PURPOSE: To evaluate and compare toric intraocular lens (IOL) implantation and spherical IOL implantation with peripheral corneal relaxing incisions to manage astigmatism during phacoemulsification. SETTING: Ophthalmology Service, Hospital Ramón y Cajal, Madrid, Spain. DESIGN: Prospective randomized comparative case series. METHODS:Eyes with cataract and corneal astigmatism (1.00 to 3.00 diopters [D]) had toric IOL implantation or peripheral corneal relaxing incisions. Outcome measures were visual outcomes, slitlamp assessment, digital toric IOL axis determination, spectacle need, and patient satisfaction. RESULTS: Three months postoperatively, the mean uncorrected distance visual acuity (UDVA) was 0.13 ± 0.10 (SD) in the toric IOL group and 0.19 ± 0.12 in the relaxing incisions group; the UDVA was better than 0.20 in 75% of eyes and 60% of eyes, respectively. Refractive cylinder decreased significantly in both groups, with a mean residual refractive astigmatism of 0.61 ± 0.41 D in the toric IOL group and 1.32 ± 0.60 D in the relaxing incisions group (P<.01). The mean toric IOL rotation was 3.65 ± 2.96 degrees, with no significant differences between slitlamp and digital photograph measurements. There was a trend toward better mesopic contrast sensitivity with glare in the toric IOL group. There were no differences in VF-14 or patient satisfaction results; 15% of patients in the toric IOL group and 45% in the relaxing-incision group required distance spectacles postoperatively. CONCLUSION: Although refractive astigmatism decreased in both groups, toric IOL implantation was more effective and predictable, resulting in greater spectacle independence.
RCT Entities:
PURPOSE: To evaluate and compare toric intraocular lens (IOL) implantation and spherical IOL implantation with peripheral corneal relaxing incisions to manage astigmatism during phacoemulsification. SETTING: Ophthalmology Service, Hospital Ramón y Cajal, Madrid, Spain. DESIGN: Prospective randomized comparative case series. METHODS: Eyes with cataract and corneal astigmatism (1.00 to 3.00 diopters [D]) had toric IOL implantation or peripheral corneal relaxing incisions. Outcome measures were visual outcomes, slitlamp assessment, digital toric IOL axis determination, spectacle need, and patient satisfaction. RESULTS: Three months postoperatively, the mean uncorrected distance visual acuity (UDVA) was 0.13 ± 0.10 (SD) in the toric IOL group and 0.19 ± 0.12 in the relaxing incisions group; the UDVA was better than 0.20 in 75% of eyes and 60% of eyes, respectively. Refractive cylinder decreased significantly in both groups, with a mean residual refractive astigmatism of 0.61 ± 0.41 D in the toric IOL group and 1.32 ± 0.60 D in the relaxing incisions group (P<.01). The mean toric IOL rotation was 3.65 ± 2.96 degrees, with no significant differences between slitlamp and digital photograph measurements. There was a trend toward better mesopic contrast sensitivity with glare in the toric IOL group. There were no differences in VF-14 or patient satisfaction results; 15% of patients in the toric IOL group and 45% in the relaxing-incision group required distance spectacles postoperatively. CONCLUSION: Although refractive astigmatism decreased in both groups, toric IOL implantation was more effective and predictable, resulting in greater spectacle independence.
Authors: Pia Leon; Marco Rocco Pastore; Andrea Zanei; Ingrid Umari; Meriem Messai; Corrado Negro; Daniele Tognetto Journal: Int J Ophthalmol Date: 2015-08-18 Impact factor: 1.779
Authors: Jonathan C Lake; Gustavo Victor; Gerry Clare; Gustavo Jm Porfírio; Ashleigh Kernohan; Jennifer R Evans Journal: Cochrane Database Syst Rev Date: 2019-12-17