The Effect of Anterior Corneal Astigmatism Orientation on Toric Intraocular Lens Outcomes

• 作者: Ayman Naseri Eugene A. Lowry Jonathan Li Priya Morjaria Seth Blumberg Steven Schallhorn Sundeep K. Kasi
• 来源期刊: 眼科学期刊(英文)
• 学科: 医学
• 关键词: TORIC LENS ASTIGMATISM CATARACT Surgery Refractive LENS Exchange
• 年，卷（期）: 2019,（2）
• 页码范围: 84-93
• 页数: 10页
• 分类号: R73

摘要

Background: It is unclear whether post-operative errors after toric intraocular lens implantation would be more amenable to pre-operative correction with a fixed adjustment or a correction ratio that scales with the magnitude of pre-operative astigmatism. Purpose: To investigate the effect of pre-operative anterior corneal astigmatism orientation on outcomes of toric intraocular lens implantation in a large population. Methods: A retrospective cohort study of 625 patients undergoing refractive lens exchange through a superior clear corneal incision with Oculentis M-Plus toric intraocular lens implantation at an Optical Express, Inc. located in the United Kingdom and Ireland. Patients were stratified by axis of astigmatism on automated keratometry as with-the-rule, against-the-rule, or oblique. Analysis of visual acuity and refractive outcomes was performed using American National Standards Institute (ANSI) guidelines on astigmatic corrections with non-vector as well as vector analyses. Analysis was limited to one eye per patient. Results: Patients who had with-the-rule (WTR) astigmatism, compared with oblique and against-the-rule (ATR), had higher vector magnitudes of surgically induced refractive correction (2.89D, 2.55D, 2.42D;p Conclusions: Refractive lens exchange surgery using toric intraocular lenses overcorrected patients who had with-the-rule astigmatism. Degree of overcorrection did not vary with severity of pre-operative astigmatism. Incorporation of axis of astigmatism in lens selection and reduction of astigmatic correction among with-the-rule patients by an absolute value of 0.25D - 0.35D, rather than proportional adjustments, may reduce cylindrical over-correction.