Accuracy and Stability of Refractive Astigmatism Correction at Time of Cataract Surgery

Monday, April 20, 2015: 4:12 PM
Room 4 (San Diego Convention Center)
P. Dee G. Stephenson, MD

To investigate the accuracy and stability of astigmatic treatments in cataract cases in which either toric IOLs  or arcuate incisions (AIs) guided by intraoperative aberrometry  were used to address astigmatism.

In this consecutive case series, astigmatic subjects seeking good uncorrected distance vision after cataract surgery were either implanted with a Trulign toric IOL or had femtosecond laser arcuate incisions to correct astigmatism.  Femtosecond laser-assisted cataract surgery with intraoperative aberrometry was employed in all cases.  Refraction and uncorrected distance visual acuity (UCDVA) are reported at 1 and 3 months.  The stability of UCDVA, postoperative spherical equivalent (SE), and postoperative refractive astigmatism from 1 to 3 months will also be reported.

At 1 month, there were 93 eyes available for analysis. The mean post-op UCDVA was 0.06 logMAR, with 100% of eyes 20/40 or better, 96% 20/30 or better, 85% 20/25 or better, and 57% 20/20 or better.  Mean post-op SE was -0.09 ± 0.26 D. The mean absolute value of prediction error (MAVPE) was 0.22 ± 0.17 D. 100% of eyes had a prediction error within 0.75 D; 92% within 0.50 D; and 66% within 0.25 D. Mean post-op astigmatism was 0.04 ± 0.18 D.  Nearly all eyes (98%) had ≤ 0.50 D of astigmatism at 1 month.  Three-month results and stability between 1 and 3 months will be reported.

Both toric IOLs and laser AIs provide effective and stable correction of astigmatism. With the aid of intraoperative aberrometry, cylinder power selection and toric IOL or AI positioning can be performed very accurately, reducing the prediction error and improving refractive results in astigmatic cataract patients.