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    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. 

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    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.

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    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).

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    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.

    Preoperative issues

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