New Toric IOL for Integration of Astigmatism Correction in Cataract Surgery

Tuesday, April 21, 2015: 8:01 AM
Room 5A (San Diego Convention Center)
Pierre-Marie Josselin, MD

Cataract surgery has known major refinements throughout this past decade and can pretend to belong to refractive surgeries. However, despite reduction in incision size and advent of new foldable biomaterials and injector cartridge, remaining postoperative cylinder of pre-existing astigmatism still impair visual outcomes. This limit could be solved by the design of toric IOLs. We evaluated the nanoFLEX Toric (STAAR Surgical) for the combined treatment of a cataract and congenital astigmatism.

Thirty eyes with preoperative regular astigmatism of 0.75 to 3.0 diopters were implanted with a nanoFLEX Toric IOL according to the magnitude of the pre-operative cylinder. This lens is made of Collamer material (a collagen and co-polymer blend), with a posterior toricity and presenting marks on the axis of correction. Characteristics of the nanoFLEX Toric IOL are determined on a specific online calculator. Surgical procedure requires high care in axis determination and lens positioning.

85% of patients achieved 20/25 or better and no patient continued to wear glasses for distance vision. Bilateral implantation was performed in 80% of patients. The mean rotation at 6 months follow-up was less than 5° with no case of more than 10°. No axis changes were observed after 1 month. All surgeries were performed with a 2.2 mm incision and with no enlargement of the incision for the injection of the lens.

In this study the nanoFLEX Toric achieved the goal of efficacy and safety for correction of astigmatism at the same time cataract removal, with a good rotational stability of the lens in the bag. The higher the preoperative cylinder, the more benefit is achieved by the nanoFLEX Toric lens