Efficacy comparison between toric intraocular lens and aspheric intraocular lens plus steep-axis incision in cataract patients with low corneal astigmatism
Ziyuan Liu, Ren Zhou, Ke Xu, Aihua Ding, Wei Wang, Tom Wu, Yanxiu Sun
Abstract
BACKGROUND: The present study aimed to evaluate and compare the efficacy of toric intraocular lens (IOL) implantation and aspheric IOL implantation with steep-axis incision for correcting mild to moderate corneal astigmatism in cataract patients. METHODS: A prospective, single-center, open label, randomized, two-arm study was designed. Cataract patients with corneal astigmatism of 1.0-2.0D were enrolled and divided into test and control groups. The test group had the AcrySof® IQ Toric IOL implanted and the control group had the AcrySof® IQ IOL implanted with a steep-axis corneal incision. All patients underwent examinations of uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), subjective refraction, and corneal astigmatism before surgery and at the 1-day, 1-month, and 3-month follow-ups. Vector astigmatism analysis was evaluated using the Alpins method. RESULTS: We enrolled 26 eyes of 20 patients in the study, with 13 eyes in each group. The test group had better vision than the control group at the 3-month follow-up and had more cases with a UCDVA of 20/20 (10/13 vs. 4/13). The surgically induced astigmatism (SIA) vector of the test group was higher than that of the control group (1.22±0.64 vs. 0.84±0.45). The correction index of the test group was closer to 1 compared to that of the control group (0.7 vs. 0.46). Approximately 85% of patients in the test group had an angle of error within -15° to 15°. However, only 23% of patients in the control group were within that range. CONCLUSIONS: Though steep-axis corneal incision was cost-saving and easy-to perform, its astigmatismcorrecting efficacy was not as good as the Toric IOL implantation for cataract patients with low to moderate corneal astigmatism.