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J Cataract Refract Surg. 2009 Mar;35(3):451-8. doi: 10.1016/j.jcrs.2008.11.043.

Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery.

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  • 1Ophthalmology Service, Donostia Hospital, San Sebastián, Spain. jmendicu@chdo.osakidetza.net

Abstract

PURPOSE:

To compare toric intraocular lens (IOL) implantation with paired opposite clear corneal incisions (OCCIs) for astigmatism correction in patients having cataract surgery.

SETTING:

Ophthalmology Service, Donostia Hospital, San Sebastián, Spain.

METHODS:

This randomized prospective clinical study comprised eyes with more than 1.00 diopter (D) of preexisting corneal astigmatism. One group had AcrySof toric IOL implantation and the other, paired 2.75 mm/3.20 mm OCCIs in the steep axis with spherical IOL implantation. Uncorrected (UCVA) and best corrected (BCVA) visual acuity, refraction, corneal and total higher-order aberrations (HOAs), photopic and mesopic contrast sensitivity, and toric IOL axis were measured 3 months postoperatively.

RESULTS:

Forty eyes (40 patients) were evaluated. In the toric group, 95% of eyes achieved 20/40 or better UCVA and 70%, 20/25 or better. In the OCCI group, 80% of eyes achieved 20/40 or better UCVA and 50%, 20/25 or better. All eyes achieved 20/25 or better BCVA. Mean refractive cylinder decreased significantly from preoperatively to postoperatively (-1.75 +/- 0.71 to -0.62 +/- 0.46 D, toric group; -1.61 +/- 0.67 to -0.97 +/- 0.51 D, OCCI group) (P<.01). In the toric group, 95% and 100% of eyes were within +/-0.50 D for J(0) and J(45), respectively. In the OCCI group, the percentages were 70% and 100%, respectively. No significant differences in HOA were found between groups (P>.1). Contrast sensitivity was similar except at the highest spatial frequency, being better in the toric group (P<.01).

CONCLUSION:

Toric IOL implantation achieved a slight enhanced effect over OCCIs in treating preexisting astigmatism.

[PubMed - indexed for MEDLINE]
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