Posters

A change of perspective in toric IOL planning: bridging the gap

Poster Details

First Author: R.Kalácska HUNGARY

Co Author(s):                        

Abstract Details

Purpose:

After cataract surgery (even in case of toric IOL implantation), many patients are left with residual astigmatism that adversely affects vision. Our aim was to reduce this by overcorrecting the patients' against-the-rule astigmatism with toric IOL implantation.

Setting:

Péterfy Hospital and Traumatology Institute, Department of Ophthalmology, Budapest, Hungary

Methods:

Between November 2016 and March 2018, we have implanted Alcon Acrysof IQ Toric lenses into 46 eyes with against-the-rule-astigmatism.The preoperative degree of astigmatism was measured by IOL Master 500 (Carl Zeiss), and toric IOL power was calculated by Barrett Toric Calculator (acrysoftoriccalculator.com). Postoperative refraction was measured by TRK-28 Auto Kerato-Refractometer (Topcon).

Results:

The average degree of anterior surface against-the-rule astigmatism of the 46 studied eyes was 1.06D (between 0.40D and 2.41D). The average cylinder power of the implanted toric IOLs was 2.52D (between 1.50D (T3) and 4.50D (T7)), which equals to 1.6D at the level of the cornea. Thus, we have overcorrected the preexisting corneal astigmatism by an average of 1.6-1.06 = 0.54D. Accordingly, we have also turned its angle and restored physiological astigmatism. The visual acuity of the patients was 0.89 without correction 1 month after surgery. Most of the patients were satisfied with their vision.

Conclusions:

The mostly with-the-rule corneal anterior surface astigmatism present at young age frequently turns into against-the-rule astigmatism with age. Literature has shown that there is also an average of 0.25-0.5 D of against-the-rule astigmatism on the posterior surface of the cornea. Our results show that in case of toric IOL implantation it is worth turning the axis of the preoperative against-the-rule astigmatism by overcorrection so that the optical system of the eye becomes closer to to that of a young one.

Financial Disclosure:

None