Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision

Abstract

Purpose: To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision. Methods: We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof. Results: In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism. Conclusions: During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.