Toric intraocular lens implantation: 100 consecutive cases.
OBJECTIVE
To evaluate the first 100 consecutive cases of toric posterior chamber silicone intraocular lens (IOL) implantation by 2 community-based ophthalmologists.


METHODS
Two private practices in western Virginia, USA.


METHODS
Data on the first 100 consecutive toric IOL implantations in 81 patients were collected in a prospective manner. Cataract surgery was performed using topical anesthesia and phaco-chop, phaco-flip, or divide-and-conquer phacoemulsification. A Staar AA4203TF or AA4203TL IOL with a 2.00 diopter (D) or 3.50 D toric power was implanted using a lens injector. After the viscoelastic material was removed, the IOL was rotated to the desired orientation. The IOL orientation was assessed postoperatively at 1 day, 1 to 2 weeks, and the last visit. The mean follow-up was 23 weeks +/- 17 (SD).


RESULTS
The IOLs performed in a predicable fashion. The mean astigmatism correction with IOLs within 15 degrees of the intended axis was 1.62 D with the 2.00 D IOL and 2.86 D with the 3.50 D IOL. Eleven patients had IOLs that were rotated more than 15 degrees away from the intended axes; in 3, the astigmatism was worse than preoperatively. The mean preoperative refractive and keratometric astigmatism was 2.48 D and 2.11 D, respectively. The mean postoperative astigmatism was 0.87 D and 2.05 D, respectively. At the last follow-up, half the patients had residual refractive astigmatism of 0.50 D or less and 45% had an uncorrected visual acuity of 20/30 or better. Of postoperative patients with a 20/30 visual acuity with or without correction, 52% could see this well no correction.


CONCLUSIONS
The results show that toric IOL implantation can help an estimated 20% of patients with astigmatism achieve good vision and a reduced need for distance spectacles. If IOL rotation occurs, it is usually during the first week and can be remedied by repositioning the IOL at 1 week.
Till
Jonathan Stanwood
JS
Lewis-Gale Clinic, Salem, Virginia 24153, USA.
Yoder
Paul R
PR
Wilcox
Thomas K
TK
Spielman
Jeffrey L
JL
D000368:Aged; D001251:Astigmatism / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011446:Prospective Studies; D011474:Prosthesis Design; D012029:Refraction, Ocular; D012826:Silicone Elastomers; D016896:Treatment Outcome; D014792:Visual Acuity
D012826:Silicone Elastomers