Refractive and visual outcome after cataract surgery with Tecnis Toric IOL implantation

Poster Details

First Author: J.Van der Hoek UK

Co Author(s):    L. Brett              

Abstract Details

Purpose:

to determine the visual and refractive outcome after cataract surgery with implantation of a Tecnis toric IOL

Setting:

Ophthalmic Department of a district general hospital in UK (Scarborough General Hospital, UK)

Methods:

consecutive non-masked case series of 10 eyes (8 patients) undergoing cataract surgery with corneal astigmatism of more than 1.3D operated on by one surgeon; pre-op astigmatism was determined by automated keratometry (IOLmaster); Patients underwent post-op refraction by the authors or an independent optometrist. Main outcome measures: post-op unaided acuity compared to pre-op best corrected visual acuity (BCVA), post-op spectacle refraction compared to pre-op keratometry, predictability of toric power and residual astigmatism (RA) calculation, occurrence of axis rotation.

Results:

10 eyes of 8 patients (age range 61-83, 7 females) underwent uncomplicated temporal approach phaco-emulsification with Tecnis toric IOL implantation; follow up ranged from 21-131 days (mean 58 days); mean pre-op LogMAR BCVA of 0.29 (0-0.60) and mean unaided post-op LogMAR acuity of 0.08 (range 0-0.30; 8 eyes had unaided LogMAR of 0). Mean pre-op corneal astigmatism -2.15 (range 1.31-2.98) and mean post-op refractive cylinder -0.58 (range 0-1.75); 8 eyes (80%) had cylinders of less than 1D, 3 (30%) required no cylinders. The mean deviation from predicted post-op cylinder was 0.47D (range 0.01-1.67D, 80% less than 0.43D). Four eyes (40%) had an axis rotation in excess of 45 degrees suggestive of over-correction. There was no statistical difference in aimed-for residual astigmatism (RA) between the groups with and without axis rotation (mean RA of 0.25D and 0.24 respectively), although 50% in the rotation group had a predicted RA of less than 0.10 versus 33% in the non-rotation group.

Conclusions:

Excellent outcomes can be achieved with the Tecnis Toric IOL resulting in significant reductions of pre-operative astigmatism and a high degree of spectacle independence in patients with moderate pre-operative astigmatism. Overcorrection and prevention of axis rotation may be minimised by aiming for a higher degree of RA in the same axis. FINANCIAL DISCLOSURE?: No