Toric intraocular lenses versus peripheral corneal relaxing incisions for astigmatism between 0.75-2.5 dioptres during cataract surgery

Abstract Purpose To compare the outcomes following toric intraocular lens (tIOL) or peripheral corneal relaxing incisions (PCRI) for keratometric astigmatism (KA ) between 0.75-2.5D during cataract surgery. Design Prospective, randomized clinical trial. Methods 80 eyes (80 participants) received eit...

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Veröffentlicht in:American journal of ophthalmology 2017
Hauptverfasser: Nanavaty, Mayank A., MBBS, DO, FRCOphth, Bedi, Kaveeta K., MBBS (Hons), BSc, Ali, Shahnaz, MBBS, BSc, Holmes, Mathew, MBBS, Rajak, Saul, FRCOphth, PhD
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Sprache:eng
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Zusammenfassung:Abstract Purpose To compare the outcomes following toric intraocular lens (tIOL) or peripheral corneal relaxing incisions (PCRI) for keratometric astigmatism (KA ) between 0.75-2.5D during cataract surgery. Design Prospective, randomized clinical trial. Methods 80 eyes (80 participants) received either tIOL or PCRI and were assessed preoperatively, 1,3,6 and 12 months postoperatively. Primary outcome measure: Un-corrected (UCDVA) and best-corrected distance LogMAR visual acuity (BCDVA) at 12 months. Secondary outcome measures: Uncorrected near visual acuity (UCNVA), manifest refraction, KA and mean keratometry (KM ), corneal aberrometry, tIOL rotation and quality-of-life questionnaire. Results Comparing tIOLs Vs. PCRIs, there was no significant difference in the UCDVA, BCDVA & UCNVA. At 12 months, 61% vs. 53% had UDCVA of 20/25 or better, 100% vs. 76% gained ≥1 lines and 59% Vs. 43% were within ±0.13D spherical equivalent. In PCRI group, anterior KA decreased at 1 month and remained stable thereafter; there was a non-significant trend towards a flatter posterior KA and steeper posterior KM and the total corneal Z2-2 was low at 1 and 12 months. Over 12 months, there were changes in posterior corneal tilt, coma and hexafoil in PCRI group. The mean rotation of the tIOLs at 12 months was 1.8±1.4degrees. tIOL patients were happier and were glad to use the non-prescription sunglasses. Conclusion There was no difference in visual acuity, although more tIOL patients gained ≥1 line and were within ±0.13D. After PCRIs, the anterior KA decreased in the early postoperative period and remained stable thereafter and posterior corneal aberrations changed constantly over 12 months.
ISSN:0002-9394
DOI:10.1016/j.ajo.2017.06.007