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Yang, Lee, Lim, and Chung: Comparison of the Clinical Outcomes of Two Types of Toric Intraocular Lens
Original Article

J Korean Ophthalmol Soc 2016;57(2):200-207.

Published online: 7 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.2.200

Comparison of the Clinical Outcomes of Two Types of Toric Intraocular Lens

Soon Won Yang, MD, Jae Hoon Lee, MD, Sung A Lim, MD, So Hyang Chung, MD, PhD

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to So Hyang Chung, MD, PhD Department of Ophthalmology, The Catholic University of Korea Seoul St. Mary's Hospital, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: 82-2-2258-6203, Fax: 82-2-599-7405 E-mail: chungsh@catholic.ac.kr

Received 20 August 2015       Revised 30 October 2015       Accepted 30 December 2015

Copyright © 2016 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

In this study evaluated clinical outcomes and higher-order aberrations in patients with implanted Tecnis ZCT toric intraocular lens (IOL) (Abbott Medical Optics Inc., Santa Ana, CA, USA) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG, Jena, Germany) in eyes with low to moderate corneal astigmatism.

Methods

We conducted a retrospective study of 32 consecutive eyes of 26 patients with a visually significant cataract and moderate corneal astigmatism (higher than 1.25 diopter [D] and lower than 4.5 D) undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics Inc.) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG). Phacoemulsification was performed by the same experienced surgeon using 2.2 mm temporal incision. Visual, refractive and aberrometric changes were evaluated during a 3-month follow-up. Power vector analysis of Cartesian astigmatism (J0) and oblique astigmatism (J45) was performed.

Results

At the 3-month follow-up, corrected distance visual acuity (CDVA) and residual astigmatism showed no statistically significant differences between groups (p = 0.203 and p = 0.364, respectively). Pre- and postoperative J0 were 0.71 ± 0.84 and 0.05 ± 0.39 in the Tecnis Toric group and, 0.88 ± 1.27 and -0.02 ± 0.16 in the AT TORBI group, respectively, which showed statistically significant differences (p = 0.029 and p = 0.032, respectively). Pre- and post-operative differences of J0 and J45 were not statistically significant (p = 0.234 and p = 0.603, respectively). No eye had IOL rotation ≥10°. Ocular aberrometry values were statistically significantly differenct between the groups, except for spherical aberration, which was higher in the AT TORBI group (p = 0.0047).

Conclusions

Both IOLs showed good postoperative uncorrected distance visual acuity, CDVA and refractive results in this study. Rotational stability was excellent for both IOLs until the 3-month follow-up.

Keywords: Astigmatism, AT TORBI, Intraocular lens, Tecnis, Toric

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Figure 1.
Surgery Guidance™ SG5000® (SMI). IOL = intraocular lens.
jkos-57-200f1.tif
Figure 2.
Refractive results at 3 months postoperatively. (A) Cylinder. (B) Spherical equivalent. Pre-OP = preoperative; POD = postoperative day.
jkos-57-200f2.tif
Table 1.
Patient demographics and clinical information
Parameters AMO Tecnis® Toric IOL AT TORBI® 709M IOL p-value*
Eyes (n) 18 14
Patients (n) 14 12
Age (years) 58.33 ± 12.66 (21~80) 45.70 ± 18.50 (21~78)
Male sex (n, %) 5 (35.7) 1 (8)
Right eyes (n, %) 8 (57.1) 9 (64)
UDVA (log MAR) 0.75 ± 0.57 (1.7~0.2) 0.89 ± 0.50 (2.0~0.1) 0.47
CDVA (log MAR) 0.38 ± 0.43 (1.7~0) 0.31 ± 0.23 (2.0~0) 0.27
Sphere (D) −2.31 ± 3.26 (−9.0~+2.25) −3.6 ± 3.04 (−8.75~+2.0) 0.39
Cylinder (D) −2.10 ± 1.14 (−5.25~−0.5) −3.30 ± 2.23 (−7.75~−0.25) 0.33
Corneal astigmatism (D) 2.10 ± 1.11 (0.75~4.5) 1.96 ± 0.96 (1.0~4.5) 0.65
Corneal spherical aberration (μ m) 0.35 ± 0.37 (−0.409~+0.352) 0.36 ± 0.31 (+0.035~+0.633) 0.27
IOL power (D) 18.25 ± 3.34 (10.5~23.0) S 12.75 ± 0.99 (1~18)
C 2.67 ± 0.99 (1~4)
IOL model (n) ZCT 150 (4), ZCT225 (7), ZCT400 (7) AT TORBI 709M (14)

Values are presented as mean ± SD unless otherwise indicated.

IOL = intraocular lens; UDVA = uncorrected distance visual acuity; CDVA = corrected distance visual acuity; S = spherical power; C = cylindrical power.

* Student t-test.

Table 2.
Preoperative and postoperative visual acuity, refraction and in the AMO Tecnis toric intraocular lens
Parameters Mean ± SD (range) p-value*
Pre op Post op
UDVA (log MAR) 0.75 ± 0.57 (1.7~0.2) 0.12 ± 0.16 (0.5~0) <0.001
CDVA (log MAR) 0.38 ± 0.43 (1.7~0) 0.03 ± 0.05 (0.1~0) <0.001
Sphere (D) −2.31 ± 3.26 (−9.0~+2.25) −0.19 ± 0.39 (−0.75~+0.5) 0.018
Cylinder (D) −2.10 ± 1.14 (−5.25~−0.5) −0.45 ± 0.20 (−0.75~−0.25) 0.0006
Spherical equivalent (D) −3.24 ± 3.68 (−10.625~+1.375) −0.15 ± 0.34 (−0.5~+0.5) 0.0037
Rotation (°) - 3.2 ± 2.2 (8~0)

Values are presented as mean ± SD unless otherwise indicated.

SD = standard deviation; Pre op = preoperative; Post op = postoperative; UDVA = uncorrected distance visual acuity; CDVA = corrected distance visual acuity.

* Student t-test.

Table 3.
Preoperative and postoperative visual acuity, refraction and rotation in the Zeiss AT TORBI toric intraocular lens
Parameters Mean ± SD (range) p-value*
Pre op Post op
UDVA (log MAR) 0.87 ± 0.47 (2~0.1) 0.11 ± 0.13 (0.2~0) <0.001
CDVA (log MAR) 0.31 ± 0.48 (2~0) 0.02 ± 0.05 (0.1~0) 0.0015
Sphere (D) −3.6 ± 3.04 (−8.75~+2.0) 0.05 ± 0.54 (−0.25~+1.0) 0.02
Cylinder (D) −3.30 ± 2.23 (−7.75~−0.25) −0.34 ± 0.38 (−1.0~0) 0.001
Spherical equivalent (D) −4.74 ± 2.47 (−10.375~+1.50) −0.09 ± 0.59 (−0.625~0.75) 0.015
Rotation (°) - 2.4 ± 2.0 (8~0)

Values are presented as mean ± SD unless otherwise indicated.

SD = standard deviation; Pre op = preoperative; Post op = postoperative; UDVA = uncorrected distance visual acuity; CDVA = corrected distance visual acuity.

* Student t-test.

Table 4.
Preoperative and postoperative J0 and J45 cylindrical vectors
Refractive astigmatism Mean ± SD (range) p-value*
Pre op Post op
AMO Tecnis Toric IOL J0 (D) 0.71 ± 0.84 0.05 ± 0.39 0.029
J45 (D) 0.50 ± 0.46 −0.01 ± 0 .17 0.472
AT TORBI 709M IOL J0 (D) 0.88 ± 1.27 −0.02 ± 0.16 0.032
J45 (D) −0.08 ± 0.91 0.01 ± 0.25 0.750

Values are presented as mean ± SD unless otherwise indicated.

SD = standard deviation; Pre op = preoperative; Post op = postoperative; IOL = intraocular lens.

* Student t-test.

Table 5.
Ocular aberrometry analysis at 3 months postoperatively
Parameters Mean ± SD (range) p-value*
AMO Tecnis Toric IOL AT TORBI 709M IOL
Total RMS (μ m) 0.39 ± 0.10 (0.22~0.5) 0.22 ± 0.11 (0.15~0.39) 0.09
Spherical aberration (μ m) 0.02 ± 0.04 (−0.04~0.05) 0.11 ± 0.08 (0.041~0.57) 0.008
Coma (μ m) 0.19 ± 0.14 (0.07~0.38) 0.11 ± 0.07 (0.05~0.21) 0.33
Trefoil (μ m) 0.19 ± 0.06 (0.13~0.26) 0.11 ± 0.11 (0.03~0.27) 0.27

Values are presented as mean ± SD unless otherwise indicated.

SD = standard deviation; IOL = intraocular lens; RMS = root-mean-square.

* Independent t-test.

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