Optimizing toric IOL outcomes via techniques, technologies
Accuracy of results requires attention to multiple sources for residual astigmatism
Maastricht, The Netherlands—A large majority of cataract surgery patients implanted with a toric IOL will achieve spectacle independence for distance vision, but a sizeable proportion are left with significant residual astigmatism and find themselves needing glasses at least sometimes.
Understanding the sources of residual astigmatism allows surgeons to choose techniques and technologies that will optimize outcomes for toric IOL surgery, according to Rudy M.M.A. Nuijts, MD, PhD.
“Results from a trial we conducted showed that 70% of patients who underwent bilateral toric IOL implantation could see 20/25 uncorrected at distance and 84% of patients were spectacle independent for distance vision,” said Dr. Nuijts, professor of ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands.
However, 26% of patients had more than 1 D of residual stigmatism and 54% were left with at least 0.5 D of residual astigmatism (Figure 1).
He reviewed factors affecting the astigmatic outcome, including preoperative measurement errors; surgically induced astigmatism (SIA); calculation inaccuracies, including the effect of posterior corneal astigmatism, and toric IOL misalignment.