Refractive and Visual Outcome of Misaligned Toric Intraocular Lens After Operative Realignment

Müller-Kassner, Annika; Sartory, Tsvetina; Mueller, Michael; Varna-Tigka, Kleopatra; Mayer, Wolfgang J.; Kreutzer, Thomas; Schuh, Anna; Priglinger, Siegfried; Kohnen, Thomas und Shajari, Mehdi (2021): Refractive and Visual Outcome of Misaligned Toric Intraocular Lens After Operative Realignment. In: American Journal of Ophthalmology, Bd. 224: S. 150-157

Abstract

PURPOSE: The study was performed to evaluate the refractive and visual outcome of patients with misaligned toric intraocular lenses (IOLs) after operative realignment, with and without back-calculation of the toric axis after implantation of the IOL. DESIGN: Institutional, retrospective case-control study. METHODS: This is a retrospective case series of 39 patients who underwent a second operation to realign a misaligned toric IOL from August 2013 to December 2019 at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Ideal toric axis was calculated using the back-calculator astigmatismfix.com. RESULTS: The study consists of 39 treated eyes (20 [51%] right eyes). The toric IOLs showed a postoperative misalignment of 25.69 +/- 26.068. Postrotational, uncorrected distance visual acuity (UDVA) improved from 0.39 +/- 0.29 logMAR to 0.27 +/- 0.18 logMAR. Refractive outcome showed a reduction of residual sphere and cylinder. The postoperative UDVA when performing alignment to the preoperative calculated axis (51%) was 0.24 +/- 0.16 logMAR with a cylinder of 0.90 +/- 0.90 diopter (D). In the group with alignment to a back-calculated axis (49%), the UDVA was 0.32 +/- 0.20 logMAR with a cylinder of 0.76 +/- 0.72 D. High cylinder power IOLs (>= 2 D) showed a higher decrease in residual cylinder when back-calculation was performed than low cylinder power IOLs (<2 D) (27% vs 9%). The mean spherical equivalent prediction error of the backcalculator was 0.54 +/- 0.55 D. CONCLUSION: Realignment of misaligned toric IOLs improves visual acuity and reduces residual refractive errors. Especially for high cylinder power IOLs, better refractive outcome can be seen when performing a back-calculation before realignment. (C) 2020 Published by Elsevier Inc.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0002-9394
• Sprache: Englisch