title: Results of higher power toric intraocular lens implantation.
abstract: OBJECTIVE
  To evaluate the efficacy, predictability, and safety of coaxial microincision phacoemulsification and toric intraocular lens (IOL) implantation in eyes with high corneal astigmatism.
  
  
  METHODS
  Two eye clinics in Germany.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Routine cataract extraction using 2.2 mm coaxial phaco equipment and Acrysof toric IOL (3.00 to 6.00 diopters [D] cylinder) implantation were performed. Examinations included optical biometry, Haigis IOL calculation, topography, and objective and subjective refractions. Retroillumination images were used to evaluate IOL alignment. Postoperative examinations were scheduled at 1 week and 3 months.
  
  
  RESULTS
  The study enrolled 40 eyes (30 patients). The mean preoperative keratometric cylinder was 3.55 ± 0.73 D (range 2.64 to 5.39 D) and the mean 3-month postoperative subjective cylinder, 0.67 ± 0.32 D. The mean logMAR uncorrected distance visual acuity improved from 0.93 to 0.20 and the mean logMAR CDVA, from 0.41 to 0.09. The mean prediction error (spherical equivalent) was +0.14 ± 0.44 D. The mean IOL rotation between 1 week and 3 months was 0.23 ± 1.9 degrees clockwise. The mean surgically induced astigmatism was 0.08 ± 0.41 D. The alignment error was below 10 degrees in 97.5% of cases. The mean vector change in refractive cylinder between 1 week and 3 months was 0.31 ± 0.19 D. The Alpins correction index was +1.01, indicating a slight tendency toward overcorrection.
  
  
  CONCLUSIONS
  Coaxial microincision phacoemulsification with toric IOL safely and predictably reduced high corneal astigmatism and improved surgical outcomes. Thorough planning and precise execution are necessary.
authors.affiliation: Augen- und Laserklinik, Castrop-Rauxel, Germany. ph@augenklinik-castroprauxel.de
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hoffmann
authors.forename: Sebastian
authors.initials: S
authors.lastname: Auel
authors.forename: Werner W
authors.initials: WW
authors.lastname: Hütz
mesh_terms: D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009887:Ophthalmoscopy; D018918:Phacoemulsification; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D000180:Acrylic Resins