Posters

Toric Intraocular Lenses during phacoemulsification for astigmatic correction post-external retinal detachment repair surgery: a case series

Poster Details

First Author: A.McGlacken-Byrne IRELAND

Co Author(s):    T. Murphy   P. Mullaney   .               

Abstract Details

Purpose:

Scleral buckle surgery for rhegmatogenous retinal detachment repair is a successful surgery suitable for most types of rhegmatogenous retinal detachment without advanced proliferative vitreoretinopathy. Though a successful surgical option, several international studies have demonstrated that encircling and segmental scleral buckles can alter the shape of the globe, increasing axial length and increasing corneal astigmatism post-operatively. This case series examines the effect of toric intraocular lens (IOL) implantation during phacoemulsification to reduce surgically induced astigmatism from previous encircling or segmental scleral buckle for rhegmatogenous retinal detachment repair.

Setting:

The electronic patient database ‘Medisoft’ system was utilised to evaluate records of patients attending Sligo University Hospital, a tertiary level cataract referral centre in Ireland, from 2010 to 2019.

Methods:

Those included in the retrospective evaluation were patients with previous uncomplicated external retinal detachment surgeries (scleral buckling, with or without adjunctive implants). Internal approaches (vitrectomy) were excluded. Patients for inclusion had a visually significant cataract and underwent uncomplicated phacoemulsification cataract surgery and toric IOL implantation. Subsequent biometry would have shown an absolute difference of the keratometry values of greater than or equal to 1.5D (diopter); they would have been selected for a toric IOL. Pre- and post-operative best-corrected visual acuity (BCVA) and refractive data was collected from post-operative optometrist assessment.

Results:

Post-operative refractive data was available for twelve eyes; of the 15 eyes with keratometry values deemed suitable for topic IOL. Average BCVA of post-operative scleral buckle patients presenting for cataract surgery was 6/15, which improved to 6/7.5 post toric IOL implantation. The average difference in keratometry values before cataract surgery was 2.19±0.26. Mean spherical equivalent before and after toric IOL implantation was –4.65±4.50 and -0.42±0.89, respectively. Mean cylinder before and after toric IOL implantation was -2.71±1.28 and -1.23±1.13, respectively. Deviation from predicted postoperative refraction post toric IOL insertion was -0.02±0.10.

Conclusions:

Surgery was uneventful in all cases and no patients in this study experienced rotational instability of their toric IOL. In this present series, a good correction of the myopic error by toric IOL after scleral buckling was achieved. This demonstrates that toric IOL implantation is a safe, predictable and effective procedure to reduce astigmatism induced from previous external retinal detachment repair surgery.

Financial Disclosure:

None