title: Clinical outcomes of complex and uncomplicated cataractous eyes after lens replacement with the AcrySof toric IOL.
abstract: OBJECTIVE
  to compare outcomes for uncomplicated versus complex eyes after implantation of AcrySof toric intraocular lenses (IOLs) (Alcon Laboratories Inc) in a retrospective series of cataractous astigmatic eyes.
  
  
  METHODS
  toric IOLs were implanted in 230 eyes of 162 adult patients. Approximately half (52%, n=120) the eyes had no complications (uncomplicated group). The other 110 (48%) eyes (complex group) had a variety of complexities, including retinal or macular problems (eg, age-related macular degeneration), angle or pressure problems (eg, glaucoma), or high astigmatism that required adjunctive limbal relaxing incisions (LRIs). Outcomes were retrospectively assessed approximately 6 weeks after surgery.
  
  
  RESULTS
  preoperative corneal astigmatism was 1.60 ± 1.20 diopters (D) overall (1.40 ± 0.70 D in the uncomplicated group and 1.90 ± 1.60 D in the complex group). Residual cylinder was 0.40 ± 0.60 D overall (P<.01 compared to baseline) and was significantly lower (P<.01) for the uncomplicated group (0.30 ± 0.40 D) than for the complex group (0.50 ± 0.80 D), which contained the adjunctive LRI subgroup (residual cylinder 0.80 ± 0.70 D). A larger percentage of uncomplicated eyes (26%) than complex eyes (16%) had at least 20/20 uncorrected distance visual acuity (UDVA) (P=.05). Excluding eyes with intentionally targeted myopic postoperative spherical equivalent, no eyes lost Snellen lines of UDVA, and the average improvement in UDVA was 0.8 ± 0.6 logMAR. Corrected distance visual acuity of the retinal/macular subgroup was poorer than the uncomplicated group pre- and postoperatively but was significantly improved by the surgery (P<.001; average improvement approximately 3 Snellen lines).
  
  
  CONCLUSIONS
  AcrySof toric IOLs reduced cylinder and improved UDVA in both complex and uncomplicated eyes with cataractous astigmatism.
authors.affiliation: Eyesight Asociates, Warner Robins, Georgia 31088, USA. JLGayton@aol.com
authors.forename: Johnny L
authors.initials: JL
authors.lastname: Gayton
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Seabolt
mesh_terms: D000180:Acrylic Resins; D000368:Aged; D001251:Astigmatism / Q000150:complications; D002386:Cataract / Q000150:complications*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000180:Acrylic Resins