title: Surgically induced astigmatism after intraocular lens implantation using the bag-in-the-lens technique.
abstract: OBJECTIVE
  To determine surgically induced astigmatism (SIA) after monofocal spherical intraocular lens (IOL) implantation using the bag-in-the-lens (BIL) technique.
  
  
  METHODS
  Department of Ophthalmology, Antwerp University Hospital, Antwerp, Belgium.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Adult patients had routine phacoemulsification followed by BIL IOL implantation, which requires a double capsulorhexis for IOL fixation. The 2.8 mm limbo-corneal self-sealing incision was temporally located. Preoperative and 3-month postoperative keratometries were measured by Scheimpflug imaging (Pentacam). The patients were divided into 2 groups based on corneal astigmatism. Group A0 consisted of eyes with physiological corneal astigmatism less than 1.00 diopter (D). Group A1 consisted of eyes with corneal astigmatism of 1.00 D or higher. Vector analysis of the corneal power was used to determine the SIA.
  
  
  RESULTS
  The study comprised 100 eyes (58 patients). There was no difference in SIA between Group A0 and Group A1. The mean preoperative and postoperative keratometries were highly correlated in both groups (A0: r(2) = 0.95; A1: r(2) = 0.83). The correlation between preoperative and postoperative vectorial astigmatism was low in Group A0 (J0: r(2) = 0.24; J45: r(2) = 0.10). The mean postoperative SIA was 0.06 D @ -24 degrees in Group A0 and 0.09 D @ 6 degrees in Group A1, with an uncertainty of ± 1.00 D.
  
  
  CONCLUSIONS
  After BIL IOL implantation, the SIA was not statistically significant. Based on these findings, the technique can be considered an option for spherocylindrical correction of corneal astigmatism of 1.00 D or more.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.
authors.affiliation: Department of Ophthalmology, Antwerp University Hospital, University of Antwerp, Belgium.
authors.forename: Laure
authors.initials: L
authors.lastname: Gobin
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Tassignon
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.forename: Veva
authors.initials: V
authors.lastname: De Groot
mesh_terms: D001251:Astigmatism / Q000209:etiology*; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D018918:Phacoemulsification / Q000009:adverse effects*; D012029:Refraction, Ocular / Q000502:physiology