Results of Femtosecond Laser-Assisted Cataract Surgery With Aspheric IOL for Low, Moderate, and High Astigmatism and With Monofocal IOL
Narrative Responses:
Purpose
To report visual results after femtosecond laser-assisted cataract surgery (FLACS) with aspheric toric IOL (Acrysof SN6AT3-T9, Alcon), compared to the non-toric aspheric IOL (SN60WF), at the Singapore National Eye Centre.
Methods
All eyes with FLACs and Acrysof aspheric toric IOL (May 2012-Aug2013) or aspheric monofocal IOL, target spherical equivalent ±0.5D, were retrospectively analyzed for % unaided visual acuity (UVA) 20/40 or better and 20/25 or better, at 6 weeks. Data included lens model (3 categories of astigmatism: low (T3-4), moderate (T5-6), high (T7-9)), surgeons and complications. Eyes with poor visual prognosis were excluded. Postoperative UVA between toric models were analyzed, and compared against non-toric IOL outcomes (SN60WF, Fisher's exact test, p<0.05). These results were benchmarked against data of 121 non-FLACS cases (SN60TT) by the same surgeons in 2011.
Results
All FLACs procedures (capsulotomy and fragmentation with Victus™ system) were successful. Overall % UVA 20/40 or better in 112 consecutive toric IOL cases was 97.3%, comparable to monofocal SN60WF at 96.6% (112/116). Mean residual refractive cylinder in FLACS-toric group was 0.57D (SD 0.4). UVA 20/40 or better amongst low (84/86, 97.7%), moderate (20/20, 100.0%) and high astigmatism-correcting groups (5/6, 84.6%) was not statistically different (p>0.05). UVA 20/25 or better was achieved in 74.1% of FLACs-toric group, comparable to FLACS-SN60WF group (68.1%, p>0.05), and significantly better than non-FLACs toric IOL outcomes (52.1%, p=0.003). Complications included: IOL repositioning (n=2); IOL exchange (n=1).
Conclusion
The Acrysof toric IOL for astigmatism correction paired with FLACS provided excellent and similar unaided vision to the aspheric monofocal IOL, and appeared significantly better than non-FLACS toric IOL results. For UVA 20/40 or better, correction efficacy was similar for mild, moderate and severe astigmatism groups.