Purpose: We aimed to investigate the clinical outcomes of toric intraocular lens (T-IOL) implantation in patients who underwent combined cataract surgery and vitrectomy.
Subjects and methods: Among patients who underwent combined cataract surgery and vitrectomy from 2016 to 2020, patients with preoperative corneal astigmatism of ≥0.8 D (real power by CASIA, TOMEY) in whom T-IOL was actually implanted after it was recommended by the toric calculator and who were followed up with for at least 3 months after surgery were included in the study. Data extracted from the charts included pre- and post-operative uncorrected or best corrected visual acuity〔logarithmic minimum angle of resolution (logMAR)〕, preoperative corneal astigmatism, astigmatic axis, predicted postoperative refraction value, postoperative subjective and objective astigmatism, postoperative subjective and objective refraction value, postoperative T-IOL axis rotation, and type of intraocular tamponade.
Results: The subjects included 73 eyes of 73 patients (46 males, 27 females; age: 69.9±9.6 years); of these, 60 eyes were with against-the-rule, 9 eyes with with-the-rule, and 4 eyes with oblique astigmatism. Uncorrected visual acuity (logMAR) improved significantly from 0.88±0.51 preoperatively to 0.33±0.37 postoperatively, and the best corrected visual acuity(logMAR)improved from 0.54±0.53 preoperatively to 0.13±0.28 postoperatively (p<0.0001, respectively). The preoperative corneal astigmatism was 1.38±0.66 D, and postoperative subjective astigmatism significantly decreased to 0.48±0.47 D(p<0.0001). Postoperative axis rotation was 4.8±4.7: 0-19 degrees, and postoperative refractive error was 0.38±0.34: 0.01-1.47 D.
Conclusion: Combined cataract surgery and vitrectomy with T-IOL significantly reduced postoperative astigmatism with clinically acceptable postoperative axis rotation and postoperative refractive error.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 801-807, 2022.