Comparison of toric intraocular lenses and peripheral corneal relaxing incisions to treat astigmatism during cataract surgery.
OBJECTIVE
To evaluate and compare toric intraocular lens (IOL) implantation and spherical IOL implantation with peripheral corneal relaxing incisions to manage astigmatism during phacoemulsification.


METHODS
Ophthalmology Service, Hospital Ramón y Cajal, Madrid, Spain.


METHODS
Prospective randomized comparative case series.


METHODS
Eyes with cataract and corneal astigmatism (1.00 to 3.00 diopters [D]) had toric IOL implantation or peripheral corneal relaxing incisions. Outcome measures were visual outcomes, slitlamp assessment, digital toric IOL axis determination, spectacle need, and patient satisfaction.


RESULTS
Three months postoperatively, the mean uncorrected distance visual acuity (UDVA) was 0.13 ± 0.10 (SD) in the toric IOL group and 0.19 ± 0.12 in the relaxing incisions group; the UDVA was better than 0.20 in 75% of eyes and 60% of eyes, respectively. Refractive cylinder decreased significantly in both groups, with a mean residual refractive astigmatism of 0.61 ± 0.41 D in the toric IOL group and 1.32 ± 0.60 D in the relaxing incisions group (P<.01). The mean toric IOL rotation was 3.65 ± 2.96 degrees, with no significant differences between slitlamp and digital photograph measurements. There was a trend toward better mesopic contrast sensitivity with glare in the toric IOL group. There were no differences in VF-14 or patient satisfaction results; 15% of patients in the toric IOL group and 45% in the relaxing-incision group required distance spectacles postoperatively.


CONCLUSIONS
Although refractive astigmatism decreased in both groups, toric IOL implantation was more effective and predictable, resulting in greater spectacle independence.
Mingo-Botín
David
D
Hospital Ramón y Cajal, Ophthalmology Service, Madrid, Spain. davminbot@gmail.com
Muñoz-Negrete
Francisco José
FJ
Won Kim
Hae Ryung
HR
Morcillo-Laiz
Rafael
R
Rebolleda
Gema
G
Oblanca
Noelia
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology; D018434:Sickness Impact Profile; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology