title: Combined 25-gauge vitrectomy and cataract surgery with toric intraocular lens with idiopathic epiretinal membrane.
abstract: OBJECTIVE
  To evaluate the stability of axis rotation, astigmatism correction, and improvement in uncorrected distance visual acuity (UDVA) up to 6 months postoperatively using an astigmatism-correcting intraocular lens (IOL) in a 25-gauge transconjunctival sutureless vitrectomy combined with cataract surgery.
  
  
  METHODS
  Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan.
  
  
  METHODS
  Prospective nonrandomized interventional study.
  
  
  METHODS
  Eyes with a preoperative corneal cylinder of more than 0.75 diopter (D) had a triple procedure for idiopathic epiretinal membrane (ERM) using an Acrysof IQ toric IOL. Outcome measures were the amount of IOL axis rotation up to 3 months postoperatively, UDVA, corrected distance visual acuity, and corneal and refractive astigmatism up to 6 months postoperatively. A comparison was performed between patients with a target postoperative spherical refraction of emmetropia (toric emmetropic group) and patients who previously had a triple procedure for idiopathic ERM using a nontoric IOL (control group).
  
  
  RESULTS
  The mean IOL axis rotation from the end of surgery until 3 months postoperatively was 3.67 degrees ± 3.13 (SD). Six months postoperatively, the mean corneal and refractive cylinders were 1.32 ± 0.61 D and 0.51 ± 0.31 D, respectively, showing a significant difference (P<.0001, paired t test). In addition, the mean UDVA was significantly improved 6 months postoperatively in the control and toric emmetropic group (0.57 logMAR versus 0.35 logMAR) (P=.028), although the toric group was more improved than the control group.
  
  
  CONCLUSIONS
  In vitrectomy (triple procedure) for idiopathic ERM with a toric IOL, postoperative IOL axis stability was similar to that reported for cataract surgery alone. Furthermore, the UDVA was better than with implantation of a spherical IOL.
authors.affiliation: Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nomoto
authors.forename: Koki
authors.initials: K
authors.lastname: Fukuda
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Yamaji
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Fujita
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000503:physiopathology; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D013536:Suture Techniques; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014786:Vision Disorders / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*