High Toricity IOLs for Elevated Astigmatism
To describe the visual and refractive outcomes of customized high toric intraocular lens implantation in patients with high amounts of corneal astigmatism.
A retrospective review of clinical consecutive cases was performed including patients with more than 3.0 diopters (D) of corneal astigmatism, aged 40 years and over treated with cataract phacoemulsification or refractive lens exchange (RLE) and in the bag toric IOL implantation AT TORBI 709M or AT LISA toric 909M (Carl Zeiss Meditec AG), this IOLs power ranges up to 12 diopters of cylinder. Age, pre- and postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuity, objective and subjective refraction, total astigmatism, residual refractive cylinder, visual stability, efficacy and safety were analyzed.
Fourteen eyes of 9 patients (mean age 50.21±7.86 years), 2 patients with topographic diagnosis of stable keratoconus, 1 with stable pellucid marginal degeneration, 2 after penetrating keratoplasty, 3 with high myopic astigmatism and 1 with high mixed astigmatism. Mean follow-up after phacoemulsification was 11.21±3.8 months. Preoperative sphere was -7.18±6.26 D, and postoperative sphere was +1.12+0.71D, preoperative cylinder was -6.17±2.63 D, which decreased postoperatively to -1.82±2.11D. Mean pre and postoperative spherical equivalents were -9.94+6.23D and 0.21±1.19D respectively. Preoperative mean UDVA was 1.39±0.65 (20/490 Snellen) and postoperative mean UDVA was 0.30+0.16 (20/39 Snellen).
Our findings suggest that high cylinder intraocular lenses may provide excellent visual and refractive outcomes. High toricity IOL implantation could be a safe, predictable, and effective treatment for the correction of high and extreme astigmatism.