J Korean Ophthalmol Soc.  2009 Jun;50(6):831-838. 10.3341/jkos.2009.50.6.831.

The Clinical Result of AcrySof Toric Intraocular Lens Implantation

• Na JH
• Lee HS
• Joo CK

• KMID: 2212359
• DOI: http://doi.org/10.3341/jkos.2009.50.6.831

Abstract

PURPOSE: To evaluate the short-term efficacy of astigmatism correction and rotational stability of AcrySof Toric Intraocular lens (IOL) implants. METHOD: We analyzed 27 eyes of 23 patients who underwent microcoaxial cataract surgery (MCCS) and AcrySof Toric IOL implantation between March 2008 and July 2008. We evaluated visual acuity, keratometry, and refraction. Slit-lamp retro-illumination photographs were obtained in all patients on 1 day, 1 month and 3 months postoperatively. The change of postoperative IOL axis alignment and the presence of anterior capsular shrinkage were analyzed. RESULT: The mean unaided visual acuity (LogMAR) improved from 1.02+/-0.38 to 0.10+/-0.12. Although postoperative manual keratometric value was not different from the preoperative value, post-operative astigmatism decreased from a mean value of 1.66+/-0.42D to 0.61+/-0.38D at 3 months postoperatively. The mean difference between achieved and intended lens axis was 1.63+/-2.83 degrees at the first post-operative day, and 1.91+/-2.92 degrees on the first postoperative month, with all cases within 10 degrees. There were two cases of IOL rotation between one day and one month postoperative follow-up, and severe anterior capsule contractions were found in them.
CONCLUSIONS
AcrySof Toric IOL is effective for correction of astigmatism and it has good post-operative rotational stability. Because most of misalignments were found at the postoperative day 1, the precise implantation of IOL, according to the intended axis, can be important during operation and immediately after the operation.

Keyword

Cataract surgery; Corneal astigmatism; Rotational stability; Toric intraocular lens

MeSH Terms

Astigmatism
Axis, Cervical Vertebra
Cataract
Contracts
Eye
Follow-Up Studies
Humans
Lens Implantation, Intraocular
Lenses, Intraocular
Visual Acuity

Figure

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  Figure 1. Time course of uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Both post-operative UCVA and BCVA were significantly improved when compared with pre-operative values (p-value<0.001).

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  Figure 2. Bar chart of magnitude of the refractive cylinders (corneal plane). Before cataract surgery, the refractive cylinder was 1.66±0.42D and considering the SIA (surgically-induced astigmatism), we could predict the post-operative refractive cylinder as 1.82±0.78D using non-toric IOL. However, in this study, the post-operative refractive cylinder was 0.61±0.38D using the toric IOL. Decrement of the cylinder was statistically significant (p-value<0.001).

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  Figure 3. Two sets of anterior segment photographs representing two cases of IOL rotation at one day and one month postoperative follow-up (Arrow: reference marks on the optic surface, red line: axis). (A, B)=Case I; (C, D)=Case II; (A, C)=In both cases, IOL was placed precisely into the intended axis (90 degrees) on the first post-operative day observation; (B, D)=At post-operative one month, IOL was rotated counterclockwise by 5 degrees and 7 degrees in Case I and II, respectively. In both cases, anterior capsules showed fibrotic change and capsule contraction.

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  Figure 4. The degree and direction of IOL rotation. Two eyes had against-the-rule astigmatism (ATR), and 8 eyes had with-the-rule astigmatism (WTR). Plus and minus refers to clockwise and counterclockwise direction, respectively. Clockwise rotation was present in 3 eyes, while the remainders had counterclockwise rotation.

Reference

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