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