Correction of moderate corneal astigmatism during cataract surgery: toric intraocular lens versus peripheral corneal relaxing incisions.
OBJECTIVE
To compare the astigmatism-reducing effect of a toric intraocular lens (IOL) and peripheral corneal relaxing incisions (PCRIs).


METHODS
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.


METHODS
Prospective masked bilateral randomized study.


METHODS
Cataract patients with a preoperative corneal astigmatism of 1.0 to 2.5 diopters (D) were included. All patients received a toric IOL in 1 eye and a nontoric IOL plus a PCRI in the other eye. Postoperative follow-up was at 1 hour, 1 month, and 6 months. The uncorrected distance visual acuity, corrected distance visual acuity, autorefraction (Topcon RM-8800), and subjective refraction were recorded. The IOL axis was assessed using retroillumination photographs.


RESULTS
The study enrolled 60 eyes of 30 patients. The mean astigmatism vector reduction was 1.74 D ± 0.64 (SD) in the toric IOL group and 1.27 ± 0.76 D in the PCRI group; the difference was statistically significant (P=.042). The mean absolute rotation of the toric IOL was 2.5 ± 1.8 degrees (maximum 6.3 degrees) in the first 6 postoperative months. Astigmatism increased in the PCRI group between the 1-month and 6-month follow-up (mean 0.38 ± 0.27 D; maximum 1.00 D) (P<.001).


CONCLUSIONS
Toric IOLs and PCRIs both reduced astigmatism; however, toric IOLs reduced astigmatism to a higher extent and they were more predictable.
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
Nino
N
Hirnschall
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
Vinod
V
Gangwani
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
Alja
A
Crnej
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
John
J
Koshy
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
Vincenzo
V
Maurino
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria. Electronic address: oliver@findl.at.
Oliver
O
Findl
D000368:Aged; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D063171:Corneal Pachymetry; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007368:Interferometry; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011446:Prospective Studies; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology