Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision

Wookyung Park; Man Soo Kim; Eun Chul Kim

doi:10.3341/jkos.2019.60.2.126

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Park, Kim, and Kim: Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(2): 126-134.

Published online: 15 February 2019

DOI: https://doi.org/10.3341/jkos.2019.60.2.126

Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision

Wookyung Park, MD¹, Man Soo Kim, MD, PhD², Eun Chul Kim, MD, PhD¹

¹Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

²Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to Eun Chul Kim, MD, PhD. Department of Ophthalmology, Bucheon St. Mary's Hospital, #327 Sosa-ro, Bucheon 14647, Korea. Tel: 82-32-340-2125, Fax: 82-32-340-2661, eunchol@hanmail.net

Received 21 June 2018 Revised 11 September 2018 Accepted 18 January 2019

The Korean Ophthalmological Society

(open-access):

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

To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision.

Methods

We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof.

Results

In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism.

Conclusions

During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.

Keywords: Astigmatism, Intraocular lens

Figures and Tables

Figure 1

Double-angle plots of refraction cylinder astigmatism. Red dots are mean values of the amount and axis of refractive astigmatisms. (A) Group 1 (n = 52) preoperative (superior), postoperative (inferior). (B) In group 1, 2.75 mm incision subgroup (n = 39). (C) In group 1, 2.2 mm incision subgroup (n = 13). (D) Group 2 (n = 46). (E) In group 2, 2.75 mm incision subgroup (n = 35). (F) In group 2, 2.2 mm incision subgroup (n = 11). D = diopter.

Table 1

Comparisons of patient characteristics between the two groups (n = 98)

Values are presented as mean ± standard deviation or number (%).

OD = right eye; UCVA = uncorrected visual acuity; logMAR = logarithms of the minimal angle of resolution; BCVA = best corrected visual acuity; D = diopter; Pre Op = before surgery.

^*Chi-square test; ^†Mann-Whitney test.

Table 2

Comparisons of patient characteristics between the subgroups

Values are presented as mean ± standard deviation or number (%).

OD = right eye; UCVA = uncorrected visual acuity; logMAR = logarithms of the minimal angle of resolution; BCVA = best corrected visual acuity; D = diopter; Pre Op = before surgery.

^*Chi-square test; ^†Mann-Whitney test.

Table 3

Preoperative and postoperative change of Auto-Keratometer astigmatism, refraction cylinder astigmatism, visual acuity and spherical euivalent

Values are presented as mean ± standard deviation.

UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; logMAR = logarithms of the minimal angle of resolution; D = diopter; Pre Op = before surgery.

^*Paired t-test; ^†Wilcoxon signed rank test.

Table 4

Comparison of differences between preoperative and postoperative refraction cylinder astigmatism and Auto-Keratometer astigmatism by groups

Values are presented as mean ± standard deviation.

^*Mann-Whitney test; ^†Independent t-test.

Table 5

Comparisons of preoperative estimated astigmatism and postoperative residual refraction cylinder astigmatism

Values are presented as mean ± standard deviation.

^*Mann-Whitney test; ^†Independent t-test.

Notes

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (2016R1A6A1A03010528).

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1D1A1A02085334).

^{Conflicts of Interest} The authors have no conflicts to disclose.

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