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International Ophthalmology

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06-08-2022 | Cataract | Original Paper

Effect of two different preoperative calculation schemes on visual outcomes of patients after toric intraocular lens implantation

Authors: Xuewen Yu, Jingwen Wang, Xueqi Lin, Dejian Xu, Shuang Ni, Siting Sheng, Wen Xu

Published in: International Ophthalmology | Issue 2/2023

Abstract

Purpose

To compare the postoperative visual outcomes of two different preoperative corneal incision schemes in TECNIS toric intraocular lens (IOL) implantation.

Methods

In this randomized controlled study, patients with preoperative corneal astigmatism greater than 1.0 diopter (D) were included. These patients were grouped according to the different preoperative schemes: steep-axis group and minimum-residual refractive astigmatism group. The outcome measurements were the residual refractive astigmatism, visual acuity, changes of corneal astigmatism, and high-order aberration at 1 month postoperatively.

Results

This study consisted of 90 eyes (45 eyes steep-axis group, 45 eyes minimum-residual refractive astigmatism group). 1 month after surgery, the refractive astigmatism was statistically lower in the minimum-residual refractive astigmatism group compared with the steep-axis group (0.58 ± 0.40D vs 0.38 ± 0.37D, P = 0.021). The minimum-residual refractive astigmatism group had a smaller difference vector (0.56 ± 0.38D vs 0.36 ± 0.35D; P = 0.047) and a smaller prediction error (0.60 ± 0.44D vs 0.37 ± 0.35D; P = 0.004). In the steep-axis group, corneal astigmatism significantly decreased compared with preoperative value (1.65 ± 0.57D vs 1.17 ± 0.64D; P < 0.001). In the minimum-residual refractive astigmatism group, the changes of corneal astigmatism before and after surgery were not significant. Moreover, total aberration and second astigmatism in ocular aberration were lower in the minimum-residual refractive astigmatism group compared with the steep-axis group (1.86 ± 1.09 vs 1.37 ± 0.95; P = 0.035 and 0.47 ± 0.28 vs 0.31 ± 0.19; P = 0.015, respectively).

Conclusion

Minimum-residual refractive astigmatism incision had better astigmatism correction and more accurate prediction. The corneal astigmatism was stable 1 month after surgery. It might lead to better visual quality in the early postoperative stage.

Trial registration number for prospectively registered trials: clinicaltrials.gov NCT04006912, 07/02/2019.

Wu Z, Liu C, Chen Z (2020) Prevalence and age-related changes of corneal astigmatism in patients undergoing cataract surgery in Northern China. J Ophthalmol 2020:6385098. https://doi.org/10.1155/2020/6385098CrossRefPubMedPubMedCentral

Chen W, Zuo C, Chen C, Su J, Luo L, Congdon N, Liu Y (2013) Prevalence of corneal astigmatism before cataract surgery in Chinese patients. J Cataract Refract Surg 39:188–192. https://doi.org/10.1016/j.jcrs.2012.08.060CrossRefPubMed

Han ES, Kim M (2019) Evaluation of biometry and corneal astigmatism in cataract surgery patients in Northern United Arab Emirates. Int Ophthalmol 39:2807–2813. https://doi.org/10.1007/s10792-019-01127-3CrossRefPubMed

Nemeth G, Szalai E, Berta A, Modis L Jr (2013) Astigmatism prevalence and biometric analysis in normal population. Eur J Ophthalmol 23:779–783. https://doi.org/10.5301/ejo.5000294CrossRefPubMed

De Bernardo M, Zeppa L, Cennamo M, Iaccarino S, Zeppa L, Rosa N (2014) Prevalence of corneal astigmatism before cataract surgery in Caucasian patients. Eur J Ophthalmol 24:494–500. https://doi.org/10.5301/ejo.5000415CrossRefPubMed

Schallhorn SC, Hettinger KA, Pelouskova M, Teenan D, Venter JA, Hannan SJ, Schallhorn JM (2021) Effect of residual astigmatism on uncorrected visual acuity and patient satisfaction in pseudophakic patients. J Cataract Refract Surg 47:991–998. https://doi.org/10.1097/j.jcrs.0000000000000560CrossRefPubMed

McAlinden C, Janicek D (2021) Toric intraocular lenses for the management of corneal astigmatism at the time of cataract surgery. J Ophthalmol 2021:3286043. https://doi.org/10.1155/2021/3286043CrossRefPubMedPubMedCentral

Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J (2016) Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis. Ophthalmology 123:275–286. https://doi.org/10.1016/j.ophtha.2015.10.002CrossRefPubMed

He W, Zhu X, Du Y, Yang J, Lu Y (2017) Clinical efficacy of implantation of toric intraocular lenses with different incision positions: a comparative study of steep-axis incision and non-steep-axis incision. BMC Ophthalmol 17:132. https://doi.org/10.1186/s12886-017-0528-xCrossRefPubMedPubMedCentral

10.

Rho CR, Joo CK (2012) Effects of steep meridian incision on corneal astigmatism in phacoemulsification cataract surgery. J Cataract Refract Surg 38:666–671. https://doi.org/10.1016/j.jcrs.2011.11.031CrossRefPubMed

11.

Koch DD, Ali SF, Weikert MP, Shirayama M, Jenkins R, Wang L (2012) Contribution of posterior corneal astigmatism to total corneal astigmatism. J Cataract Refract Surg 38:2080–2087. https://doi.org/10.1016/j.jcrs.2012.08.036CrossRefPubMed

12.

Alpins N (2001) Astigmatism analysis by the Alpins method. J Cataract Refract Surg 27:31–49. https://doi.org/10.1016/s0886-3350(00)00798-7CrossRefPubMed

13.

Alpins NA (1993) A new method of analyzing vectors for changes in astigmatism. J Cataract Refract Surg 19:524–533. https://doi.org/10.1016/s0886-3350(13)80617-7CrossRefPubMed

14.

Alpins NA, Goggin M (2004) Practical astigmatism analysis for refractive outcomes in cataract and refractive surgery. Surv Ophthalmol 49:109–122. https://doi.org/10.1016/j.survophthal.2003.10.010CrossRefPubMed

15.

Ermiş SS, Inan UU, Oztürk F (2004) Surgically induced astigmatism after superotemporal and superonasal clear corneal incisions in phacoemulsification. J Cataract Refract Surg 30:1316–1319. https://doi.org/10.1016/j.jcrs.2003.11.034CrossRefPubMed

16.

Borasio E, Mehta JS, Maurino V (2006) Torque and flattening effects of clear corneal temporal and on-axis incisions for phacoemulsification. J Cataract Refract Surg 32:2030–2038. https://doi.org/10.1016/j.jcrs.2006.09.010CrossRefPubMed

17.

Kohnen S, Neuber R, Kohnen T (2002) Effect of temporal and nasal unsutured limbal tunnel incisions on induced astigmatism after phacoemulsification. J Cataract Refract Surg 28:821–825. https://doi.org/10.1016/s0886-3350(01)01215-9CrossRefPubMed

18.

Kaufmann C, Peter J, Ooi K, Phipps S, Cooper P, Goggin M (2005) Limbal relaxing incisions versus on-axis incisions to reduce corneal astigmatism at the time of cataract surgery. J Cataract Refract Surg 31:2261–2265. https://doi.org/10.1016/j.jcrs.2005.08.046CrossRefPubMed

19.

Özyol E, Özyol P (2014) Analyses of surgically induced astigmatism and axis deviation in microcoaxial phacoemulsification. Int Ophthalmol 34:591–596. https://doi.org/10.1007/s10792-013-9858-8CrossRefPubMed

20.

Hashemi H, Khabazkhoob M, Soroush S, Shariati R, Miraftab M, Yekta A (2016) The location of incision in cataract surgery and its impact on induced astigmatism. Curr Opin Ophthalmol 27:58–64. https://doi.org/10.1097/icu.0000000000000223CrossRefPubMed

21.

Altan-Yaycioglu R, Akova YA, Akca S, Gur S, Oktem C (2007) Effect on astigmatism of the location of clear corneal incision in phacoemulsification of cataract. J Refract Surg 23:515–518CrossRefPubMed

22.

Visser N, Beckers HJ, Bauer NJ, Gast ST, Zijlmans BL, Berenschot TT, Webers CA, Nuijts RM (2014) Toric vs aspherical control intraocular lenses in patients with cataract and corneal astigmatism: a randomized clinical trial. JAMA Ophthalmol 132:1462–1468. https://doi.org/10.1001/jamaophthalmol.2014.3602CrossRefPubMed

23.

Mencucci R, Giordano C, Favuzza E, Gicquel JJ, Spadea L, Menchini U (2013) Astigmatism correction with toric intraocular lenses: wavefront aberrometry and quality of life. Br J Ophthalmol 97:578–582. https://doi.org/10.1136/bjophthalmol-2013-303094CrossRefPubMed

24.

Ferreira TB, Almeida A (2012) Comparison of the visual outcomes and OPD-scan results of AMO tecnis toric and Alcon Acrysof IQ toric intraocular lenses. J Refract Surg 28:551–555. https://doi.org/10.3928/1081597X-20120703-03CrossRefPubMed

25.

Holzer MP, Goebels S, Auffarth GU (2006) Precision of NIDEK OPD-scan measurements. J Refract Surg 22:S1021-1023CrossRefPubMed

26.

Burakgazi AZ, Tinio B, Bababyan A, Niksarli KK, Asbell P (2006) Higher order aberrations in normal eyes measured with three different aberrometers. J Refract Surg 22:898–903CrossRefPubMed

27.

Rozema JJ, Van Dyck DE, Tassignon MJ (2006) Clinical comparison of 6 aberrometers. Part 2: statistical comparison in a test group. J Cataract Refract Surg 32:33–44. https://doi.org/10.1016/j.jcrs.2004.11.052CrossRefPubMed

28.

Kohnen T, Klaproth OK, Bühren J (2009) Effect of intraocular lens asphericity on quality of vision after cataract removal: an intraindividual comparison. Ophthalmology 116:1697–1706. https://doi.org/10.1016/j.ophtha.2009.03.052CrossRefPubMed

Title: Effect of two different preoperative calculation schemes on visual outcomes of patients after toric intraocular lens implantation
Authors: Xuewen Yu
Jingwen Wang
Xueqi Lin
Dejian Xu
Shuang Ni
Siting Sheng
Wen Xu
Publication date: 06-08-2022
Publisher: Springer Netherlands
Keywords: Cataract
Incision
Published in: International Ophthalmology / Issue 2/2023
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-022-02447-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of two different preoperative calculation schemes on visual outcomes of patients after toric intraocular lens implantation

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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