title: Toric intraocular lens implantation in children with developmental cataract and preexisting corneal astigmatism.
abstract: OBJECTIVE
  To evaluate the effect of toric intraocular lens (IOL) implantation on the refractive outcomes in children with cataract and preexisting corneal astigmatism.
  
  
  METHODS
  We included children between the age group of 8-14 years who were randomized into group I (toric) and group II (non-toric), in which toric and spherical IOLs were implanted, respectively, after phacoaspiration. Primary outcome measure was comparison of preoperative keratometric and postoperative refractive cylinder. Secondary outcome measure was comparison of pre- and postoperative visual outcome.
  
  
  RESULTS
  This study included 21 eyes of 17 children with developmental cataract. The mean spherical power of the toric IOLs implanted in the group I was 22.42 ± 4.84 D (range 12.50-29.00 D) and the mean cylindrical power of toric IOL was 3.37 ± 1.43 D (range 1.50-6.00D). The mean spherical power implanted in non-toric (group II) was 20.70 ± 7.09 D (range 10-31D). Mean preoperative keratometric cylinder in group I was 2.99 ± 0.96 D (range 1.85-5.12 D) and in group II it was 3.35 ± 0.63 D (range 2.03D-4.33 D) (p = 0.31) while the mean refractive cylinder at one year postoperatively in group I was 0.50 ± 0.39 D (range 0.00-1.00 D) and in group II it was 2.05 ± 0.39 D (range 1.25D-2.50 D; p = 0.006). Twelve months postoperatively, group I had a mean spherical equivalent (SE) 0.41 ± 0.26 D (range 0.00-0.88 D) and group II had 1.8 ± 1.03 D (range 0.63-4.00 D) (p = 0.002). Uncorrected distance visual acuity (UDVA) improved from 0.94 log MAR ± 0.51 (range 0.60-2.00) to 0.43 log MAR ± 0.33 (range 0.00-1.00) in the group I at the end of 1 year and in group II, it improved from 1.52 log MAR ± 1.12 to 0.75 log MAR ± 0.70 (range 0.00-2.00) at the end of 1 year. Corrected distant visual acuity (CDVA) improved in group I from 0.72 log MAR ± 0.17 (range 0.48-1.00) to 0.19 log MAR ± 0.26 (range 0.00- 0.78) at the end of one year while in group II, it improved from 1.33 ± 1.08 (range 0.18-3.00) to 0.49 log MAR ± 0.80 (range 0.00-2.00) at the end of 1 year.
  
  
  CONCLUSIONS
  Toric IOL implantation in children significantly reduces postoperative astigmatism and thereby improves visual outcome.
authors: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Jagat
authors: J
authors: Ram
authors: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Rishiraj
authors: R
authors: Singh
authors: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Rohit
authors: R
authors: Gupta
authors: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Garvit
authors: G
authors: Bhutani
authors: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Parul Chawla
authors: PC
authors: Gupta
authors: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Jaspreet
authors: J
authors: Sukhija
mesh_terms: D000293:Adolescent; D001251:Astigmatism / Q000150:complications*; D002386:Cataract / Q000150:complications* / Q000175:diagnosis; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D012029:Refraction, Ocular / Q000502:physiology*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
keywords: astigmatism; cataract surgery; paediatric cataract; toric intraocular lens