Comparison of Refractive Stability After Nontoric Versus Toric IOL Implantation During Cataract Surgery

Monday, April 28, 2014: 8:21 AM
Room 151B (Boston Convention and Exhibition Center)
Jinsun Kim, MD, The Institute of Vision Research, Seoul, South Korea
Jei Hun Jeon, MD, The Institute of Vision Research, Seoul, South Korea
Ae Young Kwak, MD, The Institute of Vision Research, Seoul, South Korea
Eung Kweon Kim, MD, Yonsei Univ College of Medicine, Seoul, South Korea
Tae-im Kim, MD, The Institute of Vision Research, Seoul, South Korea

Narrative Responses:

Purpose
To compare refractive state changes of eyes implanted with toric intraocular lenses (IOLs) versus non-toric IOLs, after cataract extraction.

Methods
Retrospective, comparative design. In a single-institution, 121 eyes underwent phacoemulsification and implantation with either non-toric IOLs (Alcon Laboratories AcrySof IQ SN60WF) or toric IOLs (AcrySof Toric IOL). Each group included patients who got surgery with non-toric IOLs (Group I) or toric IOLs T3, T4, and T5 (Groups II-3, -4, and -5), containing 37, 29, 23, and 32 eyes/group, respectively. Spherical value, cylindrical value, and spherical equivalent (SE) of refractive error, and visual acuity were measured preoperatively and 1, 3, and 6 months after surgery.

Results
Cylindrical value was significantly decreased in all groups (p<0.05). Before surgery, SE of refractive errors was estimated as -0.21, -0.10, -0.20, and -0.22 in respective groups. Actual remaining SE was -0.19, -0.24, -0.42, and -0.56 at 1 month; -0.17, -0.26, -0.57, and -0.64 at 3 months; and -0.17, -0.26, -0.70, and -0.74 at 6 months postoperative. Groups I and II-3 follow-up SE values were similar (p>0.05 in both groups); however, there were significant myopic changes in toric IOL Groups II-4 and II-5 after surgery, versus Group I (p<0.05).

Conclusion
Selection of toric IOLs for cataract surgery requires a refined formula to precisely determine necessary IOL power, especially in cases with high levels of astigmatism, to reliably and accurately prevent myopic outcomes.