Toric intraocular lens vs. peripheral corneal relaxing inci- sions to correct astigmatism in eyes undergoing cataract surgery.

Abstract

Purpose: To compare toric intraocular lens implantation (Toric-IOL) with peripheral corneal relaxing incisions (PCRIs) for astigmatism correction in patients undergoing cataract surgery.

Methods: 54 patients (54 eyes) with more than 0.75 diopter (D) of preexisting corneal astigmatism were classified as group A (0.75-1.50D) or group B (1.75-2.50D). The patients were randomized to undergo Toric-IOL or PCRIs in the steep axis with spherical IOL implantation. LogMAR uncorrected visual acuity (LogMAR UCVA), LogMAR best corrected visual acuity (LogMAR BCVA), error of vector (|EV|), surgery induced refraction correction (|SIRC|), and correction rates (CR) were measured 1 month and 6 months postoperatively.

Results: At 6 months postoperatively, all 54 eyes had LogMAR BCVA ≤ 0.2. Patients who underwent PCRIs and Toric-IOL with LogMAR BCVA ≤ 0.1 showed no significant differences in group A (P = 1.00) or in group B (P = 0.59). Group A showed no significant differences in LogMAR UCVA (P = 0.70), |EV| (P = 0.13), |SIRC| (P = 0.71), and CR (P = 0.56) in patients underwent PCRIs and Toric-IOL. However, group B showed significant differences in LogMAR UCVA (P < 0.01), |EV| (P < 0.01)), |SIRC| (P < 0.01), and CR (P < 0.01). The LogMAR UCVA and |EV| between 1 and 6 months showed no significant differences in patients in group A. However, in group B, they are significant differences.

Conclusion: The efficacy and stability of Toric-IOL and PCRIs were equal in low astigmatic patients. Toric-IOL achieved an enhanced effect over PCRIs in higher astigmatic patients. PCRIs had the more refractive regression than Toric-IOL in 6 months.