Astigmatism Management in Cataract Surgery with the Acrysof Toric Intraocular Lens (IOL)

Purpose: To present clinical data on residual refractive astigmatism, uncorrected visual acuity (UCVA), and rotational misalignment of the Acrysof Toric IOL (SN60TT) after implantation in cataract surgery. Setting/venue: Department of Ophthalmology, Academic Hospital Maastricht. Methods: The AcrySof Toric IOL contains a toric component on the posterior surface of the optic, but is otherwise structurally identical to the AcrySof single-piece IOL. Three toric models were evaluated in cylinder powers of 1.50D (SN60T3, n=13), 2.25D (SN60T4, n=10), and 3.0D (SN60T5, n=11) at the IOL plane. An Acrysof Toric T3–5 IOL was implanted in 47 eyes of 18 patients with a mean age of 73.0±15.5. The average pre-op refractive and corneal cylinder was –2.96±1.74 and 2.91±1.95 respectively. In 13 eyes the preoperative corneal astigmatism exceeded the SN60T5 toric IOL power and a partial astigmatism correction was intended. Outcome measures included residual refractive astigmatism, uncorrected visual acuity and IOL misalignment. Results: At 6 months postoperatively, the average refractive cylinder was 0.69D±0.46, –0.43D±0.43 and –0.75D±0.45 in T3, T4 and T5 groups, respectively. The average UCVA for the T3–5 groups was 0.79±0.24, 0.96±0.19 and 0.83±0.16. The IOL misalignment for T3–5 groups was 2.6 +/–, 4.14+/– and 4.86+/– degrees, respectively. UCVA of 0.8 or better was achieved in 81% of all eyes in T3–5 groups. In the 13 eyes where partial astigmatism correction was intended an UCVA of 0.5 or better was achieved in 73% of eyes and 53% of patients were spectacle independent for reading due to residual mixed astigmatism. Conclusion: Astigmatism correction in cataract surgery with the Acrysof Toric IOL is effective and safe. In cases with partial astigmatism correction residual mixed astigmatism may result in spectacle freedom for near vison.

Financial disclosure: none