Mini-incision cataract surgery and toric lens implantation for the reduction of high myopic astigmatism in patients with pellucid marginal degeneration (original) (raw)
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Astigmatism Correction in Cataract Surgery with Foldable Toric IOL
MVP Journal of Medical Sciences, 2014
Aim: To evaluate correction of pre-existing astigmatism after foldable Toric IOL implantation in patients undergoing cataract surgery. Materal & Methods: In this prospective observational study we included 10 eyes of 10 patients with astigmatism between 2.00D to 6.00D &undergoing cataract surgery. Phacoemulsification was performed with Toric IOL implantation through 2.8mm clear corneal temporal incision. Patients were examined post operatively for Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA) & residual refractive astigmatism. Statistical Analysis: Statistical analysis was performed by the SPSS program for Windows, ver.16.0.Continuous variables are expressed as mean ± SD, and categorical variables are presented as absolute numbers and percentage. For the statistical test, a p value less than 0.05 was taken to indicate a significant difference. Results: The UCVA was 6/9 or better in 90% of eyes. 80% eyes achieved 6/6 BCVA. The mean refractive cylinder corrected from-3.4 ± 1.4 D to-0.60 ± 0.27 D which was statistically significant. (p value=0.0001). Conclusion: Toric IOL implantation is an effective, safe surgical option to manage pre-existing corneal astigmatism during cataract surgery.
Journal of refractive surgery (Thorofare, N.J. : 1995), 2015
To evaluate vector analysis, rotational stability, and refractive and visual outcome of a new toric intraocular lens (IOL) for correction of preexisting corneal astigmatism during routine cataract surgery. In this prospective, interventional case series, 30 toric, aspheric Bi-Flex T toric IOLs (Medicontur Medical Engineering Ltd., Inc., Zsámbék, Hungary) were implanted in 20 consecutive patients with topographic corneal astigmatism between 1.50 and 4.00 diopters (D) and evaluated within the first year after implantation. Appropriate IOL-toric alignment was facilitated by combined imaging/eye tracking technology. Postoperative evaluation included refraction and uncorrected and corrected distance visual acuities (UDVA, CDVA). For each visit, photodocumentation in retroillumination was performed to evaluate toric alignment and potential toric IOL rotation. Vector analysis of refractive astigmatism was performed using the Alpins method. At 12 months postoperatively, a reduction of the r...
BMC ophthalmology, 2017
Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular corneal astigmatism and a patient with keratoconus following pars plana vitrectomy. As far as we are aware, there are no reported cases of toric IOL implantation in a vitrectomized eye with keratoconus nor of toric IOL implantation in patients with scleral-buckle-induced regular corneal astigmatism. Two patients with myopia and high corneal astigmatism underwent cataract operation with toric IOL implantation after posterior segment surgery. Myopia and high astigmatism (>2.5 diopter) were caused by previous scleral buckling in one case and by keratoconus in the other case. Pre- and postoperative examinations during the follow-up of included uncorrected and spectacle corrected distance visual acuity (UCDV...
https://www.ijrrjournal.com/IJRR\_Vol.6\_Issue.7\_July2019/Abstract\_IJRR0022.html, 2019
Aim: To study the role of opposite clear corneal incision (OCCI) and toric IOL in correcting pre-existing astigmatism and to compare their efficacy for correcting pre-existing astigmatism in phacoemulsification in cataract surgery. Material and Methods: The study was a prospective study conducted in a tertiary care hospital in North India and included 50 eyes of 50 patients of age >40 years with visually significant cataract and pre-existing regular corneal astigmatism from 1.0 D to 3.0 Ddivided into two groups of 25 each. Group 1 had toric IOL implantation and Group 2underwent paired 3.20 mm OCCIs on the steep axis with spherical IOL implantation. UCVA & BCVA, refraction and toric IOL axis rotation were measured postoperatively on day 1, day 7, I month, 2 month and 3 month. Results: In our analysis 84% and 76% eyes in gp 1 and gp 2, resp., had uncorrected visual acuity (UCVA) of 6/9 or better .96% eyes in both the groups attained 6/9 or better best corrected visual acuity (BCVA) at 3 month post-operatively. Mean refractive cylinder decreased significantly from preop to postop, 2.19 ± 0.45 D to 0.26 ± 0.36 D in group 1 (Toric) and 1.58 ± 0.45 D to 0.43 ± 0.38 D in group 2 (OCCI). The mean reduction in refractive cylinder was 1.93D in the toric IOL group and 1.15D in OCCI group. There was statistically significant difference in correcting astigmatism in the two groups. Conclusion-Toric IOL implantation achieved an enhanced effect over OCCIs in treating pre existing astigmatism in patients undergoing cataract surgery. No significant toric IOL axis rotation was noted in any eye.
Medical Journal Armed Forces India, 2017
Backgroud: Modern day cataract surgery aims at a spectacle free vision which becomes difficult in cases with pre-operative astigmatism more than 1.5 D. Implantation of toric intra-ocular lenses (IOL) after phacoemulsification in such eyes is one of the ways to counteract this problem. Methods: Thirty eyes with pre-operative astigmatism between 1.5 D and 4.5 D were implanted with toric IOLs following uneventful phaco-emulsification. The estimation of the axis of implantation of this toric IOL included calculating the surgically induced astigmatism (SIA) of the surgeon. Results: Post-operatively, 20 (66.67%) patients had a visual acuity 6/9 or better and 17 (57%) had a visual acuity of 6/6 at 12 weeks. The mean postoperative uncorrected visual acuity (UCVA) was 0.12 AE 0.15 at 12 weeks. The difference between means of preoperative best corrected visual acuity (BCVA) LogMAR and postoperative UCVA at 12 wk LogMAR was found to be statistically significant at p = 0.001. Mean (SD) scores of pre-op astigmatism of study group was À2.20 (0.67) and residual astigmatism was À0.32 (0.44). Conclusions: The difference between means of pre-op astigmatism and residual astigmatism in the study group was significant at p = 0.001 with 95% CI À2.22 to À1.50. This significant difference was because of the toric IOL implantation.
Clinical Ophthalmology
The purpose of this study was to evaluate the clinical outcomes of apodized diffractive +3.0 D multifocal toric intraocular lens (IOL) implantations in subjects with preoperative corneal astigmatism. Patients and methods: This was a prospective cohort study conducted at 21 US sites. The study population consisted of 574 subjects, aged 21 years, with preoperative astigmatism 0.75-2.82 D, and potential postoperative visual acuity (VA) 0.2 logMAR, undergoing bilateral cataract removal by phacoemulsification. The intervention was bilateral implantation of aspheric apodized diffractive +3.0 D multifocal toric or spherical multifocal nontoric IOLs. The main outcome measures were monocular uncorrected near and distance VA and safety at 12 months. Results: A total of 373/386 and 182/188 subjects implanted with multifocal toric and nontoric IOLs, respectively, completed 12-month follow-up after the second implantation. Toric IOLs were noninferior in monocular uncorrected distance (4 m) and near (40 cm) VA but had 1 line better binocular uncorrected intermediate VA (50, 60, and 70 cm) than nontoric IOLs. Toric IOLs reduced cylinder to within 0.50 D and 1.0 D of target in 278 (74.5%) and 351 (94.1%) subjects, respectively. Mean ± standard deviation (SD) differences between intended and achieved axis orientation in the first and second implanted eyes were 5.0°±6.1° and 4.7°±4.0°, respectively. Mean ± SD 12-month IOL rotations in the first and second implanted eyes were 2.7°±5.8° and 2.2°±2.7°, respectively. No subject receiving toric IOLs required secondary surgical intervention due to optical lens properties. Conclusion: Multifocal toric IOLs were noninferior to multifocal nontoric IOLs in uncorrected distance and near VAs in subjects with preexisting corneal astigmatism and effectively corrected astigmatism of 0.75-2.82 D.
British Journal of Ophthalmology, 2014
Purpose To evaluate the clinical outcome in eyes with significant corneal astigmatism after cataract surgery with implantation of a new diffractive multifocal toric intraocular lens (IOL). Methods Prospective, non-randomised multicentre clinical study including 57 eyes of 38 consecutive patients with an age between 37 and 84 years that underwent cataract surgery with implantation of the toric multifocal IOL Tecnis ZMT (Abbott Medical Optics, Santa Ana, California, USA). Changes in uncorrected and corrected logMAR distance, intermediate and near visual acuity ((uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), corrected near visual acuity) and manifest refraction were evaluated during a 2-4 month follow-up. Additionally, patients were asked about photic phenomena and spectacle dependence. The surgeons subjectively assessed various aspects of the surgery. Results A significant improvement in CDVA was observed postoperatively (p<0.01), with a significant reduction in manifest cylinder (p<0.01). Mean postoperative binocular UDVA and UNVA were 0.04 ±0.10 and 0.06±0.12, respectively. Monocular UDVA and UNVA was 0.20 or better in 85.4% and 87.0% of eyes, respectively. Mean binocular logMAR UIVA was 0.21±0.20. Only 10.5% of patients required postoperative correction for near or intermediate distance. The incidence of moderate to severe photic phenomena was limited. Surgeons defined the IOL implantation in most cases as easy or very easy, with a satisfaction rate with the procedure of 84%. Conclusions The implantation of the multifocal toric IOL is a safe procedure that provides a very good visual rehabilitation in eyes with corneal astigmatism.