Vector analysis of astigmatic changes after cataract surgery with toric intraocular lens implantation

Alió, Jorge L.; Piñero, David P.; Tomás, Javier; Alesón, Alicia

doi:10.1016/j.jcrs.2010.12.053

Cited by 61 publications

(30 citation statements)

References 57 publications

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“…The postoperative manifest cylinder refraction at 6 months (means ± standard deviation) was -0.74 D ± 0.26 D in the LRI group and -0.62 D ± 0.17 D in the toric IOL group, values consistent with those reported in the current literature (-0.71 D ± 0.42 D (13) and -0.94 D ± 0.40 D (23) ). These refractions were consistently lower than the intended astigmatism within each group and showed comparable outcomes between groups (Table 2).…”

Section: Discussionsupporting

confidence: 89%

Treatment of astigmatism during phacoemulsification

Freitas¹,

Boteon²,

Carvalho³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purpose: To compare the effectiveness of limbal relaxing incisions (LRI) with that of toric intraocular lens (IOL) implantation for the treatment of astigmatism during phacoemulsification using nonvectorial (predictability, safety, and efficacy) and vectorial analyses. Methods: This longitudinal observational case series assessed 62 eyes of 31 consecutive cataract patients with preoperative corneal astigmatism of 0.75-2.50 diopters (D) in both eyes. Patients were randomly assigned to 2 groups: a toric IOL group, which received toric IOLs in both eyes, and an LRI group, which received spherical IOLs associated with LRI placement in both eyes. All patients were evaluated at 1, 3, and 6 months after surgery, when refractive astigmatism analysis was performed using both nonvectorial and Alpins vectorial methods. Outcomes were assessed within each group and compared between groups. Results: The proportion of eyes within ±0.50 D of the intended correction at 3 and 6 months after surgery was 75% and 71.88%, respectively, in the LRI group and 40% and 66.67%, respectively, in the toric IOL group. In the remaining period, the proportion was greater in the toric IOL group. The safety index showed no difference at any time point. The efficacy index at 1 and 3 months after surgery was significantly higher in the toric IOL group (0.43 and 0.44, respectively) than in the LRI group (0.31 and 0.36, respectively). At 6 months after surgery, the status of eyes in the LRI group was as follows: 53.13% were undercorrected, 43.74% achieved the intended correction, and 3.13% were overcorrected. In the toric IOL group, 16.76% eyes were undercorrected, 76.67% achieved the intended correction, and 6.67% were overcorrected. The success rates for astigmatic surgery, astigmatism reduction at the intended axis, and astigmatism corrected were 43%, 62%, and 64%, respectively, in the LRI group and 57%, 81%, and 94%, respectively, in the toric IOL group. Conclusions: Our results suggest that the use of toric IOLs may be advantageous over the use of LRIs for the treatment of astigmatism during phacoemulsification. Although such advantages seem subtle in nonvectorial analyses, they are highlighted in vectorial analyses.

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Section: Discussionsupporting

confidence: 89%

Treatment of astigmatism during phacoemulsification

Freitas¹,

Boteon²,

Carvalho³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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“…(18,19) Differences between pre and postoperative refractive cylinders were statistically significant within each group throughout the follow up period (p value = 0.00). Between groups, however, they were not (p value > 0.05).…”

Section: Discussionmentioning

confidence: 92%

Comparison of clinical outcomes between limbal relaxing incisions and toric intraocular lenses in eyes with astigmatic corneas

Freitas¹,

Boteon²,

Carvalho³

et al. 2014

Revista Brasileira De Oftalmologia

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“…This confirms that the rotational stability of the evaluated bitoric IOL was good in most cases, which is consistent with the level of rotational stability reported for other toric IOLs. 8,18,19 Mendicute et al 8 reported a mean IOL rotation of 3.63° in eyes implanted with the Acrysof toric IOL, with 96% of eyes showing an IOL rotation of 10° or less. With the same type of toric IOL, Alió et al 18 obtained a mean value of IOL rotation of 3.35° ± 3.56°.…”

Section: Discussionmentioning

confidence: 99%

“…8,18,19 Mendicute et al 8 reported a mean IOL rotation of 3.63° in eyes implanted with the Acrysof toric IOL, with 96% of eyes showing an IOL rotation of 10° or less. With the same type of toric IOL, Alió et al 18 obtained a mean value of IOL rotation of 3.35° ± 3.56°. Sheppard et al 5 found a mean absolute IOL misalignment from the intended axis of 3.4° (range: 0° to 12°) in a sample of eyes implanted with the Tecnis toric IOL (Abbott Medical Optics, Inc., …”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Capsular Bag Stability of a Four-Point Haptic Bitoric Intraocular Lens

Kretz¹,

Breyer²,

Klabe³

et al. 2015

J Refract Surg

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PURPOSE: To evaluate the visual, refractive, and aberrometric outcomes of a bitoric intraocular lens (IOL) and its stability and alignment within the capsular bag. METHODS:A retrospective study including 41 eyes of 24 patients with preexisting corneal astigmatism of 0.75 diopters or greater undergoing cataract surgery with implantation of the bitoric IOL AT TORBI 709M (Carl Zeiss Meditec, Jena, Germany). Visual and refractive outcomes were evaluated during a 3-month follow-up period. The misalignment between intended and real axis and the levels of corneal, internal, and ocular aberrations (KR-1W; Topcon, Tokyo, Japan) were also evaluated. RESULTS:A total of 76% and 97% of eyes had a postoperative spherical equivalent within ±0.50 and ±1.00 diopters of emmetropia, respectively. Likewise, a total of 86% and 95% of eyes had a postoperative absolute value of refractive cylinder of 0.50 or less and 1.00 or less diopters, respectively. Mean postoperative corrected distance visual acuity was 0.00 logMAR (20/20 Snellen). Mean values of postoperative monocular and binocular uncorrected distance visual acuity were 0.10 and 0.00 logMAR (20/25 and 20/20 Snellen), respectively. The aberrometric analysis confirmed that the magnitude of ocular higher-order aberrations was mainly due to corneal optics and that the corneal astigmatism correction was sufficient with the toric IOL. Mean absolute IOL misalignment was 3.5º with values ranging from 0º to 10º. CONCLUSIONS:The bitoric IOL AT TORBI 709M is able to provide a predictable correction of corneal astigmatism with low postoperative levels of ocular higher-order aberrations.[J Refract Surg. 2015;31(7): 431-436.] new concept of toric intraocular lens (IOL) has been recently developed and released, the bitoric IOL. This type of IOL distributes cylinder power symmetrically on the front and back surface of the IOL, and not only on one surface as with toric IOLs currently available.1 This optical design has the theoretical advantage of obtaining IOLs of better optical quality when high cylinders should be corrected.2 One example of this type of toric IOL is the AT TORBI 709M (Carl Zeiss Meditec, Jena, Germany), which uses bitoric, monofocal, and aspheric (aberration neutral) optics.1 Previous studies have shown excellent visual and refractive outcomes after cataract surgery with implantation of this specific model of IOL.

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Vector analysis of astigmatic changes after cataract surgery with toric intraocular lens implantation

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 61 publications

References 57 publications

Treatment of astigmatism during phacoemulsification

Treatment of astigmatism during phacoemulsification

Comparison of clinical outcomes between limbal relaxing incisions and toric intraocular lenses in eyes with astigmatic corneas

Clinical Outcomes and Capsular Bag Stability of a Four-Point Haptic Bitoric Intraocular Lens

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