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Salvador-Roger R, Vila-Andrés R, Micó V, Esteve-Taboada JJ. Vecto-keratometry: determination of anterior corneal astigmatism in manual keratometers using power vectors. Expert Rev Med Devices 2023; 20:517-524. [PMID: 37114569 DOI: 10.1080/17434440.2023.2206019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND A new keratometric routine that employs power vector management for manual keratometers is described. This study evaluates the agreement of the new proposed keratometric technique with the classical one. RESEARCH DESIGN AND METHODS The applicability of a new keratometric routine was verified using Helmholtz's and Javal's keratometers. Results were obtained by two different and well-trained examiners over two different samples, one including 65 and the other 74 eyes, respectively. Both conventional keratometry and the newly proposed routine (named vecto-keratometry) were used in each eye to obtain the results. The clinical agreement between the methods was evaluated using Bland-Altman and Passing-Bablok analysis. RESULTS For Helmholtz's keratometer, Bland-Altman plots showed good agreement between methods for both astigmatic components being J0 = 0.04 ± 0.20 D and J45 = -0.07 ± 0.17 D. For Javal's keratometer, Passing-Bablok regression test determined regression line for J0 difference as y0 = 1.03, confidence interval: [0.98, 1.10] and regression line for J45 difference as y45 = 0.97, confidence interval: [0.83, 1.12]. CONCLUSIONS Vecto-keratometry provides accurate clinical results. It has been demonstrated that there are no significant differences between methods in any of the power vector astigmatic components; thus, both methods can be applied interchangeably.
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Affiliation(s)
- Raquel Salvador-Roger
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - Rosa Vila-Andrés
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - Vicente Micó
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - José J Esteve-Taboada
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
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Rémignon CH, Levron A, Agard E, Douma I, El-Chehab H, Brunet O, Sejournet L, Billant J, Dot C. Impact of Total Corneal Astigmatism Estimated With the Abulafia-Koch Formula Versus Measured With a SS-OCT Biometer on the Refractive Outcomes of a Toric Intraocular Lens in Cataract Surgery. J Refract Surg 2023; 39:171-179. [PMID: 36892238 DOI: 10.3928/1081597x-20230103-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
PURPOSE To compare the impact of total corneal astigmatism (TCA) estimated with the Abulafia-Koch formula (TCAABU) versus measured by Total Keratometry (TK), swept-source optical coherence tomography (OCT) coupled with telecentric keratometry (TCATK) on the refractive outcomes after cataract surgery with toric intraocular lens (IOL) implantation. METHODS Two hundred one eyes of 146 patients who underwent cataract surgery with toric IOL implantation (XY1AT; HOYA Corporation) were included in this single-center, retrospective study. For each eye, TCAABU (estimated from the anterior keratometry values measured with the IOLMaster 700 [Carl Zeiss Meditec AG]) and TCATK (measured using TK IOLMaster 700) were entered into the HOYA Toric Calculator. Patients were operated on based on TCAABU. For each eye, centroid and mean absolute error in predicted residual astigmatism (EPA) were calculated according to TCA used (TCAABU or TCATK). The cylinder power and the axis of the posterior chamber IOL were compared. RESULTS The mean uncorrected distance visual acuity was 0.07 ± 0.12 logMAR, the mean spherical equivalent was 0.11 ± 0.40 D, and mean residual astigmatism was 0.35 ± 0.36 D. Mean centroid EPA was 0.28 D at 132° with TCAABU and 0.35 D at 148° with TCATK (P(x) < .001; P(y) < .01). Mean absolute EPA was 0.46 ± 0.32 D with TCAABU and 0.50 ± 0.37 D with TCATK (P < .01). In the with-the-rule astigmatism subgroup, a deviation from the target of less than 0.50 D was achieved in 68% of eyes with TCAABU versus 50% of eyes with TCATK. The proposed posterior chamber IOL was different depending on the calculation methods used in 86% of cases. CONCLUSIONS Both calculation methods showed excellent results. However, the predictability error was significantly reduced when TCAABU was used compared to TCATK measured with the IOLMaster 700 in the whole cohort. Finally, TCA was overestimated by TK in the with-the-rule astigmatism subgroup. [J Refract Surg. 2023;39(3):171-179.].
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Kawahara A. Predicting Residual Astigmatism in Cataract Surgery. VISION (BASEL, SWITZERLAND) 2022; 6:vision6040070. [PMID: 36548932 PMCID: PMC9785719 DOI: 10.3390/vision6040070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
The purpose of this review is to evaluate the prediction of postoperative residual astigmatism and to determine the best prediction method for astigmatism correction. In recent findings for residual astigmatism in non-toric monofocal intraocular lens (IOL) implanted eyes, vector analysis can be used to correctly evaluate residual astigmatism by decomposing it. In predicting residual astigmatism, the with-the-rule (WTR) and against-the-rule (ATR) astigmatism components can now be almost predicted. This may be due to advances in inspection equipment and surgical technique. However, there are still issues with the oblique astigmatism component. In addition, corneal astigmatism is the most important predictor of postoperative residual astigmatism, and other predictors, such as refractive astigmatism, age, and lens thickness, have also been mentioned. However, all but corneal astigmatism are questionable because of the possibility of confounding variables. Total corneal astigmatism is more accurate in predicting residual astigmatism than anterior corneal astigmatism. Several predictions of residual astigmatism have been reported, but complete prediction has not been possible. Further research is needed, especially in predicting oblique astigmatism. However, I emphasize that the accuracy of predicting WTR and ATR astigmatism has improved considerably and can be predicted using regression equations with total corneal astigmatism.
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Fus M, Pitrova S. Evaluation of Decentration, Tilt and Angular Orientation of Toric Intraocular Lens. Clin Ophthalmol 2022; 15:4755-4761. [PMID: 34983999 PMCID: PMC8699775 DOI: 10.2147/opth.s346968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/30/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The aim of this study was to develop software for the universal objective evaluation of factors influencing intraocular correction of astigmatism, such as decentration, tilt, axial position and angular orientation the toric intraocular lens (IOL). Patients and Methods Software was developed using the MS Visual Studio environment. The analysis was presented using images of 67 eyes with an implanted IOLs of the SN6ATx model series. Decentration and angular position of the lens were obtained from images of the anterior segment of the eye, using a Visucam unit. Tilt was measured on tomographic images from OCT Avanti (in meridian of highest tilt and perpendicular meridian) and preoperative biometry parameters of eye (axial length, anterior chamber depth – ACD, ocular lens thickness – LT, limbus diameter and mean keratometry value) including postoperative anterior chamber depth (pACD) were measured using Lenstar LS900. Results Applying the software methodology to the evaluation of individual toric IOL parameters, the following results were obtained: mean decentration 0.25 ± 0.17 mm which was observed in 61.19% of eyes, mean misalignment to the planned axis equal to 3.8 ± 3.6 degrees, mean highest inclination equal to 3.7 ± 1.2 degrees and mean difference of pACD and ACD was equal to 1.46 ± 0.31 mm. There was only a weak nonsignificant correlation between preoperative ACD versus decentration and tilt of IOL or a weak significant correlation between preoperative LT and both decentration and misalignment of IOL. Conclusion The use of the presented methodology for determining the positional parameters of the toric IOL provided comparable results with the results of recent studies. Software design can be considered as a suitable alternative to previously published techniques, with the significant advantage of the possibility of using universal input images, their graphical editing and especially the possibility of comprehensive analysis of all parameters.
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Affiliation(s)
- Martin Fus
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Sarka Pitrova
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
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Hirnschall N, Findl O, Bayer N, Leisser C, Norrby S, Zimper E, Hoffmann P. Sources of Error in Toric Intraocular Lens Power Calculation. J Refract Surg 2021; 36:646-652. [PMID: 33034356 DOI: 10.3928/1081597x-20200729-03] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 07/21/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the influencing factors on remaining astigmatism after implanting a toric intraocular lens (IOL) during cataract surgery. METHODS This retrospective study included parameters that were considered to have an influence on toric IOL power calculation. Therefore, data from the literature and the authors' own data were used. This included axial eye length, anterior chamber depth, central corneal thickness, corneal radii (anterior and posterior), diurnal changes of the cornea, inter-device differences, rotational misalignment of the IOL, tilt and decentration of the IOL, pupil size, angle kappa, and surgically induced astigmatism. Ray-tracing and Gaussian error propagation analysis was performed to quantify the sources of error. RESULTS In total, 4,949 eyes (4,365 eyes of 42 studies and 584 eyes of retrospectively analyzed study data) were included in the study and the difference vector between aimed and calculated remaining astigmatism was 0.81 diopters (D). The main source of error was the preoperative measurement of the cornea (27%), followed by IOL misalignment (14.4%) and IOL tilt (11.3%). Other factors, such as angle kappa (10.9%), pupil size (8.1%), surgically induced astigmatism (7.8%), anterior chamber depth (7.5%), axial eye length (7.5%), and decentration (5.6%), also contributed to the refractive astigmatic error. CONCLUSIONS The main source of error in toric IOL power calculation is the preoperative corneal measurement followed by IOL misalignment and tilt. [J Refract Surg. 2020;36(10):646-652.].
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Levron A, El Chehab H, Agard E, Bernard A, Verrecchia S, Badri Y, Dot C. Impact of estimated total keratometry on the refractive outcomes of the XY1AT toric intraocular lens in cataract surgery. J Fr Ophtalmol 2021; 44:e487-e492. [PMID: 34340885 DOI: 10.1016/j.jfo.2021.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 10/20/2022]
Affiliation(s)
- A Levron
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - H El Chehab
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - E Agard
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - A Bernard
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - S Verrecchia
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - Y Badri
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France; French Military Health Service Academy of Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
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Abstract
PURPOSE To compare clinical outcomes after cataract surgery and bilateral implantation of 2 diffractive trifocal toric intraocular lenses (IOLs). SETTING Hospital da Luz, Lisbon, Portugal. DESIGN Double-arm, randomized, prospective case series. METHODS A total of 60 patients were randomly allocated to receive bilateral implantation of either the FineVision Pod FT toric IOL (PhysIOL) or the AcrySof IQ PanOptix toric IOL (Alcon). Visual and refractive outcomes, contrast sensitivity, IOL misalignment, and quality of vision outcomes (QoV questionnaire) were evaluated at 3 months postoperatively. Surgically induced astigmatic changes were evaluated by vector analysis. RESULTS Each group (FineVision toric and AcrySof IQ PanOptix toric) comprised 30 patients (60 eyes). No significant differences between groups were found regarding uncorrected and corrected distance and near visual outcomes (P ≥ .333). Mean postoperative distance-corrected intermediate visual acuity at 60 cm was 0.04 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and 0.09 ± 0.11 logMAR in the PanOptix and Pod FT group, respectively (P = .032). Mean IOL axis misalignment was 1.59 degrees ± 2.15 degrees (PanOptix group) and 1.89 degrees ± 3.31 degrees (Pod FT group) (P = .821). Mean magnitude of error of astigmatic correction was -0.09 diopters (D) and -0.11 D in the PanOptix group and Pod FT group, respectively (P = .333). Contrast sensitivity, QoV scores for the presence of photic phenomena, and the level of spectacle independence were similar in both groups (P > .05). CONCLUSIONS Both trifocal toric IOLs allowed complete patient visual restoration, and good spectacle independence and good visual quality outcomes. The PanOptix IOL provided superior intermediate visual acuity for distances around 60 cm.
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Nováček LV, Němcová M, Tyx K, Lahodová K, Rejmont L, Rozsíval P, Studený P. Evaluation of Astigmatism-Correcting Efficiency and Rotational Stability after Cataract Surgery with a Double-Loop Haptic Toric Intraocular Lens: A 1-Year Follow-Up. Biomed Hub 2021; 6:30-41. [PMID: 33791315 PMCID: PMC7991491 DOI: 10.1159/000513894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the clinical outcomes, predictability of results, efficiency of astigmatism correction, and rotational stability of the Bi-Flex 677TAY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary) monofocal toric intraocular lens (IOL) designed for cataract patients with astigmatism. METHODS The IOLs were implanted either mono- or binocularly, following routine cataract surgery. Visual and refractive outcomes, as well as off-axis rotation were assessed throughout a 1-year follow-up period. All clinical data for this work were collected retrospectively. Vector analysis based on the Alpins method was performed to assess the efficiency of astigmatism correction. RESULTS No complications or adverse events occurred during surgery or the follow-up period. IOL implantation brought 88% of eyes into the ±0.50 D, and 100% into the ± 1.00 D range compared to the target spherical equivalent refraction, emmetropia. Astigmatism correction brought similar results: 94% of eyes had a residual cylindrical error of not higher than ±0.50 D, and 97% were within ±1.00 D. Vector analysis resulted in a correction index of 0.96 and a difference vector of 0.17. Both refractive and visual outcomes showed long-term stability. During the 12-month follow-up period, no eyes had a rotation of >5°. Absolute rotation after 1 year was 1.42 ± 1.89° (median = 0°), while signed rotation was 1.06 ± 2.12° (median = 0°). CONCLUSION The Bi-Flex 677TAY monofocal toric IOL, designed by Medicontur Medical Engineering Ltd., represents an efficient and safe solution for cataract patients with astigmatism. Clinical and refractive outcomes are predictable, and rotational stability ensures long-term visual comfort.
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Affiliation(s)
- Ladislav Viktor Nováček
- Department of Ophthalmology, Institute of Aviation Medicine Prague, Prague, Czechia
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, Prague, Czechia
| | - Marie Němcová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, Prague, Czechia
| | - Kateřina Tyx
- Department of Ophthalmology, Institute of Aviation Medicine Prague, Prague, Czechia
| | - Kristýna Lahodová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, Prague, Czechia
| | - Leoš Rejmont
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, Prague, Czechia
| | - Pavel Rozsíval
- Department of Ophthalmology, Institute of Aviation Medicine Prague, Prague, Czechia
- Department of Ophthalmology Charles University Prague, Faculty of Medicine in Hradec Králové, Prague, Czechia
| | - Pavel Studený
- Department of Ophthalmology Královské Vinohrady University Hospital, and 3rd Faculty of Medicine, Charles University, Prague, Czechia
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Ra H, Hwang HS, Kim HS, Kim MS, Kim EC. Toric intraocular lens implantation in cataract patients with corneal opacity. BMC Ophthalmol 2020; 20:98. [PMID: 32169054 PMCID: PMC7068861 DOI: 10.1186/s12886-020-01352-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/18/2020] [Indexed: 11/20/2022] Open
Abstract
Background To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods Thirty-one eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) were statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P < 0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P < 0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R = 0.91 P < 0.05 and R = 0.92 P < 0.05, respectively). Conclusion Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.
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Affiliation(s)
- Ho Ra
- Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul, South Korea.,Department of Ophthalmology, Bucheon St. Mary's Hospital, 327 Sosa-ro, Wonmi-gu, Bucheon, Gyeonggi-do, 14647, South Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Hyun Seung Kim
- Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Man Soo Kim
- Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Eun Chul Kim
- Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul, South Korea. .,Department of Ophthalmology, Bucheon St. Mary's Hospital, 327 Sosa-ro, Wonmi-gu, Bucheon, Gyeonggi-do, 14647, South Korea.
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Efficacy of astigmatic correction after femtosecond laser-guided cataract surgery using intraoperative aberrometry in eyes with low-to-moderate levels of corneal astigmatism. Int Ophthalmol 2020; 40:1181-1189. [PMID: 31927679 DOI: 10.1007/s10792-020-01283-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/04/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the efficacy of astigmatic correction with two types of toric intraocular lenses (IOLs) after femtosecond laser-assisted cataract surgery (FLACS) in eyes with low-to-moderate corneal astigmatism using intraoperative aberrometry for optimizing the position of the toric IOL. METHODS Retrospective study includes a total of 99 eyes of 73 patients with anterior keratomeric astigmatism ≤ 3 D and undergoing FLACS (Catalys, Johnson & Johnson Vision) with implantation of a monofocal (Ankoris, PhysIOL) or a multifocal toric IOL with the same platform (Pod FT, PhysIOL). In all cases, intraoperative aberrometry was used (Optiwave refractive analysis, ORA, system, Alcon). Visual and refractive outcomes were evaluated preoperatively and at 4 months after surgery with vector analysis of astigmatic changes. RESULTS A total of 89.9%, 93.9% and 97.0% showed a postoperative sphere, cylinder and spherical equivalent within ± 0.50 D, respectively. Mean difference vector (DV) was 0.22 ± 0.27 D, mean magnitude of error (ME) was 0.13 ± 0.29 D, and mean angle of error (AE) was 1.52 ± 11.64°. Poor correlations of preoperative corneal astigmatism with DV (r = - 0.032, p = 0.833), ME (r = - 0.344, p = 0.001) and AE (r = - 0.094, p = 0.377) were found. Likewise, no statistically significant differences were found between monofocal and multifocal toric IOL subgroups in DV (p = 0.580), ME (p = 0.702) and AE (p = 0.499). CONCLUSIONS The combination of FLACS and intraoperative aberrometry to optimize the position of a toric IOL allows a very efficacious correction of preexisting low-to-moderate corneal astigmatism.
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Bandeira F, Morral M, Elies D, Eguiza S, Souki S, Manero F, Güell JL. Transitional conic toric intraocular lens for the management of corneal astigmatism in cataract surgery. Clin Ophthalmol 2018; 12:1071-1079. [PMID: 29922036 PMCID: PMC5995409 DOI: 10.2147/opth.s148599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Synopsis Transitional toric intraocular lens (IOL) was developed to improve refractive outcomes in cataract surgery. We report refractive, vectorial outcomes, and stability of spherical equivalent over 12 months after implantation of this IOL. Purpose To evaluate visual and refractive outcomes of a transitional conic toric intraocular lens (IOL) (Precizon®) for the correction of corneal astigmatism in patients undergoing cataract surgery. Setting The Ocular Microsurgery Institute (IMO), a private practice in Barcelona, Spain. Design This is a retrospective, non-randomized study. Methods Retrospective chart review of 156 patients with preoperative regular corneal astigmatism >0.75 diopters (D) who underwent consecutive phacoemulsification and Precizon toric IOL implantation between January 2014 and December 2015 was performed. Two groups were divided according to attempted residual refraction: group 1 with emmetropia and group 2 with mild myopia for monovision. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refraction were analyzed preoperatively and 3, 6, and 12 months postoperatively. Results Precizon toric IOL was implanted in 97 eyes of 61 patients. Six months postoperatively, none of the eyes lost any line of CDVA. In all, 98% of the eyes were within ±1.00 D of attempted spherical correction. The mean preoperative keratometric cylinder was 1.92 ± 1.04 D (range 0.75–6.78), and the mean postoperative refractive cylinder was 0.77 ± 0.50 D (range 0–2.25), with 81% of the eyes with ≤1.00 D of residual cylinder. Two IOLs required realignment due to intra-operative positioning error. Eleven eyes required enhancement with corneal refractive surgery. Conclusion Preexisting regular corneal astigmatism was effectively and safely corrected by the implantation of the transitional conic toric IOL in patients undergoing cataract surgery.
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Affiliation(s)
- Francisco Bandeira
- Cornea and External Disease Department, Federal University of São Paulo, São Paulo, Brazil
| | - Merce Morral
- Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain
| | - Daniel Elies
- Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain.,European School for Advanced Studies in Ophthalmology (ESASO), Lugano, Switzerland
| | - Sergio Eguiza
- Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain
| | - Spyridoula Souki
- Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain
| | - Felicidad Manero
- Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain
| | - Jose L Güell
- Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain.,European School for Advanced Studies in Ophthalmology (ESASO), Lugano, Switzerland.,Ophthalmology, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
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Kern C, Kortüm K, Müller M, Kampik A, Priglinger S, Mayer WJ. Comparison of Two Toric IOL Calculation Methods. J Ophthalmol 2018; 2018:2840246. [PMID: 29545950 PMCID: PMC5818930 DOI: 10.1155/2018/2840246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/17/2017] [Accepted: 11/23/2017] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To compare two calculators for toric intraocular lens (IOL) calculation and to evaluate the prediction of refractive outcome. METHODS Sixty-four eyes of forty-five patients underwent cataract surgery followed by implantation of a toric intraocular lens (Zeiss Torbi 709 M) calculated by a standard industry calculator using front keratometry values. Prediction error, median absolute error, and refractive astigmatism error were evaluated for the standard calculator. The predicted postoperative refraction and toric lens power values were evaluated and compared after postoperative recalculation using the Barrett calculator. RESULTS We observed a significant undercorrection in the spherical equivalent (0.19 D) by using a standard calculator (p ≤ 0.05). According to the Baylor nomogram and the refractive influence of posterior corneal astigmatism (PCA), undercorrection of the cylinder was lower for patients with WTR astigmatism, because of the tendency of overcorrection. An advantage of less residual postoperative SE, sphere, and cylinder for the Barrett calculator was observed when retrospectively comparing the calculated predicted postoperative refraction between calculators (p ≤ 0.01). CONCLUSION Consideration of only corneal front keratometric values for toric lens calculation may lead to postoperative undercorrection of astigmatism. The prediction of postoperative refractive outcome can be improved by using appropriate methods of adjustment in order to take PCA into account.
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Affiliation(s)
- C. Kern
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - K. Kortüm
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - M. Müller
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - A. Kampik
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - S. Priglinger
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - W. J. Mayer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
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Löffler F, Böhm M, Herzog M, Petermann K, Kohnen T. Tomographic Analysis of Anterior and Posterior and Total Corneal Refractive Power Changes After Femtosecond Laser-Assisted Keratotomy. Am J Ophthalmol 2017; 180:102-109. [PMID: 28549845 DOI: 10.1016/j.ajo.2017.05.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze the effect of penetrating femtosecond laser-assisted keratotomy (pFLAK) during laser lens surgery on anterior and posterior corneal astigmatism and total corneal refractive power (TCRP) astigmatism (CAant, CApost, CATCRP) measured with Scheimpflug tomography. DESIGN Prospective, interventional case series. METHODS This institutional study included 27 eyes of 23 patients (aged 65 ± 8 years) with low-to-moderate CATCRP determined with Scheimpflug tomography (Pentacam HR; Oculus, Wetzlar, Germany) after penetrating femtosecond laser-assisted keratotomy (pFLAK) and laser lens surgery. The CAant, CApost, and CATCRP were determined before and 1 and 3 months after surgery. Vector analysis according to the Alpins method was used to calculate surgically induced astigmatism (SIA). RESULTS The mean preoperative CAant (0.97 ± 0.30 diopter [D]) was significantly reduced to 0.63 ± 0.34 D (P < .001). SIAant was 0.71 ± 0.37 D. The CApost showed no significant change, from preoperative 0.26 ± 0.12 D to 0.26 ± 0.10 D postoperatively (P = .625). In line with this finding, SIApost was low (0.12 ± 0.07 D). The CATCRP showed similar results as CAant. CONCLUSION pFLAKs planned according to Scheimpflug-based CATCRP result in a significant reduction of the CAant and CATCRP, but do not affect the posterior corneal curvature significantly, as measured by Scheimpflug tomography. Further research is required to develop a new valid nomogram for laser-assisted lens surgery.
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Affiliation(s)
- Franziska Löffler
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Myriam Böhm
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Michael Herzog
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Kerstin Petermann
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany.
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Park Y, Kim MS, Kim EC. Comparison of Efficacies in Treating Astigmatism between Toric Intraocular Lens Implantation and Limbal Relaxing Incision. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.11.1225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yooyeon Park
- Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Man Soo Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Eun Chul Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
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