Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery

Kessel, Line; Andresen, Jens; Tendal, Britta; Erngaard, Ditte; Flesner, Per; Hjortdal, Jesper

doi:10.1016/j.ophtha.2015.10.002

Cited by 256 publications

(175 citation statements)

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“…This includes procedures such as limbal relaxing incisions [14], opposite clear corneal incisions [15], excimer laser refractive procedures [16, 17], femtosecond laser-assisted astigmatic keratotomy [18], and toric IOL implantation [19–22]. At present, toric IOL implantation is highly recognized and it can be used to correct up to 8.0 D of corneal astigmatism after cataract surgery [23, 24]. In the present study, 21.28% of cataract patients in Central China had corneal astigmatism values between 1.5 D and 4.0 D, most of which could be effectively corrected with toric IOLs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China

et al. 2017

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BackgroundTo evaluate the distribution of biometric parameters and corneal astigmatism using the IOLMaster device before phacoemulsification in cataract patients in Central China.MethodsConsecutive cataract patients were recruited at the Central Hospital of Wuhan between January 2015 and June 2016. Ocular axial length (AL), keratometry values, anterior chamber depth (ACD) and horizontal corneal diameter (white to white [WTW]) of each cataract-affected eye were measured with the IOLMaster device.ResultsThe study evaluated 3209 eyes of 2821 cataract patients. The mean AL, ACD, and WTW were 24.38 ± 2.47 mm, 3.15 ± 0.48 mm, and 11.63 ± 0.43 mm, respectively. Corneal astigmatism of 0.51–1.00 diopters (D) was the most common range of values (34.96%). A total of 10.56% patients exhibited a corneal astigmatism greater than 2.0 D. The flat and steep keratometry values gradually increased with age. The mean ACD and WTW showed increasing trends as the AL increased (P < 0.001). When the AL was shorter than 26.0 mm, the keratometry decreased as AL increased. The against-the-rule (ATR) astigmatism proportion increased with age and the with-the-rule (WTR) astigmatism proportion decreased with age.ConclusionsThe profile of ocular biometric data and corneal astigmatism may help ophthalmologists improve their surgical procedures and make an appropriate IOL choice to gain a high quality of postoperative vision.

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Section: Discussionmentioning

confidence: 99%

Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China

et al. 2017

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“…Toric intraocular lenses (IOLs) are arguably one of the most successful methods to reduce astigmatism at the time of cataract surgery 1. However, residual astigmatism after toric IOL implantation remains a concern, with 36.5% of eyes not within 25% of their target astigmatism correction and 35.2% having uncorrected distance visual acuity worse than 20/25 1,2.…”

Section: Introductionmentioning

confidence: 99%

“…However, residual astigmatism after toric IOL implantation remains a concern, with 36.5% of eyes not within 25% of their target astigmatism correction and 35.2% having uncorrected distance visual acuity worse than 20/25 1,2. In otherwise healthy and uncomplicated cataract surgeries, one of the most important causes for unexpected residual astigmatism postoperatively is believed to be inaccurate preoperative keratometry measurements 2.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes with toric intraocular lenses planned using an optical low coherence reflectometry ocular biometer with a new toric calculator

Gundersen¹,

Potvin²

2016

OPTH

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PurposeTo prospectively evaluate postoperative clinical outcomes with implantation of toric intraocular lenses (IOLs) using preoperative keratometry from an optical low coherence reflectometry (OLCR) ocular biometer (Lenstar® LS900) and the built-in Barrett toric calculator.Patients and methodsA prospective observational study recruited one or both eyes of subjects who underwent uncomplicated cataract surgery with toric IOL implantation using OLCR biometery data and the Barrett toric IOL calculator for toric IOL planning. Data were collected at the preoperative, operative, 1-day and 2-month postoperative visits. The primary outcome measure was the manifest refractive astigmatism magnitude at 2 months. The secondary outcome measures included the manifest refraction, corneal keratometry, and distance visual acuity (corrected and uncorrected). The results obtained with the Barrett toric calculator were compared with simulated results based on the toric calculators designed for the IOLs being used.ResultsData from 98 eyes of 54 subjects were available for analysis. In the 74 eyes with postoperative lens orientation as planned, and sufficient IOL cylinder power to correct subjects’ measured astigmatism, 77% of eyes (57/74) had 0.5 diopter (D) or less refractive cylinder 2 months postoperatively, while 89% (66/74) had 0.75 D or less. Simulated results after adjusting actual IOL orientation to the planned orientation suggested that the Barrett calculator would result in postoperative residual astigmatism about 0.2 D lower than that expected with standard calculators.ConclusionUse of the Barrett toric calculator with biometry data from the Lenstar LS900 biometer for toric IOL planning in a clinical setting resulted in significantly lower levels of residual refractive cylinder than might be expected with standard calculators. Postoperative lens orientation and variability in the measurement of corneal astigmatism pre- and postoperatively appear to be important limiting factors in toric IOL outcomes.

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“…[12][13][14] Öyle ki katarakt cerrahisi sonrasında erken dönem GİB yükselmeleri-nin en sık nedeni ön kamarada kalan VEM'e bağlı trabeküler akımın blokajıdır. [3][4][5] Kalan VEM büyük oranda GİL implantasyonu esnasında kullanılan VEM'dir. Çünkü kapsüloreksis ve nükleus emülsi-fikasyonu esnasında kullanılan VEM yüksek vakum ve sıvı akımı nedeniyle ön kamaradan uzaklaşmaktadır.…”

Section: Discussionunclassified

“…3,4 Ayrıca gittikçe yaygınlaşan premium GİL uygulamalarında GİL arkasındaki VEM'in yeteri kadar temizlenmemesi GİL'de pozisyon değişiklik-lerine bağlı görme problemlerine neden olabilir. 5 Ancak cerrahi sonunda özellikle siliyer sulkustaki ve GİL'in arkasındaki VEM'in tümüyle temizlenmesi her zaman mümkün olmamaktadır.…”

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Reliability of Hydroimplantation Technique in Phacoemulsifification Surgery

Özateş¹,

Koç²

2018

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Hidroimplantasyon yöntemiyle göz içi lensi (GİL) yerleştirilmesinin cerrahi sonrası göz içi basıncına (GİB) ve kadranlara göre korneal endotel hücrelerine etkisini değerlendirmek. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Randomize ve prospektif çalışmaya Lens Opacities Classification System III'e göre NO2 den daha yüksek nükleer kataraktı olan, fakoemülsifikasyon ve GİL implantasyonu yapılmış 68 hastanın 68 gözü dahil edildi. Hastalar GİL implantasyonunda kullanılan tekniğe göre viskoelastik materyal (VEM) grubu ve hidroimplantasyon grubu olmak üzere 2 gruba ayrıldı. Hastaların cerrahi sonrası GİB, merkezi kornea kalınlığı (MKK), santral/superior/inferior/temporal / nazal kadranlarda endotel hücre sayıları preoperatif değerlerle karşılaştırılarak, grupların cerrahi sü-releri değerlendirildi. B Bu ul lg gu ul la ar r: : Hastaların 32'si (15 erkek, 17 kadın, ortalama yaşı: 60,9±9,9 yıl) VEM grubunda, 36'sı (17 erkek, 19 kadın, ortalama yaşı 59,0±7,8 yıl) hidroimplantasyon grubunda yer almaktaydı. Toplam cerrahi süresi VEM grubunda 8,12±1,01 dk, hidroimplantasyon grubunda 6,59±0,56 dk olup, cerrahi süre hidroimplantasyon grubunda anlamlı olarak daha düşüktü. Grupların preoperatif GİB değerleri benzer iken, postoperatif 5. saatte GİB VEM grubunda anlamlı olarak daha yüksekti. Ancak bu farkın 24. saatte kaybolduğu izlendi. Grupların MKK değerleri hem preoperatif hem de postoperatif dönemde benzerdi. Endotel hücre kaybı hidroimplantasyon grubunda tüm kadranlarda VEM grubuna göre daha fazlaydı ancak aradaki fark istatiksel olarak anlamlı değildi (santral; p=0,222; superior; p=0,091; inferior; p=0,583; temporal; p=0,089; nazal; p=0,096). İki grupta da en fazla endotel kaybı süperior kadranda izlendi. S So on nu uç ç: : Hidroimplantasyon cerrahi süresini kısaltan, cerrahi sonrası erken dönemde GİB artışını engelleyen ve endotel açısından da güvenilir bir yöntemdir. Ancak çalışma sonuçlarımız değerlendirilirken hasta populasyonunun küçük olması göz önünde bulundurulmalıdır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Fakoemülsifikasyon; katarakt; hidroimplantasyon; endotel; viskoelastik madde A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To assess the effect of intraocular lens (IOL) implantation with hydroimplantation technique on postoperative intraocular pressure (IOP) and corneal endothelial cells. M Ma at te er ri ia al l a an nd d M Me et th ho od d: : This prospective randomized clinical study examined 68 eyes of 68 patients with nuclear cataract greater than NO2 according to Lens Opacities Classification System III. Patients formed viscoelastic material (VEM) and hydroimplantation groups according to technique used in IOL implantation. Preoperative and postoperative IOP, central corneal thickness (CCT), corneal endothelial cell count at central, superior, inferior, temporal and nasal cornea outcomes were analyzed and compared. R Re es su ul lt ts s: : The VEM group consisted of 32 patients (15 male, 17 female, mean age:60.9±9.9 years) and the hydroim...

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Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery

Abstract: We found that toric IOLs provided better UCDVA, greater spectacle independence, and lower amounts of residual astigmatism than non-toric IOLs even when relaxing incisions were used.

Cited by 256 publications

References 50 publications

Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China

Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China

Clinical outcomes with toric intraocular lenses planned using an optical low coherence reflectometry ocular biometer with a new toric calculator

Reliability of Hydroimplantation Technique in Phacoemulsifification Surgery

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