Aspheric Toric IOL Versus Limbal Relaxing Incisions in Eyes With Cataracts and Corneal Astigmatism: Randomized Study
Narrative Responses:
Purpose
The purpose of this study is to compare the results of aspheric toric IOLs and limbal relaxing incisions (LRI) in managing cataracts and corneal astigmatism at the time of surgery.
Methods
60 eyes with age-related cataracts necessitating surgery were recruited. All had pre-operative BCVA <0.2 logMAR and between 1.0-2.5D of pre-operative regular corneal astigmatism as measured by keratometry and confirmed by corneal topography. Eyes were randomized to receive phacoemulsification with either 1) implantation of aspheric monofocal IOL (Tecnis 1-Piece IOL) with LRI, or 2) aspheric toric IOL (Tecnis® Toric IOL). All surgeries were done by single surgeon with usual pre-op manual limbal marking and video-assisted eye tracking system. Uncorrected (UC) VA, BCVA, manifest refraction, keratometry and subjective need for spectacles were measured in months 1 and 3 post-operatively.
Results
60 eyes completed the surgery, with one patient excluded at post-op month 1 due to medical illness. UCVA improved 0.36±0.22 overall and similar in LRI and Toric groups. Cylinder reduction 0.64 diopter in LRI group and 1.35 diopter in Toric group, and the difference was significant (p=0.002). More patients in the Toric group (100%) were spectacle-free post-operatively than those in LRI group (87%). Rotational stability of the toric IOL was acceptable at 3%.
Conclusion
Toric IOLs significantly reduced corneal astigmatism after cataract surgery, compared to LRI. More patients remained spectacle free after receiving toric IOLs.