effective way to correct preexisting corneal astigmatism in cataract surgery.

Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism

PurposeTo compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism.Patients and methodsThis study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated.ResultsThis study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B.ConclusionBoth procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients.

Toric intraocular lens orientation and residual refractive astigmatism: an analysis.

PurposeTo analyze intraocular lens (IOL) orientation data from an online toric back-calculator (astigmatismfix.com) for determining if differences were apparent by lens type.MethodsA retrospective review of astigmatismfix.com toric back-calculations that included IOL identification and intended orientation axis.ResultsOf 12,812 total validated calculation records, 8,229 included intended orientation and lens identification data. Of the latter, 5,674 calculations (69%) involved lenses oriented 5° or more from their intended position. Using estimated toric lens usage data, the percentage of lenses with orientation ≥5° from intended was 0.89% overall, but the percentage varied significantly between specific toric lens brands (P<0.05). The percentage of back-calculations related to lenses that were not oriented as intended was also statistically significantly different by lens brand (P<0.05). When IOLs were misoriented, they were significantly more likely to be misoriented in a counterclockwise direction (P<0.05). This was found to be due to a bias toward counterclockwise orientation observed with one specific brand, a bias that was not observed with the other three brands analyzed here.ConclusionThe percentage of eyes with lens orientation ≥5° from intended in the Toric Results Analyzer data set was <1% of toric IOLs in general, with the relative percentage of Tecnis® Toric IOLs significantly higher than AcrySof® Toric IOLs. Both of these had higher rates than the Staar® Toric and Trulign® Toric lenses, with the availability of higher Tecnis and AcrySof cylinder powers a likely contributing factor. The AcrySof Toric IOL appears to be less likely than the Tecnis Toric IOL to cause residual astigmatism as a result of misorientation. The Tecnis Toric IOL appears more likely to be misoriented in a counterclockwise direction; no such bias was observed with the AcrySof Toric, the Trulign® Toric, or the Staar Toric IOLs.

An easy and practical method for toric intraocular lens implantation: marking corneal astigmatic axis at slit-lamp.

The objective of this study was to present a practical method of marking the corneal astigmatic axis for the patient sitting at the slit-lamp before toric intraocular lens (IOL) implantation. Eighteen eyes of 18 patients, who underwent uncomplicated phacoemulsification, with an implantation of Acrysof toric IOL were included. We marked the astigmatic axis while the patient sitting at the slit-lamp before surgery. The patient was asked to look at a distant target at head height with the fellow eye. Using the rotator switch, the slit light of the slit-lamp was just turned on to the steep astigmatic meridian in the orthograde position. Then, two tips of the astigmatic meridian were marked with a marking pen, where the slit light crossed at the limbus 180° away. Preoperative corneal and postoperative refractive astigmatism values were compared. Uncorrected and corrected postoperative visual acuities (UDVA and BCVA) and IOL rotations at early and late periods were noted. The mean age and mean follow-up were 63.6±14.6years and 9.4±5.3months (range 3-16months), respectively. Mean postoperative UDVA and BCVA at Snellen chart were 0.62±0.21 and 0.82±0.13, respectively. Mean preoperative keratometric and mean postoperative refractive astigmatism values were 2.48±0.87 D and 0.66±0.48 D, respectively. Reduction of astigmatism was significant (p<0.01). The mean rotation at 1week and that at last follow-up were 2.1°±3.1° and 2.3°±3.0°, respectively. Marking corneal astigmatic axis at slit-lamp is a simple and effective method in toric intraocular lens implantation. Surgeon does not need additional instrument except a slit-lamp and a marking pen, and can complete the marking task in just one setting.

The Results of Toric Intraocular Lens Implantation in Patients With Cataract and High Astigmatism After Penetrating Keratoplasty.

To evaluate the results of toric intraocular lens (IOL) implantation in patients with cataract and postpenetrating keratoplasty astigmatism. Seven eyes of 7 patients with cataract and more than 3.5 diopters (D) astigmatism following penetrating keratoplasty were included in this retrospective case series study. All of the eyes underwent phacoemulsification and Acrysof toric IOL (t5-t9) implantation at least 6 months later than the complete suture removal. Corrected visual acuity (CVA), manifest astigmatism, the keratometry measurements, and complications were assessed. The mean preoperative CVA significantly increased (0.7±0.3 [range: 0.3-1.3] logMAR to 0.1±0.04 [range: 0.05-0.15] logMAR; P<0.05) at mean 8.71±4.11 months after the surgery. The mean preoperative corneal astigmatism and the average manifest refractive astigmatism at the last visit were 5.4±0.9 D (range: 4.25-7 D) and 1.6±0.6 D (range: 0.5-2.5 D), respectively. The mean attempted cylinder correction at spectacle plane was 4.3±0.9 D (range: 2.4-4.7 D) whereas the mean cylinder correction was 4.6±0.5 D (range: 3.9-5.9 D), showing a slightly tendency for overcorrection. All eyes (100%) were within 1 D of predicted residual astigmatism. No complication occurred during the follow-up. Toric IOL implantation seems to be an effective, predictable, and safe procedure in patients with cataract formation and high astigmatism after penetrating keratoplasty.

Visual outcomes after phacoemulsification with AcrySof toric intraocular lens implantation

Introduction : To study the visual outcome of AcrySof toric intraocular lens (IOL) implantation in patients having cataract associated with astigmatism. Materials and Methods : In this prospective interventional case series, 30 eyes of 28 patients with preoperative astigmatism of 1.5–4.5D cylinder underwent phacoemulsification with AcrySof toric IOL implantation. All patients were assessed on day 1, 1 week, 1 month, 2 months, and 3 months postoperatively. The outcome measures were uncorrected visual acuity (UCVA), refractive cylinder, and degree of IOL rotation. Results : Mean UCVA improved significantly in study eyes (P < 0.05) at 3 months. The mean refractive astigmatism reduced from the preoperative value 3.05 ± 0.06 D to 0.208 ± 0.058 D (P=0.001). The mean axis of rotation was 2.76 ± 1.88° in all eyes. Ninety percent of all eyes had mean axis of IOL rotation 10°. Only three eyes had mean axis of rotation 10° or more. Conclusion : AcrySof toric IOL implantation is an effective method to correct preoperative astigmatism in cataract patients. Keywords : Acrysof toric IOL, astigmatism, toric IOL, visual outcome

Evaluation of the Results of Using Toric IOL in the Cataract Surgery of Keratoconus Patients.

To evaluate the results of using AcrySof toric intraocular lenses (IOLs) in the cataract surgery of patients with keratoconus (KCN). In this study, 23 eyes of 17 patients with KCN who underwent cataract surgery using the toric IOL were evaluated. The amount and axis of the corneal astigmatism were measured by manual keratometry, corneal topography, refractive map of the Pentacam, and equivalent K reading of the Pentacam in all patients. The mean uncorrected visual acuity increased significantly 3 months after the surgery (P<0.01). The mean best-corrected visual acuity was 0.28±0.10 logMAR, 0.51±0.52 logMAR, and 0.83±0.55 logMAR before the surgery and 0.16±0.09 logMAR, 0.18±0.12 logMAR, and 0.35±0.13 logMAR after the surgery in the mild, moderate, and severe KCN groups, respectively (P<0.01). The mean IOL rotation was 2.50±1.18 degrees, 2.50±1.51 degrees, and 2.67±1.15 degrees in the mild, moderate, and severe KCN groups. The lowest mean absolute error was seen in the mild and moderate KCN groups with corneal topography-derived keratometry using the SRK/T formula and in the severe KCN group with corneal topography-derived keratometry and manual keratometry using the SRK/T and SRK II formulas. The use of toric IOLs resulted in desirable vision and refraction in the cataract surgery of patients with nonprogressive KCN. As for determining the IOL power, it seems that keratometry derived from the 3 mm central zone in the axial map of corneal topography using the SRK/T formula has the lowest error.

Comparison of SRK/T and Haigis formulas for predicting corneal astigmatism correction with toric intraocular lenses

To compare the accuracy of the SRK/T and Haigis formulas for predicting corneal astigmatism correction with a toric intraocular lens (IOL). Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea. Retrospective cross-sectional study. Eyes with an Acrysof toric IOL were enrolled in the study. The corneal plane effective cylinder power of toric IOLs (target induced astigmatism vector [TIA]) predicted by the SRK/T and Haigis formulas were compared with the cylindrical correction achieved postoperatively (surgically induced astigmatism vector [SIA]). The magnitude of error was defined as the difference between the magnitudes of the SIA and TIA. The median absolute magnitudes of error predicted by the SRK/T and Haigis formulas were compared. The median absolute errors predicted by the 2 formulas were also compared. The mean postoperative SIA was 1.80 diopters (D) ± 0.55 (SD). The magnitude of error predicted by the SRK/T and Haigis formulas was 0.31 ± 0.40 D and 0.23 ± 0.40 D, respectively. The median absolute magnitude of error predicted by the Haigis formula was statistically significantly smaller than that predicted by the SRK/T formula (P < .001). The median absolute error predicted by the Haigis formula (0.35 D) was also statistically significantly smaller than that predicted by the SRK/T formula (0.43 D) (P = .003). The Haigis formula was more accurate than the SRK/T formula not only in predicting the refractive outcome but also in predicting corneal astigmatism correction by toric IOLs. No author has a financial or proprietary interest in any material or method mentioned.