Correction of Astigmatism After Cataract Surgery Using the Light Adjustable Lens: A 1-year Follow-up Pilot Study

Abstract

In this pilot study, the LAL proved to be an efficient, predictable, and stable method of managing astigmatism in cataract patients.

Influence of the Overall Intraocular Lens Diameter on Rotational Stability

“…A slightly higher rotation of 4-5° was observed for a Z-haptic toric IOL (MicroSil 6116TU, HumanOptics) by Dick et al [11] and De Silva et al [12]. Good rotational stability was also observed for the light adjustable lens [15]. Differences between plate haptic toric IOL design and open-loop haptic toric IOL design have been discussed controversially in the literature.…”

Surgical management of astigmatism with toric intraocular lenses

“…Spectacle-independence for distance vision was reported by 60% to 85% of patients with unilateral toric IOL (3,6,31,34) and by 69% to 97% of patients with bilateral toric IOLs (7,8,35,36) . Reported percentages of patients with residual refractive astigmatism lower than 0.50 D range from 25% to 100% (9,10,37,38) . In addition, patients with forme fruste keratoconus and mild non-progressive keratoconus generally have a meaningful reduction in ocular astigmatism and improved uncorrected visual acuity after toric IOL implantation (11)(12)(13) .…”

“…Toric IOLs correct corneal astigmatism at the time of cataract surgery and are a predictable treatment in general (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . Monofocal toric IOLs can be used to correct the patient's vision for distance, for near or for both (this latter being attained via monovision) (3)(4)(5)(6)(7)(8)(9)(10) , while multifocal toric IOLs aim at providing good uncorrected vision for near, intermediate and far (14)(15)(16)19) . Moreover, toric phakic IOLs are a largely reversible treatment option for pre-cataractous patients who are not good candidates for corneal refractive surgery and have clinically significant astigmatism (20)(21)(22) .…”

Cataract Surgery in Keratoconus with Irregular Astigmatism

“…With appropriate light delivery settings, Light Adjustable Lenses (LAL) are attempt, at least in part, to address this issue on stable etasia, since this post-insertion method for the correction of refractive errors has been used successfully to correct astigmatism after cataract surgery (Hengerer et al, 2011, Lichtinger et al, 2011, Sandstedt et al, 2006, Schwartz et al, 2001). Topo-guided phototherapeutic keratectomy (PTK) has also been proposed after corneal collagen cross-linking to both stabilize the corneal ectasia and reduce the residual ametropia and other relevant HOA (Krueger et al, 2011, Kymionis et al, 2011.…”