Comparative evaluation of rotational stability and visual outcome of toric intraocular lenses with and without a capsular tension ring

Anju Rastogi, Samreen Khanam, Yashpal Goel, Kamlesh, Prolima Thacker, Prateek Kumar, Anju Rastogi, Samreen Khanam, Yashpal Goel, Kamlesh, Prolima Thacker, Prateek Kumar

Abstract

Purpose: To evaluate the rotational stability of toric intraocular lens (IOL) when co-implanted with a capsular tension ring (CTR) as compared to that of a toric IOL without a CTR.

Methods: This was a prospective randomized clinical trial performed in a tertiary care centre in India. Fifty adult human eyes with visually significant cataract and regular corneal astigmatism ≥1.5D divided into two groups of 25 eyes each, A and B by simple randomization. Eyes with corneal pathology, lens subluxation, and a specular endothelial cell count <2000/mm2 were excluded from the study. The eyes in both the groups underwent standard phacoemulsification and were implanted with a toric IOL. In Group A, a CTR was put in the bag before IOL implantation. The groups were called for follow-up on day 1, 1 week, 1 month, and 3 months, postoperatively. The axis of the toric IOL on each visit was measured by slit lamp imaging in retroillumination and analyzed digitally.

Results: Mean rotation of toric IOL at 3 months postoperatively was 1.85 ± 1.72° in Group A and 4.02 ± 2.04° in Group B. The difference was statistically significant (P = 0.003).

Conclusion: Coimplantation of a CTR is a safe and effective technique for ensuring better rotational stability of toric IOLs.

Keywords: Astigmatism; cataract; toric intraocular lens.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Rotation of the toric IOL as measured using ImageJ in a patient (S. No. 8) of Group A. Rotation at the end of 3 months was 1.2°. (b) Rotation of the toric IOL as measured using ImageJ in a patient (S. No. 8) of Group B. Rotation at the end of 3 months was 5.9°
Figure 2
Figure 2
Mean rotation of toric IOL (in degrees) in Group A and Group B at postoperative visits from the baseline axis of day 1

References

    1. Ferrer-Blasco T, Montés-Micó R, Peixoto-de-Matos SC, González-Méijome JM, Cerviño A. Prevalence of corneal astigmatism before cataract surgery. J Cataract Refract Surg. 2009;35:70–5.
    1. Lans LJ. Experimentelle untersuchungen uber entstehung von astigmatismus durch nich-perforirende corneawunden. Graefes Arch Ophthalmol. 1898;45:117.
    1. Oshika T, Shimazaki J, Yoshitomi F, Oki K, Sakabe I, Matsuda S, et al. Arcuate keratotomy to treat corneal astigmatism after cataract surgery: A prospective evaluation of predictability and effectiveness. Ophthalmology. 1998;105:2012–6.
    1. Lever J, Dahan E. Opposite clear corneal incisions to correct pre-existing astigmatism in cataract surgery. J Cataract Refract Surg. 2000;26:803–5.
    1. Shimizu K, Misawa A, Suzuki Y. Toric intraocular lenses: Correcting astigmatism while controlling axis shift. J Cataract Refract Surg. 1994;20:523–6.
    1. Novis C. Astigmatism and toric intraocular lenses. Curr Opin Ophthalmol. 2000;11:47–50.
    1. Visser N, Bauer NJ, Nuijts RM. Toric intraocular lenses: Historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg. 2013;39:624–37.
    1. Collins TJ. ImageJ for microscopy. Biotechniques. 2007;43:25–30.
    1. Grabow HB. Early results with foldable toric IOL implantation. Eur J Implant Refract Surg. 1994;6:177–8.
    1. Patel CK, Ormonde S, Rosen PH, Bron AJ. Postoperative intraocular lens rotation: A randomized comparison of plate and loop haptic implants. Ophthalmology. 1999;106:2190–5.
    1. Linnola RJ, Sund M, Ylönen R, Pihlajaniemi T. Adhesion of soluble fibronectin, laminin, and collagen type IV to intraocular lens materials. J Cataract Refract Surg. 1999;25:1486–91.
    1. Myers TD, Olson RJ. Comparison of the effects of viscoelastic agents on clinical properties of the Unfolder lens injection system. J Cataract Refract Surg. 1999;25:953–8.
    1. Shah GD, Praveen MR, Vasavada AR, Vasavada VA, Rampal G, Shastry LR, et al. Rotational stability of a toric intraocular lens: Influence of axial length and alignment in the capsular bag. J Cataract Refract Surg. 2012;38:54–9.
    1. Ruhswurm I, Scholz U, Zehetmayer M, Hanselmayer G, Vass C, Skorpik C, et al. Astigmatism correction with a foldable toric intraocular lens in cataract patients. J Cataract Refract Surg. 2000;26:1022–7.
    1. Findl O, Drexler W, Menapace R, Georgopoulos M, Rainer G, Hitzenberger CK, et al. Changes in intraocular lens position after neodymium: YAG capsulotomy. J Cataract Refract Surg. 1999;25:659–62.
    1. Holland E, Lane S, Horn JD, Ernest P, Arleo R, Miller KM, et al. The AcrySof toric intraocular lens in subjects with cataracts and corneal astigmatism: A randomized, subject-masked, parallel-group, 1-year study. Ophthalmology. 2010;117:2104–11.
    1. Waltz KL, Featherstone K, Tsai L, Trentacost D. Clinical outcomes of TECNIS toric intraocular lens implantation after cataract removal in patients with corneal astigmatism. Ophthalmology. 2015;122:39–47.
    1. Scialdone A, De Gaetano F, Monaco G. Visual performance of 2 aspheric toric intraocular lenses: Comparative study. J Cataract Refract Surg. 2013;39:906–14.
    1. Bascaran L, Mendecute J, Macias-Murelaga B, Arbalaitz N, Martinez Soroa I. Efficacy and stability of AT TORBI 709 M toric IOL. J Cataract Refract Surg. 2013;29:194–9.
    1. Lanzetta P, Chiodini RG, Polito A, Bandello F. Use of capsular tension ring in phacoemulsification. Indications and technique. Indian J Ophthalmol. 2002;50:333–7.
    1. Jacob S, Agarwal A, Agarwal A, Agarwal S, Patel N, Lal V, et al. Efficacy of a capsular tension ring for phacoemulsification in eyes with zonular dialysis. J Cataract Refract Surg. 2003;29:315–21.
    1. Wiley WF. Combining a CTR with a plate haptic toric IOL. Cataract Refract Surg Today. 2012:32–3.
    1. Safran SG. Use of Capsular Tension Ring to Prevent Early Post-operative Rotation of a Toric Intraocular Lens in High Axial Myopia. JCRS Online Case reports. 2015. [Last accessed on 2015 Aug 02]. Available from:
    1. Sagiv O, Sachs D. Rotation stability of a toric intraocular lens with a second capsular tension ring. J Cataract Refract Surg. 2015;41:1098–9.
    1. Zhao Y, Li J, Yang K, Li X, Zhu S. Combined special capsular tension ring and toric IOL implantation for management of astigmatism and high axial myopia with cataracts? Semin Ophthalmol. 2016:1–6. doi: 10.1080/08820538.2016.1247181.
    1. Miyake T, Kamiya K, Amano R, Iida Y, Tsunehiro S, Shimizu K, et al. Long-term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism. J Cataract Refract Surg. 2014;40:1654–60.

Source: PubMed

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