Long-term refractive outcome and rotational stability of AcrySof Toric intraocular lens in an NHS hospital setting

Session Details

Session Title: Toric IOLs

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

Paper Time: 17:27

Venue: Capital Hall B

First Author: : L.Ilari UK

Co Author(s): :    P. Udani              

Abstract Details

Purpose:

To evaluate the refractive stability and long term follow up of a Toric intraocular implant ( IOL) to correct corneal astigmatism at the time of cataract extraction.

Setting:

Princess Royal University Hospital, King’s College NHS Foundation Trust, London, UK.

Methods:

This was a retrospective non comparative case series of 24 eyes ( 19 patients , mean age: 73, range 53 to 84) who had cataract surgery with implantation of an AcrySof Toric IOL (Alcon Laboratories, Inc., Fort Worth, TX). Preoperative keratometric astigmatism was 3.02 D (SD 0.84, range: cylinder powers 1.95 D to 4.5 D). Measurements included unaided and corrected distance and near visual acuity, automated keratometry (Canon RK-F1,Tokyo, Japan), IOL Master (Carl Zeiss Meditec AG), Pentacam (Oculus GmbH). Patients were followed up at 2 weeks, 3 months, 6 months and 1 year. Average follow up was 12.1 months (range: 3 to 24 months). Rotational stability was also investigated after obtaining preoperative and postoperative dilated anterior segment digital photographs.

Results:

Mean postoperative residual refractive cylinder was 0.62 D (SD: 0.52 D, range from 0 D to 1.75 D) with a reduction of 79.5% from preoperative keratometric astigmatism. Postoperative refractive cylinder was ≤0.5 D in 76.9% of eyes and ≤ 1 D in 92.3%. Manifest spherical equivalent (SE) was -0.18 D ( SD: 0.53, range from -1.13 D to 0.5 D). Uncorrected distance visual acuity (UCVA) logMAR was 0.15 (SD: 0.15, range from -0.1 to 0.48) and corrected distance visual acuity (CDVA) logMAR was 0 (SD: 0.13, range from -0.1 to 0.18). UCVA was ≥ 0 logMAR (corresponding to 6/6 Snellen acuity or better) in 58.3% of eyes and ≥0.3 logMAR (corresponding to 6/12 Snellen acuity or better) in 91.7%. Mean early postoperative IOL rotation at 2 weeks was 3.08º (range 0º to 9º, p >0.05). Mean late postoperative rotation was 1.23º (range 0º to 3º, p >0.05). No IOL rotated more than 10º and 90.5% rotated 5º or less. No intraoperative complications were recorded. Two eyes (8.3%) developed a mild posterior capsule opacification at 12 and 14 months respectively which has not required laser capsulotomy.

Conclusions:

The Acrysof Toric IOL is safe and effective in correcting moderate degrees of keratometric astigmatism. Long term follow up shows a stable refractive outcome and a very good rotational stability.

Financial Interest:

NONE