Rotational stability of Toric intraocular lenses

Abhinav Singh, Gaurav Kapoor, Vinod K Baranwal, Nidhi Kalra, Abhinav Singh, Gaurav Kapoor, Vinod K Baranwal, Nidhi Kalra

Abstract

Background: A prospective study to evaluate the rotational stability of toric intraocular lenses (IOLs).

Methods: A prospective study of 30 eyes in 29 patients. All patients with regular astigmatism of range 0.75-4 D were included in the study. Exclusion criteria included irregular corneal astigmatism, post-refractive surgery and corneal dystrophies. All patients underwent uncomplicated phacoemulsification cataract surgery by the same surgeon. Three eyes with corneal astigmatism of 0.75-1.5 D were implanted with the AcrySof SA60T3 IOL, eight eyes with astigmatism between 1.5 and 2.0 D received the SA60T4 IOL and eight eyes with astigmatism between 2.0 and 2.50 D received the SA60T5 and rest with astigmatism of 2.5 D and higher received SA60T6 and above models. Main outcome measure was the post-operative position of the lens, assessed at day 1, 1 week, 1 month and 6 months, using toric marker and the slit lamp.

Results: There was no significant rotation of IOL observed during a follow-up period of 6 months. Overall, the post-operative rotation was within 5° in 95% of cases. There was no trend for either clockwise or anti-clockwise rotation. However, IOL rotation happens mostly within the first month of surgery, and if it is significant, it requires early repositioning.

Conclusion: Toric IOLs are very effective and consistent in correcting astigmatism during the cataract surgery. Once placed to its position, toric IOLs demonstrate rotational stability in the capsular bag.

Keywords: Astigmatism; Cataract surgery; Toric intraocular lenses; Toric lenses.

© 2020 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.

Figures

Fig. 1
Fig. 1
Toric intraocular lens (IOL).
Fig. 2
Fig. 2
Toric marking set.
Fig. 3
Fig. 3
(a) Intra-operative marking. (b) Intra-operative axis.
Fig. 4
Fig. 4
Anterior capsular polishing.
Chart 1
Chart 1
Pre- and post-operative pattern of astigmatism.

References

    1. Kaur M., Shaikh F., Falera R., Titiyal J.S. Optimizing outcomes with toric intraocular lenses. Indian J Ophthalmol. 2017;65:1301–1313.
    1. He Wenwen, Zhu Xiangjia, Du Yu, et al. 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 Ophthalmic. 2017;17:132.
    1. Kessel L., Andresen J., Tendal B., Erngaard B., Flesner P., Hjortdal J. Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systemic review and meta analysis. Ophthalmology. 2016;123:275–286.
    1. Grabow H.B. Early results with foldable toric IOL implantation. Eur J Implant Refract Surg. 1994;6:177–178.
    1. Ruhswurm I., Scholz U., Zehetmayer M., Hanselmayer G., Vass C., Skorpik C. Astigmatism correction with a foldable toric intraocular lens in cataract patients. J Cataract Refract Surg. 2000;7:1022–1027.
    1. Zhu X., He W., Zhang K., et al. Factors influencing 1-year rotational stability of AcrySof Toric intraocular lenses. Br J Ophthalmol. 2016;100:263–268.
    1. Patel C.K., Ormonde S., Rosen P.H., Bron A.J. Postoperative intraocular lens rotation: a randomized comparison of plate and loop haptic implants. Ophthalmology. 1999;106:2190–2195.
    1. Linnola R.J., Sund M., Ylönen R., Pihlajaniemi T. Adhesion of soluble fibronectin, laminin, and collagen type IV to intraocular lens materials. J Cataract Refract Surg. 1999;25:1486–1491.
    1. Myers T.D., Olson R.J. Comparison of the effects of viscoelastic agents on clinical properties of the unfolder lens injection system. J Cataract Refract Surg. 1999;25:953–958.
    1. Shah G.D., Praveen M.R., Vasavada A.R., et al. Rotational stability of a toric intraocular lens: influence of axial length and alignment in the capsular bag. J Cataract Refract Surg. 2012;38:54–59.
    1. Toto L., Vecchiarino L., D'Ugo E., et al. Astigmatic correction with toric IOL: analysis of visual performance, position and wavefront error. J Refract Surg. 2013;25:476–483.
    1. Holland E., Lane S., Horn J.D., et al. The AcroSof Toric intraocular lens in subjects with cataracts and corneal astigmatism: a randomized, subject masked. parallel-group, 1- year study. 2010;117:2104–2111.
    1. Mendicute J., Irigoyen C., Aramberri J., et al. Foldable toric intraocular lens for astigmatism correction in cataract patients. J Cataract Refract Surg. 2008;34:601–607.
    1. Miyake T., Kamiya K., Amano R., et al. Long term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism. J Cataract Refract Surg. 2014;40:1654–1660.

Source: PubMed

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