title: Clinical results after spherotoric intraocular lens implantation using the bag-in-the-lens technique.
abstract: OBJECTIVE
  To evaluate the clinical results after implantation of a spherotoric intraocular lens (IOL) using the bag-in-the-lens (BIL) technique.
  
  
  METHODS
  Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium.
  
  
  METHODS
  Evidence-based manuscript.
  
  
  METHODS
  Consecutive eyes with cataract and corneal astigmatism had implantation of a spherotoric BIL intraocular lens (IOL). The IOL was centered based on the patient's pupillary entrance using Purkinje reflexes of the surgical microscope light.
  
  
  RESULTS
  The study enrolled 52 eyes of 35 patients (23 women) with corneal astigmatism ranging from 0.90 to 6.19 diopters (D). The toric power was between 1.00 D and 8.00 D. One-third of eyes had an additional ocular comorbidity (including amblyopia) that could influence the clinical outcomes; 5.2% had an irregular astigmatism up to 15 degrees. Twelve eyes had high myopia (axial length [AL] >26 mm) and 5 eyes, high hyperopia (AL <21 mm). The mean preoperative corrected distance visual acuity was 0.58 ± 0.25 (SD). Postoperatively, the uncorrected distance visual acuity (UDVA) was 0.5 or better in 92% of eyes, the mean UDVA was 0.85 ± 0.21 D, the mean magnitude of error was 0.05 ± 0.49 D, and the mean angle of error was 0.29 ± 0.89 degree. Astigmatism correction was successful in 82% of eyes.
  
  
  CONCLUSIONS
  Spherotoric BIL IOL implantation yielded outcomes similar to those with other spherotoric IOLs, even in eyes with ocular comorbidity or irregular astigmatism up to 15 degrees.
authors.affiliation: Department of Ophthalmology, Antwerp University Hospital, and Faculty of Medicine, Antwerp University, Antwerp, Belgium. marie-jose.tassignon@uza.be
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Tassignon
authors.forename: Laure
authors.initials: L
authors.lastname: Gobin
authors.forename: Danny
authors.initials: D
authors.lastname: Mathysen
authors.forename: Jan
authors.initials: J
authors.lastname: Van Looveren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000150:complications; D001699:Biometry; D058442:Capsule Opacification / Q000517:prevention & control; D019923:Capsulorhexis / Q000379:methods; D002386:Cataract / Q000150:complications; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult