Dongmei Ma1,2,3, Xiaoyan Han1,2,3, Zhixiang Hua1,2,3, Jiying Shen4, Limei Zhang4, Tian Qiu1,2,3, Jianfeng Luo5,6,7, Lei Cai1,2,3, Jin Yang8,9,10. 1. Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Rd., Xuhui District, Shanghai, China. 2. NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. 3. Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China. 4. Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China. 5. Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China. 6. NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China. 7. Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China. 8. Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Rd., Xuhui District, Shanghai, China. jin_er76@hotmail.com. 9. NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. jin_er76@hotmail.com. 10. Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China. jin_er76@hotmail.com.
Abstract
PURPOSE: To assess the contribution of capsular tension ring (CTR) to postoperative stability and visual outcomes of a plate-haptic toric intraocular lens (IOL). METHODS: This prospective cohort study was performed among patients underwent toric IOL (AT TORBI 709 M) implantation with or without CTR at the Eye and ENT hospital between April 2020 and November 2021. Propensity score matching (PSM) was performed to balance baseline factors. Postoperatively, uncorrected distance visual acuity (UCVA) and residual astigmatism, as well as IOLs' rotation, tilt, and decentration, were analyzed. Grouped multiple linear regression analysis was used to model predictive factors of rotation in each group. Additionally, a meta-analysis of data from 4 publications (284 eyes) and current study was performed to evaluate the effect of CTR co-implantation on toric IOL rotation. RESULTS: After PSM, 126 eyes from each group were included for further analysis. Postoperatively, UDVA was 0.31 ± 0.38 logMAR and 0.27 ± 0.36 logMAR in the CTR and NCTR groups, respectively (P = 0.441), and residual astigmatism was 0.75 ± 0.52 D and 0.86 ± 0.65 D, respectively (P = 0.139). The rotation of toric IOL was significantly smaller in the CTR group than in the NCTR group (4.63 ± 6.27 vs. 10.93 ± 16.05 degrees, P < 0.001). The regression models of the two groups and the coefficients of LT were significantly different (P < 0.001 and P = 0.001, respectively). Furthermore, the meta-analysis confirmed that CTR co-implantation reduced toric IOL rotation (MD, - 1.59; 95% CI, - 3.10 to - 0.09; P = 0.038). CONCLUSION: CTR enhances rotational stability of toric IOL by reducing the impact of LT, and CTR co-implantation is recommended in patients with lens thickness (LT) ≥ 4.5 mm, white-to-white (WTW) ≥ 11.6 mm, or high preexisting astigmatism.
PURPOSE: To assess the contribution of capsular tension ring (CTR) to postoperative stability and visual outcomes of a plate-haptic toric intraocular lens (IOL). METHODS: This prospective cohort study was performed among patients underwent toric IOL (AT TORBI 709 M) implantation with or without CTR at the Eye and ENT hospital between April 2020 and November 2021. Propensity score matching (PSM) was performed to balance baseline factors. Postoperatively, uncorrected distance visual acuity (UCVA) and residual astigmatism, as well as IOLs' rotation, tilt, and decentration, were analyzed. Grouped multiple linear regression analysis was used to model predictive factors of rotation in each group. Additionally, a meta-analysis of data from 4 publications (284 eyes) and current study was performed to evaluate the effect of CTR co-implantation on toric IOL rotation. RESULTS: After PSM, 126 eyes from each group were included for further analysis. Postoperatively, UDVA was 0.31 ± 0.38 logMAR and 0.27 ± 0.36 logMAR in the CTR and NCTR groups, respectively (P = 0.441), and residual astigmatism was 0.75 ± 0.52 D and 0.86 ± 0.65 D, respectively (P = 0.139). The rotation of toric IOL was significantly smaller in the CTR group than in the NCTR group (4.63 ± 6.27 vs. 10.93 ± 16.05 degrees, P < 0.001). The regression models of the two groups and the coefficients of LT were significantly different (P < 0.001 and P = 0.001, respectively). Furthermore, the meta-analysis confirmed that CTR co-implantation reduced toric IOL rotation (MD, - 1.59; 95% CI, - 3.10 to - 0.09; P = 0.038). CONCLUSION: CTR enhances rotational stability of toric IOL by reducing the impact of LT, and CTR co-implantation is recommended in patients with lens thickness (LT) ≥ 4.5 mm, white-to-white (WTW) ≥ 11.6 mm, or high preexisting astigmatism.
Authors: Teresa Ferrer-Blasco; Robert Montés-Micó; Sofia C Peixoto-de-Matos; José M González-Méijome; Alejandro Cerviño Journal: J Cataract Refract Surg Date: 2009-01 Impact factor: 3.351