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Comparison of Astigmatism Correction using Either Peripheral Corneal Relaxing Incisions or Toric Intraocular Lenses

2015; SAGE Publishing; Volume: 26; Issue: 3 Linguagem: Inglês

10.5301/ejo.5000690

1724-6016

İlkay Kılıç Müftüoğlu, Yonca A. Akova, Sibel Aksoy, Erkan Ünsal,

Ophthalmology and Visual Impairment Studies

Purpose To compare the efficacy and short-term stability of toric intraocular lenses (tIOL) and peripheral cornea relaxing incisions (PCRI) during phacoemulsification. Methods Patients with preexisting corneal astigmatism had cataract surgery either with tIOL (AcrySof Toric) (39 eyes of 35 patients) or standard intraocular lens (AcrySof) + PCRIs (38 eyes of 33 patients). Patients were retrospectively evaluated for manifest refraction, corneal topography, and uncorrected and corrected visual acuities preoperatively and at postoperative 1 and 6 months. The Alpins vectorial method was used to analyze the target induced astigmatism (TIA) and surgically induced astigmatism (SIA), magnitude of error (the difference between the magnitude of SIA and TIA) (ME), and correction index. Results Mean preoperative corneal astigmatism was 2.21 ± 1.32 D in the tIOL group and 2.24 ± 0.96 D in the PCRI group; the difference was not significant. The decrease in astigmatism was significant in both groups at last follow-up (64% tIOL group, 32% PCRI group, p<0.01, Wilcoxon signed rank test). The mean remaining refractive astigmatism was significantly higher in the PCRI group than in the tIOL group at 1-month (1.42 ± 1.22, 0.89 ± 0.68, respectively) and 6-month follow-ups (1.75 ± 1.37 D, 0.92 ± 0.72, respectively) (p<0.01). The mean ME was significantly lower (−0.35 versus −0.88) with a higher correction index (0.96 versus 0.56) in the tIOL group at 6 months postoperatively. Conclusions Both tIOL implantation and using PCRI were effective methods to reduce preoperative astigmatism at the time of the cataract surgery. However, tIOLs provided better remaining astigmatism with a more stable refraction than PCRI.