title: Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification.
abstract: OBJECTIVE
  To compare toric intraocular lens (IOL) implantation and astigmatic keratotomy (AK) in correction of astigmatism during phacoemulsification.
  
  
  METHODS
  Tertiary care hospital.
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Consecutive patients with visually significant cataract and moderate astigmatism (1.25 to 3.00 diopters [D]) were randomized into 2 groups. Temporal clear corneal 2.75 mm phacoemulsification with toric IOL implantation was performed in the toric IOL group and with 30-degree coupled AK at the 7.0 mm optic zone in the keratotomy group. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, keratometry, topography, central corneal thickness, and endothelial cell density were evaluated preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively.
  
  
  RESULTS
  The study enrolled 34 eyes (34 patients), 17 in each group. There was no difference in UDVA or CDVA between the 2 groups at any follow-up visit. The mean preoperative and postoperative refractive cylinder was 2.00 D ± 0.49 (SD) and 0.33 ± 0.17 D, respectively, in the toric IOL group and 1.95 ± 0.47 D and 0.57 ± 0.41 D, respectively, in the keratotomy group (P=.10). The mean residual astigmatism at 3 months was 0.44 ± 1.89 @ 160 in the toric IOL group and 0.77 ± 1.92 @ 174 in the keratotomy group (P=.61). All eyes in the toric IOL group and 14 eyes (84%) in the keratotomy group achieved a residual refractive cylinder of 1.00 D or less (P=.17).
  
  
  CONCLUSIONS
  Toric IOL implantation was comparable to AK in eyes with moderate astigmatism having phacoemulsification.
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Khatik
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Electronic address: namrata.sharma@gmail.com.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sri Vatsa
authors.initials: SV
authors.lastname: Sehra
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Parfulla K
authors.initials: PK
authors.lastname: Maharana
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Urmimala
authors.initials: U
authors.lastname: Ghatak
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Khokhar
authors.affiliation: From Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Chawla
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D002452:Cell Count; D019781:Corneal Topography; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology