Keywords
Long-term
Myopia
Rotational stability
Submitted : 2024-03-13
Accepted : 2024-03-28
Published : 2024-04-12
Abstract
Objective: To analyze the enduring rotational steadiness of AcrySof IQ Toric intraocular lens (IOL) in cataract patients suffering from myopia in a long-term study. Methods: A retrospective study was conducted on a case series involving 78 patients. A total of 120 eyes with an axial length (AL) ranging from 24–30 mm and corneal astigmatism ≥ 1.50 D underwent implantation of AcrySof IQ Toric IOL guided by the version navigation system. The eyes were divided into two groups based on AL. Group A included 60 eyes with high myopia (AL ≥ 26 mm), while Group B consisted of eyes with low to moderate myopia (24 mm ≤ AL < 26 mm). Data on the preoperative AL were collected. Measurements were taken for residual astigmatism, the best corrected visual acuity (BCDVA), corneal astigmatism, and IOL rotation occurring between 24- and 48-months post-surgery. The percentage of eyes with an IOL rotation of under 5° and 10° was analyzed. Results: The mean length of follow-up times was recorded as 34.27 ± 4.98, and the average rotation was 2.73 ± 1.29°. Group A exhibited a slightly higher average rotation of 2.87 ± 1.31°, compared to the rotation of 2.59 ± 1.27° observed in Group B. At both the 24–36 month and 26–48 month post-operation marks, the degree of IOL rotation did not show a statistically significant difference between the two groups, with none of the patients experiencing a rotation exceeding 10° (P > 0.05). The percentage of rotation degrees under 5° was recorded as 98.22%. After the procedure, the BCDVA was 0.13 ± 0.03 LogMAR. There was a substantial increase in the χ2 value after the operation as compared to the pre-operative χ2 value (χ2 = 76.79). The standard deviation of preoperative corneal astigmatism was statistically significant (P < 0.05) at 2.17 ± 1.08 D. Following the surgical procedure, the remaining astigmatism was measured at 0.41 ± 0.26 D. The data showed a notable gap in statistical significance (t = 4.281, P < 0.05). Conclusion: The AcrySof Toric IOL was a reliable solution for managing corneal astigmatism in cataract patients with myopia, demonstrating excellent long-term rotational stability.
References
Tomiyama ES, Logan AK, Richdale K, 2021, Corneal Elevation, Power, and Astigmatism to Assess Toric Orthokeratology Lenses in Moderate-to-High Astigmats. Eye Contact Lens, 47(2): 86–90.
Reitblat O, Levy A, Megiddo Barnir E, et al., 2020, Toric IOL Calculation in Eyes with High Posterior Corneal Astigmatism. J Refract Surg, 36(12): 820–825.
Ferreira TB, Ribeiro P, Ribeiro FJ, et al., 2017, Comparison of Methodologies Using Estimated or Measured Values of Total Corneal Astigmatism for Toric Intraocular Lens Power Calculation. J Refract Surg, 33(12): 794–800.
Reitblat O, Levy A, Kleinmann G, et al., 2016, Effect of Posterior Corneal Astigmatism on Power Calculation and Alignment of Toric Intraocular Lenses: Comparison of methodologies. J Cataract Refract Surg, 42(2): 217–225.
Hayashi K, Yoshida M, Hayashi S, et al., 2022, Long-Term Changes in The Refractive Effect of A Toric Intraocular
Lens on Astigmatism Correction. Graefes Arch Clin Exp Ophthalmol, 260(2): 509–519.
Chamberlain P, Peixoto-de-Matos SC, Logan NS, et al., 2019, A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci, 96(8): 556–567.
Greene PR, Medina A, Juvenile Myopia, 2017, Predicting the Progression Rate. Mathews J Ophthalmol, 2(1): 12.
Lin T, Yang Y, Lin J, et al., 2021, A Comparative Study of Macular and Choroidal Thickness and Blood-Flow Parameters in Patients with Intermediate and Simple Juvenile Moderate Myopia. Int J Gen Med, 14: 1343–1348.
Singh A, Kapoor G, Baranwal VK, et al., 2022, Rotational Stability of Toric Intraocular Lenses. Med J Armed Forces India, 78(1): 68–73.
Kaur M, Shaikh F, Falera R, et al. 2017, Optimizing Outcomes with Toric Intraocular Lenses. Indian J Ophthalmol, 65(12): 1301–1313.
Mendicute J, Irigoyen C, Ruiz M, et al., 2009, Toric Intraocular Lens Versus Opposite Clear Corneal Incisions to Correct Astigmatism in Eyes Having Cataract Surgery. J Cataract Refract Surg, 35(3): 451–458.
Kwitko S, Marafon SB, Stolz AP, 2020, Toric Intraocular Lens in Asymmetric Astigmatism. Int Ophthalmol, 40(5): 1291–1298.
Kaur M, Shaikh F, Falera R, et al., 2017, Optimizing Outcomes with Toric Intraocular Lenses. Indian J Ophthalmol, 65(12): 1301–1313.
Ra H, Hwang HS, Kim HS, et al., 2020, Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity. BMC Ophthalmol, 20(1): 98.
Kuo IC, 2020, Decentration of A Toric Intraocular Lens Implant in A Patient with Simple Megalocornea. Am J Ophthalmol Case Rep, 19: 100754.
Luo J, Liu Y, Wang F, et al., 2021, Effect of the kappa angle on depth of focus after implantation of the TECNIS Symfony intraocular lens. Int Ophthalmol. 41(7): 2513-2520.
Liu Y, Wei D, Bai T, et al., 2021, Using machine learning to predict post-operative depth of focus after cataract surgery with implantation of Tecnis Symfony. Eur J Ophthalmol, 31(6): 2938-2946.
Trindade BLC, Garcia JC, Nogueira LR, 2021, Toric IOL in Combined DMEK and Cataract Surgery. Clin Ophthalmol, 15: 1511–1516.
Luebke J, Boehringer D, Maier P, et al., 2020, Toric IOL Positioning with A No-Touch Head-Up Display Axis Alignment. Int Ophthalmol, 40(3): 617–626.
O’Neill BP, Diakonis VF, Tsaousis KT, et al., 2021, Outcomes of Toric IOL Implantation Guided by Iris-Registered Femtosecond Laser Capsulotomy Markings. Int Ophthalmol, 41(12): 4009–4015.
Osawa R, Oshika T, Sano M, et al., 2021, Rotational Stability of Modified Toric Intraocular Lens. PLoS One, 16(3): e0247844.
Sasaki K, Eguchi S, Miyata A, et al., 2021, Anterior Capsule Coverage and Rotational Stability of An Acrylic Toric Intraocular Lens. J Cataract Refract Surg, 47(5): 618–621.