Posters

Visual and refractive outcomes following toric intraocular lens (TIOL) implantation during cataract surgery in an National Health Service (NHS) hospital

Poster Details

First Author: B.Lu Morrell UK

Co Author(s):    B. Singh   A. Coombes   N. Cascone              

Abstract Details

Purpose:

Modern advances in ophthalmic surgical techniques and intraocular lens technology now allow patients with corneal astigmatism to undergo cataract surgery with implantation of toric IOLs. Existing data suggests that toric IOLs (TIOLs) represent an excellent, cost-effective option for improving vision for astigmatic cataract patients. Currently, TIOLs are not routinely funded across the NHS and criteria for funding is decided locally. At our hospital, cataract patients with greater than 2D of astigmatism are considered for TIOL implantation. Therefore, our aim was to assess postoperative visual and refractive outcomes of these patients.

Setting:

Our study was conducted in the department of ophthalmology of a large, central London NHS hospital.

Methods:

Retrospective cohort study of all patients who had undergone cataract surgery with implantation of TIOL MX60T (Bausch & Lomb) between February and December 2019. Data were collected from our electronic patient record (EPR) software “Medisoft” on patient demographic, visual acuity, autorefraction, keratometry, operation data, and lens data. Analysis of data was performed using Microsoft Excel.

Results:

Thirty eyes of twenty-three subjects aged 65.5±7.6 years were analysed. Mean preoperative corneal astigmatism was 3.22D±1.65 (range 1.91-9.7). Mean postoperative refractive astigmatism was 1.13D±0.6 (range 0.25-4.5). Mean post-op unaided visual acuity was 0.18±0.20 (range -0.16-0.6). Mean improvement in visual acuity was 0.46D ±0.62 LogMAR (p=0.0003). Mean postoperative spherical equivalent was -0.52D±0.83 (range -2.375-1.44). Mean deviation from predicted post-op refractive error was -0.26D±0.85 (range -1.78-1.44). Correct lens alignment was achieved in 94.7% of cases.

Conclusions:

Our study demonstrates improvement in visual and refractive outcomes in the majority of patients with corneal astigmatism implanted with TIOLs during cataract surgery, comparable to other studies conducted in a similar setting. Our patients demonstrated a significant improvement in both visual acuity and astigmatic error following their surgery. Weaknesses include small sample size, lack of data on quality of life indicators and spectacle independence, and lack of vector analysis data. Notwithstanding, our results indicate efficacy of TIOL implantation in cataract patients with high corneal astigmatism, strengthening their role in the NHS service.

Financial Disclosure:

None