Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery
Received 7 July 2008; received in revised form 5 November 2008; accepted 12 November 2008.
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 J0 and J45, 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.
From the Ophthalmology Service (Mendicute, Irigoyen, Ruiz, Illarramendi), Donostia Hospital, San Sebastián, and the Optics Department (Ferrer-Blasco, Montés-Micó), University of Valencia, Valencia, Spain
Corresponding author: Javier Mendicute, MD, PhD, Servicio de Oftalmología, Hospital Donostia, P° Dr. Begiristáin, 115, 20080 San Sebastián, Spain.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT