Quality of vision following bilateral toric and bilateral monofocal intraocular lens implantation in patients with cataract and corneal astigmatism: results of an RCT

Session Details

Session Title: Toric IOLs

Session Date/Time: Sunday 14/09/2014 | 16:30-18:30

Paper Time: 17:21

Venue: Capital Hall B

First Author: : N.Visser THE NETHERLANDS

Co Author(s): :    H. Beckers   N. Bauer   S. Gast   B. Zijlmans   C. Webers   R. Nuijts

Abstract Details

Purpose:

to compare the quality of vision following bilateral toric and bilateral monofocal intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism.

Setting:

the University Eye Clinic of the Maastricht University Medical Center, the Netherlands; and the Eye Hospital Rotterdam, the Netherlands.

Methods:

86 patients with bilateral cataract and at least 1.25 diopters of corneal astigmatism were randomized for bilateral toric or monofocal IOL implantation. Six months postoperatively, uncorrected and best-corrected distance vision acuity (UDVA and BDVA), spectacle use for distance vision, contrast sensitivity, wavefront aberrometry (corneal aberrations and total ocular aberrations) and refractive error-related quality of vision (RQL-42 questionnaire) were determined.

Results:

Six monts postoperatively, an UDVA of 20/25 or better was achieved in 70% and 30% of patients in the toric and monofocal groups, respectively (P<0.001). About 80% of patients in the toric group were spectacle independent for distance vision, compared to 20% in the monofocal group (P<0.001). Contrast sensitivity was comparable in both groups. Regarding corneal aberrations, root mean square (RMS) of lower-order astigmatism (0.525 ± 0.088 µm vs 0.467 ± 0.202 µm) and total higher-order aberrations (0.045 ± 0.039 µm vs 0.031 ± 0.014 µm) was comparable between toric and monofocal groups, respectively (P>0.05). Regarding total ocular aberrations, RMS of lower-order astigmatism was significantly lower in the toric group compared to the monofocal group (0.256 ± 0.217 µm vs 0.490 ± 0.272 µm; P<0.001). No significant differences were found in RMS of total higher-order aberrations. At 6 months postoperatively, refractive error-related quality of life was 78 points in the toric group, compared to 77 points in the monofocal group (P>0.05). No significant differences were found between toric and monofocal groups for any of the subscales, including Far vision, Dependence on correction and Satisfaction with correction.

Conclusions:

We found a significantly better UDVA and higher spectacle independency for distance vision following toric IOL implantation compared to monofocal IOL implantation in patients with cataract and corneal astigmatism. No significant differences were found in contrast sensitivity, higher-order aberrations or refractive error-related quality of life.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, One or more of the authors... research is funded, fully or partially, by a competing company, One or more of the authors... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One or more of the authors... receives consulting fees, retainer, or contract payments from a competing company