Prospective study of Precizon toric intraocular lens implantation outcomes

Session Details

Session Title: Refractive Lens Exchange

Session Date/Time: Tuesday 16/09/2014 | 16:30-18:00

Paper Time: 17:12

Venue: Capital Hall A

First Author: : C.Vale PORTUGAL

Co Author(s): :    R. Massa   I. Casal   P. Sousa   M. Lume   R. Salgado   M. Brochado

Abstract Details

Purpose:

The aim of this study was to evaluate the visual and refractive outcomes and the rotational stability of the new aspheric Precizon toric intraocular lens (IOL) implantation after cataract surgery in patients with corneal astigmatism.

Setting:

Department of Ophthalmology, Hospital de Santo António - Centro Hospitalar do Porto, EPE. Oporto, Portugal

Methods:

This prospective observational study included 34 eyes of 17 presbiopic patients with corneal astigmatism greater than 1.0 diopter (D) and indication for refractive lens exchange (RLE) or cataract surgery that were proposed for bilateral implantation of Precizon® toric IOL. All patients underwent an extensive preoperative and postoperative examination, including uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BCVA), slit-lamp examination, autorefractometry (KA-1000®), dilated fundoscopy, retina evaluation using optical coherence tomography (Spectralis®), and corneal topography using Scheimpflug imaging (Pentacam®). Data for IOL calculation was performed with optical coherence biometry (IOLMaster®). The target postoperative spherical equivalent was emmetropia. Outcomes of visual acuity, refractive and keratometric astigmatism, and IOL rotation were analyzed at the first and third months. Retroilluminated slitlamp photographs were taken at each visit. Contrast sensitivity function (Metrovision®) was assessed before surgery and at third month evaluation. Patient satisfaction was recorded.

Results:

The preoperative Keratometric cylinder measured with IOLMaster® was similar to that measured with Pentacam® (2.78±1.72 vs. 2.71±1.75, P=0.10). The mean postoperative uncorrected distance visual acuity (UCDVA) was significantly better than preoperative BCVA (0.02 logMar±0.04 vs. 0.11 logMar±0.09, P=0.00). Postoperative UCDVA was 0.06 logMar or better in all eyes at 3 months. The mean spherical equivalent was reduced to -0.09±0.14 D from -4.78±2.98 (P=0.00). Mean refractive astigmatism was reduced to -0.08±0.28 D (range: -1.00 to +0.50) from -2.91±1.73 D (P=0.00). The mean absolute rotation of the IOL was 2.15±1.09 at 1st month evaluation and 2.3±1.08 degrees at 3rd month (P=0.08). One eye had IOL rotation of 5 degrees, the remaining eyes had rotation of less than 5 degrees. However, no significant correlation was found between lens rotation and the magnitude of refractive cylinder at the end of follow-up. None of the lens required secondary alignment. 94% of the patients were spectacle independent for distance vision at the final visit. Monocular contrast sensitivity function remained stable after surgery, at all spatial frequencies, and were within the normal range. Satisfaction with visual acuity and quality of vision was rated as very good by all the patients. No complications during the follow-up were found.

Conclusions:

This new toric intraocular lens appears to have acceptable rotational stability and to have good performance regarding predicatibility and efficacy in the correction of preexisting astigmatism during cataract surgery. As long as patients and IOL are carefully selected there are no major safety-concerned complications. Patients reported a very high level of satisfaction with this new IOL that can allow spectacle-independence for distance vision.

Financial Interest:

NONE