Efficacy of state-funded toric intraocular lens implantation in cataract surgery with high corneal astigmatism

Session Details

Session Title: Presented Poster Session: Toric IOLs

Venue: Poster Village: Pod 1

First Author: : A.Swampillai UK

Co Author(s): :    N. Habib   A. Khanan Kaabneh   P. Buckhurst                 

Abstract Details

Purpose:

To determine the efficacy of toric intraocular lens (TIOL) implantation in cataract surgery patients with high levels of pre-operative corneal astigmatism in a state funded, National Health Service (NHS) hospital.

Setting:

Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, England.

Methods:

Retrospective cohort study involving consecutive cases of TIOL implantation in cataract surgery with over 3.00DC of pre-operative corneal astigmatism. Ocular biometry was obtained using IOL Master 700 (Carl Zeiss Meditec), TIOL power was calculated using the manufacturer’s online calculator and all patients had corneal topography. Subjects were implanted with the Tecnis TIOL (Abbot Medical Optics) with capsular tension ring stabilisation using the Callisto system (Carl Zeiss Meditec). Visual acuity and refraction were assessed at 4-6 weeks post-operatively. Vector analysis was used to calculate surgically induced refractive correction (SIRC), correction ratio (CR), error magnitude (EM) and error vector (EV).

Results:

69 eyes of 48 subjects aged 73.8±11.9 (mean 73.8, SD 11.9) were included. Eyes with ocular co-morbidities included dry age-related macular degeneration (n=14), amblyopia (n=8), high myopia (n=7), glaucoma (n=4), previous corneal transplantation (n=2), nanophthalmos (n=2) and corneal scarring (n=1). Pre-operative corneal astigmatism was 4.25±1.69DC (range 3.00-12.00), post-operative refractive astigmatism was 1.31±1.05DC (range 0.00-6.50DC) and post-operative unaided visual acuity was 0.25±0.19LogMAR. The following TIOL models were used; ZCT300 (n=2), ZCT375 (n=11), ZCT450 (n=18), ZCT525 (n=11), ZCT600 (n=14), ZCT700 (n=4), ZCT800 (n=9). Vector analysis demonstrated an SIRC of 4.08±1.39DC, CR=1.1±0.3, EM -0.4±1.0 and EV of 1.23±0.72.

Conclusions:

The results demonstrate the efficacy of TIOL implantation in patients with high corneal astigmatism and provide strong evidence advocating their use in cataract surgery within a state funded hospital eye service. Refractive astigmatism was significantly lower than the pre-operative corneal astigmatism and a low error vector was achieved relative to the magnitude of correction.

Financial Disclosure:

None