scholarly journals Toric Intraocular Lenses in Cataract Surgery

2011 ◽  
Vol 04 (01) ◽  
pp. 38
Author(s):  
Rosa Braga Mele ◽  
Keyword(s):  
Cataract Surgery ◽  
Contact Lenses ◽  
Treatment Options ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Rotational Stability ◽  
Toric Iol ◽  
Toric Iols ◽  
High Prevalence ◽  
Increasing Demand

Cylindrical deficits in patients with corneal astigmatism of 0.50 diopter (D) to 1.00D may influence visual acuity. Increasing age and cataract surgery are correlated with greater prevalence and extent of corneal astigmatism. Conventionally, spectacles and contact lenses have been used to improve or correct corneal astigmatism. However, increasing demand for freedom from spectacles for distance vision and high prevalence of pre-existing corneal astigmatism in cataract patients have forced cataract surgery for the correction of aphakia and pre-existing corneal astigmatism to become common practice. However, implantation of toric intraocular contact lenses (IOLs) into the eye during cataract surgery may be a more predictable, powerful, and stable way of correcting pre-operative corneal astigmatism and may provide an adjunct or alternative to spectacles or relaxing incisions. Early toric IOLs were associated with post-operative rotational stability, lens misalignment, and safety concerns. The use of the new AcrySof® IQ Toric IOL for the correction of aphakia and pre-existing corneal astigmatism has largely mitigated these concerns. In addition, the AcrySof® IQ Toric IOL may also replace other treatment options for correcting pre-existing corneal astigmatism in patients undergoing cataract surgery.

scholarly journals Treatment of Corneal Astigmatism at the Time of Cataract Surgery, What Can Be Promised

2015 ◽  
Vol 09 (02) ◽  
pp. 102
Author(s):  
George Beiko ◽  
Keyword(s):  
Cataract Surgery ◽  
Treatment Options ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Technological Advances ◽  
Made In

The treatment of corneal astigmatism at the time of cataract surgery is commonplace. Corneal incisional surgery and toric intraocular lenses (IOLs) are routinely utilised; the role of each modality is understood and defined. Although technological advances have been made in the assessment of the cornea and in the execution of the treatment options, recent innovations in toric IOL designs may be more significant for the comprehensive ophthalmologist.

Combined implantation of toric and spherical intraocular lenses for low corneal astigmatism correction

2021 ◽  
Vol 1 (3) ◽  
pp. 118-123
Author(s):  
Valeria Albano ◽  
Alessandra Sborgia ◽  
Carmela Palmisano ◽  
Giovanni Alessio
Keyword(s):  
Low Power ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Refractive Outcomes ◽  
Astigmatism Correction ◽  
Uncorrected Distance Visual Acuity ◽  
Toric Iols ◽  
Standard Deviation Range ◽  
Spherical Iol

Background: This study compared outcomes of combined toric versus spherical intraocular lens (IOL) implantation in patients with low corneal astigmatism. Methods: In this retrospective contralateral study, patients with corneal astigmatism who received combined toric (FIL 611 T, Soleko, Rome, Italy) and spherical IOL (FIL 611 T, Soleko, Rome, Italy) implants were recruited. Eyes were examined preoperatively and then again 3 months postoperatively. Postoperatively, uncorrected distance visual acuity (UCDVA), residual astigmatism, and spherical equivalent (SE) were compared between the toric IOL-implanted eyes and the spherical IOL-implanted fellow eyes. Results: Among the 46 included cases (age 69 ± 12.7 years [mean± standard deviation]; range: 60‒78 years), 86.9% of eyes (n = 40) in the toric IOL group had a postoperative refractive cylinder of ≤ 0.25 diopters (D), compared with 4.3% (n = 2) of eyes in the spherical IOL group. Both groups showed a statistically significant reduction in refractive cylinder and improvement in UCDVA after cataract surgery (both P = 0.01). Similarly, toric IOLs were superior (69.6%) to spherical lenses (2.2%) in obtaining a SE of ≤ 0.25 D. Conclusions: To our knowledge, no previous study had sought to compare low-power toric and spherical IOLs in low corneal astigmatism in the same patient's eyes. Our findings suggest that low-power toric IOLs may result in good refractive outcomes as compared with spherical IOLs implanted in the fellow eye of the same patient, although both result in significant UCDVA improvement. Well‐designed clinical research studies with a longer follow-up and more participants are necessary to confirm these findings.

scholarly journals Toric Intraocular Lenses for the Management of Corneal Astigmatism at the Time of Cataract Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Colm McAlinden ◽  
David Janicek
Keyword(s):  
Cataract Surgery ◽  
Human Error ◽  
Data Entry ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Vector Analysis ◽  
Corneal Incision ◽  
Toric Iol ◽  
Iol Power ◽  
The Mean

Aims/Background. To assess astigmatic outcomes with the use of toric intraocular lenses (IOLs) for patients with significant amounts of corneal astigmatism undergoing cataract surgery. Methods. This audit was conducted in a UK ophthalmology department and included 48 eyes of 42 patients. Surgery was performed during 2019 in patients with 2.50 diopters (D) or more corneal astigmatism. Anterior keratometry readings were used to determine the toric IOL power. Vector analysis using the Alpins method was used to assess changes in astigmatism pre to postoperatively. Results. There were 18 right and 26 left eyes included. In terms of gender, 61% of patients were female and 39% were male. The mean (±standard deviation (SD)) age was 70 (±11) years. The mean (±SD) axial length, K1, K2, and delta K was 23.55 (±1.4) mm, 42.71 (±1.39) D, 45.78 (±1.60) D, and 3.01 (±0.89) D, respectively. Postoperatively, the median spherical, cylinder, and spherical equivalent refraction was 0.00 D, −1.00 D, and 0.00 D, respectively. Postoperatively, 41% of the eyes had ≤0.50 D of spectacle astigmatism and 80% had ≤1.00 D. No patient required a secondary procedure to reposition the IOL from rotation. In vector analysis with the use of polar diagrams, there was a tendency for overcorrection of with-the-rule astigmatism and undercorrection of against-the-rule astigmatism. Conclusions. Significant reductions in astigmatism can be achieved with the use of toric IOLs in patients undergoing cataract surgery. Further improvements may be possible with surgeon-specific determination of their surgically induced astigmatism and flattening effect from the main corneal incision. Furthermore, the use of an optical biometer that directly measures the posterior corneal curvature and permits automatic toric IOL power determination with modern formulas avoiding the need for manual data entry may reduce the risk of human error and improve visual and refractive outcomes.

scholarly journals Femtolaser Assisted Cataract Surgeryand Toric Lenses in Patients with Astigmatism. Review

2020 ◽  
Vol 17 (1) ◽  
pp. 13-19
Author(s):  
I. L. Kulikova ◽  
N. S. Timofeeva
Keyword(s):  
Visual Acuity ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Rotational Stability ◽  
Visual Functions ◽  
Advantages And Disadvantages ◽  
Astigmatism Correction ◽  
Toric Iols ◽  
Theoretical Advantage

The presence of concomitant corneal astigmatism is the most common cause of low visual functions in patients with surgical treatment of cataracts. The implantation of toric intraocular lenses is procedure of choice in the correction of corneal astigmatism from 1.0 DPT and more in patients with cataracts. Successful results depend on several factors, the most important of which: the correct and stable position of the intraocular lens (IOL) in the capsule bag, the absence of residual astigmatism, the choice of the implanted IOL’s model, taking into account material and design of lens elements. Deviation of the cylindrical component by 10 degrees reduces visual acuity up to 35 %. Repeated intervention for the purpose of toric lens reposition, according to the literature, varies from 0,65 to 9 % and is carried out with the rotation of IOL more than 10°. Femtolaser-assisted phacoemulsification allows partially automate the surgical process, making it more efficient and safe, creating a theoretical advantage over manual techniques of surgery. In practice, the capsulorexis formed by the femtolaser is characterized by a regular rounded shape with a given diameter and provides a coating of optical part of IOL for 360°, which, according to various sources, contributes to a lesser degree of decentralization and tilt of the lens in the capsule bag and can be considered as one of the reasons for obtaining a more accurate refractive result and, as a consequence, higher visual functions. The review presents the results of clinical studies of corneal astigmatism correction during standard and femtolaser-assisted phacoemulsification with implantation of various models of toric IOLs: visual acuity, rotational stability, residual astigmatism percentage, wave front change. Researchers continue to discuss the advantages and disadvantages of modern technologies. However, the problem of increasing the predictability of the surgical outcome in order to obtain a higher refractive result both in the early and in the long-term postoperative period remains unquestionable.

scholarly journals Toric Intraocular Lens Implantation in the Correction of Moderate-To-High Corneal Astigmatism in Cataract Patients: Clinical Efficacy and Safety

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiaodi Qiu ◽  
Yumeng Shi ◽  
Xiaoyan Han ◽  
Zhixiang Hua ◽  
Yi Lu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Rotational Stability ◽  
Related Factors ◽  
Toric Iol ◽  
Iol Implantation ◽  
Effective Option ◽  
One Year ◽  
Cataract Patients

Background/Aims. To investigate the long-term efficacy and rotational stability of toric intraocular lenses (IOLs) implanted for the correction of moderate-to-high corneal astigmatism. Methods. A total of 57 cataract patients (57 eyes) with regular corneal astigmatism (≥2.57 D) were enrolled in this retrospective cohort study. Phacoemulsification with toric IOL implantation was performed for all patients. The uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were recorded before and one year after surgery, and statistical analysis of preoperative corneal astigmatism, postoperative residual astigmatism, aberrations, IOL rotation, and related factors was performed to evaluate the efficacy, safety, and stability of toric IOLs in correcting moderate-to-high corneal astigmatism. Results. One year after surgery, visual acuity was significantly improved compared with that before surgery (preoperative log MAR 0.87 ± 0.34 vs. postoperative log MAR 0.31 ± 0.26, p < 0.001 ), and the self-reported spectacle independence rate was 68.42%. The total residual astigmatism was 1.18 ± 0.85 D, which was significantly less than the preoperative value (3.41 ± 0.99 D) ( p < 0.001 ). The degree of toric IOL rotation was 4.93 ± 3.02°, and 54.39% of patients had a lens rotation of less than 5°. The IOLs of 5.26% (3 eyes) of patients rotated more than 10°, and these patients received glasses instead of undergoing IOL repositioning. Conclusions. Toric IOL implantation provided optimal vision outcomes and low spectacle dependence during a one-year follow-up period. The results from our study show that toric IOL implantation is a safe and effective option for cataract patients with moderate-to-high corneal astigmatism.

scholarly journals Rotational stability of modified toric intraocular lens

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247844
Author(s):  
Ryoko Osawa ◽  
Tetsuro Oshika ◽  
Masahiko Sano ◽  
Takuma Yuguchi ◽  
Tadayoshi Kaiya
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Toric Iols ◽  
Corrected Distance Visual Acuity ◽  
One Way Anova

We evaluated the rotational stability of a new toric intraocular lens (IOL), HOYA XY-1 toric IOL that is an improved version of HOYA 355 toric IOL, with longer overall length (13.0 mm vs. 12.5 mm), shortened unfolding time, and texture processing of the surface of haptics. Data from 193 eyes of 165 patients (76.4 ± 8.3 years old) with preoperative corneal astigmatism exceeding 0.75 diopters who had undergone phacoemulsification and toric IOL implantation were collected and analyzed. Corneal astigmatism, refractive astigmatism, and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 1 day, 1 week, and 1 month after surgery. The degree of IOL decentration, IOL tilt, and toric axis misalignment was assessed at 1 day and 1 month postoperatively. Fifty eyes received AcrySof toric IOL, 51 eyes TECNIS toric IOL, 46 eyes HOYA 355 toric IOL, and 46 eyes HOYA XY-1 toric IOL. The amount of axis misalignment from the intended axis was significantly different among IOLs (p = 0.004, one-way ANOVA), and HOYA XY-1 showed significantly less amount of axis misalignment than TECNIS (p = 0.020, Tukey’s multiple comparison) and HOYA 355 (p = 0.010). The proportion of eyes that showed axis misalignment <10° at 1 month postoperatively was significantly higher with HOYA XY-1 toric IOL than with other toric IOLs (χ2 test, p = 0.020). HOYA XY-1 toric IOL, the modified version of HOYA 355 toric IOL, showed excellent rotational stability in comparison with other models of toric IOLs.

scholarly journals Comparative evaluation of rotational stability of toric IOLs with four-eyelet vs two-eyelet capsular tension rings in eyes with high myopia

2021 ◽  
Vol 14 (3) ◽  
pp. 378-382
Author(s):  
Hui-Min Jiang ◽  
◽  
Li-Ming Tao ◽  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Iol ◽  
Toric Iols ◽  
Group A ◽  
The Mean ◽  
Group B

AIM: To compare the rotational stability of Toric intraocular lens (IOLs) implantation combined with four-eyelet or two-eyelet capsular tension rings (CTRs) in eyes with high myopia and cataract. METHODS: This prospective randomized controlled interventional study included 33 eyes which had preoperative corneal astigmatism ≥1.5 D and ocular axial length ≥25.5 mm. These eyes were randomly divided into two groups to undergo phacoemulsification and toric IOL implantation with either four-eyelet CTR implantation (group A, n=16) or two-eyelet CTR implantation (group B, n=17). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), phoropter examination results, and toric IOL rotation degrees were tested 6mo after the surgery. RESULTS: In both groups, the toric IOL was in the capsular sac 6mo after surgery. The difference between the two groups in terms of visual outcome was not found to be statistically significant (P>0.05) at a follow-up of 6mo. The mean residual astigmatism values were 0.56±0.22 D and 0.92±0.24 D in A and B groups, respectively (P<0.001). The mean rotation degree of IOL was 1.00°±0.73° in group A and 3.53°±1.46° in group B (P<0.001). CONCLUSION: In cataract patients with high myopia and astigmatism, four-eyelet CTR can effectively increase the rotation stability of toric IOLs, achieving the desired goal of correcting corneal astigmatism.

scholarly journals Mobile App for Pre- and Intraoperative Assessment of Astigmatism Correction with Toric Intraocular Lenses in Cataract Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Francisco Aecio Fernandes Dias ◽  
Vinicius Jose Fernandes Dias ◽  
Barbara de Araujo Lima Dutra ◽  
Anna Christina Siqueira Marques ◽  
Edgar Marçal ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Case Series ◽  
Mobile App ◽  
Mean Difference ◽  
Ease Of Use ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Astigmatism Correction ◽  
Case Series Study ◽  
The Mean

Purpose. To develop a mobile app that allows capturing and editing of photographs, performs image transposition and projection of a protractor with 360° axis markings, and permits accurate visualization of programmed alignment for the positioning of toric intraocular lenses (IOLs). Methods. In this prospective case series study, a codesign methodology was chosen to develop the Eye Axis Check application. After app development, measurements were obtained and comparisons were made between manual marks and toric IOL alignment without and with the app in 30 eyes that had undergone cataract surgery with toric IOLs. The mobile app was made available to 15 ophthalmic surgeons in different cities to assess its usability. Results. The users approved the developed application for its ease of use and utility. The mean difference between the markings made manually and those made with the app was 1° (±2°; range: 0°–5°), and the mean difference between the IOL position and the assessment made by the app was 3° (±3°; range: 0°–12°). Upon comparison of the agreement between the app measurements and the manual measurements for the IOL angle, no significant differences were found, and an excellent concordance (0.997) and a strong positive linear correlation (0.995) were observed. Conclusion. A mobile app for preoperative planning and intraoperative toric IOL alignment was developed and revealed to be useful and easy to use.

scholarly journals Two Different Corneal Incision Designs for Correcting Corneal Astigmatism During Cataract Surgery With Multifocal Intraocular Lens Implantation

2021 ◽  
Author(s):  
Dan Liu ◽  
Cong Fan ◽  
Chunyan Li ◽  
Jian Jiang
Keyword(s):  
Cataract Surgery ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Corneal Incision ◽  
Multifocal Iol ◽  
Clear Corneal Incision ◽  
Corneal Aberrations ◽  
Multifocal Intraocular Lenses ◽  
Post Surgery ◽  
The Mean

Abstract Background: Multifocal intraocular lenses (IOLs) is very intolerant to residual corneal astigmatism and patients with more than 1.0 D of residual corneal astigmatism are not suitable candidates for implantation of multifocal IOLs. The purpose of this study was to evaluate the efficacy of a single clear corneal incision (CCI) or an opposite clear corneal incision (OCCI) made on a steep meridian for correction of low to moderate corneal astigmatism during implantation of multifocal IOLs.Methods: This is a retrospective cohort study. A total of 50 patients with pre-operative total corneal astigmatism, ranging between 0.5 and 2.0 diopters (D), who underwent cataract surgery and received multifocal IOLs were included. Correction of corneal astigmatism was done via single CCIs on steep meridians in patients with 0.5–1.2 D total corneal astigmatisms, and OCCIs in patients with 1.3–2.0 D total corneal astigmatisms. Visual acuity, corneal astigmatism, ocular aberrations, corneal aberrations, and subjective vision quality were evaluated after surgery.Results: At 12-weeks post-surgery, the mean uncorrected distance vision (UCDV) was 0.06±0.09 logarithm of the minimum angle of resolution (logMAR) and 0.03±0.09 logMAR, and the mean uncorrected near vision (UCNV) was 0.08±0.11 logMAR and 0.09±0.09 logMAR in the CCI and OCCI groups, respectively. The change in corneal astigmatism was 0.52 ± 0.22D and 1.06 ± 0.23D in the CCI and OCCI groups, respectively (P<0.001). Total corneal higher-order aberrations (HOAs) and trefoil increased in both groups (P<0.05); however, there was no difference in the change in total corneal HOAs between the two groups (P>0.05). Conclusions: CCI and OCCI made on a steep axis could be an option for correction of mild-to-moderate astigmatism during cataract surgery with multifocal IOL implantation.

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