Assessment of the refractive outcomes of patients with regular corneal astigmatism implanted with high-power toric intraocular lenses.

Abstract

Background: To describe the refractive outcomes of eyes with high regular corneal astigmatism undergoing age-related cataract surgery.

Methods: Astigmatic patients who underwent cataract surgery with implantation of high-power XY1AT HOYA^® toric lenses (IOLs) (≥ T5) between March 2020 and June 2022 were included. Patients were divided into 2 groups based on the type of Total Corneal Astigmatism (TCA) used for the toric IOL calculation: group 1 = TCA^TK- 700 (TCA measured by the Iol Master 700^®) and group 2 = TCA^AK- 700 (TCA estimated from the anterior keratometry of the Iol Master 700^® and using the Abulafia-Koch regression). The best-uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective spherical equivalent (SSEq) and subjective residual cylinder (SRC) were assessed at 1 month. The predictability (centroid [CEPA] and mean absolute error in predicted astigmatism [MAEPA]) of the 2 TCA assessment methods was analyzed.

Results: 96 eyes of 74 patients were included. In the whole cohort, the UDVA was 0.14 ± 0.19 logMAR, the CDVA was 0.04 ± 0.07 logMAR. Postoperative SSEq was - 0.24 ± 0.53D. Postoperative SRC was - 0.48 ± 0.56D. The UDVA, SSEq and SRC did not significantly differ between groups. The MAEPA was significantly better with TCA^AK-700 compared to TCA^TK-700: 0.58 ± 0.52D versus 0.65 ± 0.55D (p = 0.01). No significant difference was observed for the CEPA (p(x) = 0.09, p(y) = 0.19).

Conclusions: XY1AT HOYA^® toric IOLs are a very good alternative even in case of high toricity. Residual astigmatism predictability is high, it would be better with TCA^AK- 700. This data should be confirmed with a larger sample of patients.