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To assess the amount of reduction in the toric IOL power by customizing the corneal incision site and thereby improving visual outcomes in patients undergoing phacoemulsification cataract surgery

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Session Details

Session Title: Presented Poster Session 03: Cataract Surgery Outcomes 2

Session Date/Time: Saturday 13/09/2014 | 09:30-11:00

Paper Time: 09:30

Venue: Pod 3 (Poster Village)

First Author: : A.Braganza INDIA

Co Author(s): :    V. Kharbanda   A. Heda   R. Shetty   B. H C     

Abstract Details


To assess the amount of reduction in the Toric IOL power required by customizing the corneal incision site (taking it on the steeper axis) and comparing it with the theoretical Toric IOL power calculated using the surgeons preferred (non-customized, superotemporal) corneal incision .


Tertiary Eye Care Centre, South India


49 eyes of 38 patients who underwent uneventful phacoemulsification with Toric IOL implantation were included in the study. All surgeries were performed by the same surgeon AB . The preferred incision site is Superotemporal ( 135 deg RE, 45 deg LE), however the main incision in these patients was customized to be taken at the steeper axis so as to reduce the amount of Toric IOL power. For all the patients, the same Toric IOL calculator was used at the same time to calculate the theoretrical t Toric IOL power with the surgeons preferred incision, the difference of the average Toric IOL power for both the groups was measured and analyzed for significance. At the final visit ( 6 weeks) the patients were evaluated for best corrected visual acuity , residual astigmatism and the orientation of the toric axis.


Mean age of the patient was 65.22+/-9.8 years. The BCVA at the final visit was 20/20 and N 6 for all the patients, average residual astigmatism was 0.98, and the average rotation off the axis was 4.5 deg. The average Toric power used with the customized incision was 2.55 D while the average theoretical Toric power calculated with the preferred ( non customized incision) was 3.33D . The difference between the two values was tested by using the Mann Whitney U test as the data was non normative and we found that the difference in the values was strongly significant (p<0.001).


Most surgeons prefer to use their preferred incision site during cataract surgery and thereby stay within their comfort zone. Our study proves that the Toric IOL power required can be reduced by customizing the corneal incision site, thereby improving visual quality post operatively by reducing the amount of residual astigmatism that occurs due to average Toric IOL rotation off its original axis.

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