Toric intraocular lens for correction of high corneal astigmatism in cataract patients

2020 ◽  
Vol 1 (2) ◽  
pp. 83-88
Author(s):  
Irene Simo ◽  
◽  
Laura Remón ◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Medical Engineering ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Before And After ◽  
The Mean ◽  
Axis Rotation

AIM: To evaluate the efficacy of Bi-Flex toric intraocular lens (T-IOL; Medicontur, Medical Engineering, Ltd., Inc.) implantation to correct preexisting astigmatism in patients having cataract surgery. METHODS: This retrospective consecutive study included 22 eyes of 16 patients with more than 2.50 diopters (D) of corneal preexisting astigmatism having cataract. Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective and subjective refraction and keratometric and topographic cylinder were measured. Postoperative the toric IOL axis was evaluated using vector analysis. RESULTS: Postoperatively, subjective refractive cylinder was reduced significant (P<0.05) from 4.05±1.53 D to 1.35±0.86 D. The component J0 reduced in magnitude from -0.81±2.02 D to -0.12±0.62 D (P<0.05). Both, UCVA and BCVA improved significantly at 1mo after surgery (P<0.05 in both cases). After the surgery, the UCVA and BCVA were 0.24±0.19 and 0.06±0.08, respectively. The mean toric IOL axis rotation was 2.95±5.25 degree, with rotation less than 10 degrees in 86.36% of eyes. No differences in mean keratometric values obtained before and after surgery were found (P>0.05 for J0 and J45). CONCLUSION: Implantation of the Bi-Flex toric IOL is a safe and effective method to correct the preexisting regular astigmatism (greater than 2.50D).

scholarly journals Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation

2012 ◽  
Vol 1 (2) ◽  
pp. 128-130
Author(s):  
Tova Lifshitz ◽  
Jaime Levy ◽  
Anry Pitchkhadze
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Cylinder Power ◽  
Best Corrected Visual Acuity

ABSTRACT We present the case of a 73-year-old patient who underwent successful phacoemulsification and toric intraocular lens (IOL) implantation to correct high stable astigmatism due to keratoconus and cataract. Preoperative refraction was −3.25 −4.0 × 98°. A toric IOL (Acrysof SN60T6) with a spherical power of 16.5 D and a cylinder power of 3.75 D at the IOL plane and 2.57 D at the corneal plane was implanted and aligned at an axis of 0°. Uncorrected visual acuity improved from 6/60 to 6/10. Postoperative best corrected visual acuity was 6/6, 6 months after the operation. In conclusion, phacoemulsification with toric IOL implantation can be performed in eyes with keratoconus and cataract. How to cite this article Levy J, Pitchkhadze A, Lifshitz T. Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation. Int J Kerat Ect Cor Dis 2012;1(2):128-130.

scholarly journals Suturing technique for scleral fixation of toric intraocular lens in the traumatic aphakic eye with corneal astigmatism

2018 ◽  
Vol 29 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Qintuo Pan ◽  
Zhengwei Yang ◽  
Xiaomeng Chen ◽  
Wenlong Wei ◽  
Zhisheng Ke ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Vertical Direction ◽  
Corneal Astigmatism ◽  
Suture Fixation ◽  
Toric Intraocular Lens ◽  
Corrected Visual Acuity ◽  
Scleral Suture Fixation ◽  
Aphakic Eyes ◽  
The Mean

Purpose: To describe the clinical outcomes of traumatic aphakic eyes with corneal astigmatism after using a novel technique for toric intraocular lens suture fixation. Methods: In total, 12 eyes of 12 patients who underwent a new scleral suture fixation technique of one-piece toric intraocular lens (SN6AT series, Alcon Inc., TX, USA) were included in our retrospective study. Preoperative patient status, postoperative visual acuity and refractive outcomes, postoperative intraocular lens rotation, tilt, decentration, and complications were analyzed. Results: The mean follow-up was 11.6 ± 1.0 months. The mean preoperative best-corrected visual acuity was 0.55 ± 0.32 in the logarithm of minimum angle of resolution equivalent; the postoperative best-corrected visual acuity was 0.45 ± 0.34. The mean preoperative total corneal astigmatism was 2.51 ± 1.67 D. The mean postoperative residual astigmatism was 0.77 ± 0.54 D. The mean intraocular lens rotation was 3.33° ± 1.37° (range, 1°–6°). The mean intraocular lens tilt in horizontal direction was 3.64° ± 1.02° (range, 2.6°–6.3°) and in vertical direction it was 3.19° ± 1.07 ° (range, 1.6°–5.2°). The mean intraocular lens decentration in horizontal direction was 0.14 ± 0.03 mm (range, 0.089–0.192 mm) and in vertical direction it was 0.15 ± 0.02 mm (range, 0.113–0.181 mm). One patient had mild vitreous hemorrhage and two other patients had high postoperative residual sphere and astigmatism, respectively. But no other serious complications were observed. Conclusion: Scleral suture fixation of foldable toric intraocular lens to correct corneal astigmatism can be a safe and effective alternative technique to manage traumatic aphakic eyes that lack adequate capsular support.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

Abstract Background: To analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

scholarly journals Clinical Performance of Toris K Contact Lens in Patients with Moderate to Advanced Keratoconus: A Real Life Retrospective Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ihsan Yilmaz ◽  
Ferah Ozcelik ◽  
Berna Basarir ◽  
Gokhan Demir ◽  
Gonul Durusoy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Clinical Performance ◽  
Real Life ◽  
Soft Contact Lenses ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Central Cone ◽  
The Mean

Objectives.To evaluate the visual performance of Toris K soft contact lenses in patients with moderate-to-advanced keratoconus and also to compare the results according to cone types, cone location, and severity of keratoconus.Materials and Methods.Sixty eyes of 40 participants were included in this retrospective study. Uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BCVA), best-contact lens corrected visual acuity (BCLCVA), and comfort rating via visual analogue scales (VAS) were measured.Results.The mean age was 27.3 ± 8.6 years (range: 18 to 54). The mean logMAR UCVA, BCVA, and BCLCVA were 0.85 ± 0.38 (range: 0.30–1.30), 0.47 ± 0.27 (range: 0.10–1.30), and 0.16 ± 0.20 (range: 0–1.00). There were significant increases in visual acuities with contact lenses (p<.05). BCLCVA was significantly better in oval type than globus type (p=.022). UCVA and BCLCVA were significantly better in moderate keratoconus group (p=.015,p=.018). The mean line gain in Snellen was 3.6 ± 1.8 lines (range: 0–7 lines). The mean line gain was higher in central cone group than paracentral cone group and oval group than globus group (p=.014,p=.045). The mean VAS score was 8.14 ± 1.88 (range: 6–10).Conclusions.Toris K can improve visual acuity of patients with keratoconus. Toris K is successful even in the moderate and advanced form of the disease.

scholarly journals Correction of High Corneal Astigmatism during Cataract Surgery

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Experience ◽  
Intraocular Lens ◽  
Surgical Intervention ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Surgical Interventions ◽  
Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

Abstract Background: The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications and no adverse events were reported.Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

scholarly journals Management of Cataract in Patients with Irregular Astigmatism with Regular Central Component by Phacoemulsification Combined with Toric Intraocular Lens Implantation

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Yi Gao ◽  
Zi Ye ◽  
Wenqian Chen ◽  
Jinglan Li ◽  
Xinlin Yan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Quality ◽  
Central Component ◽  
Regular Component ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Corrective Effect ◽  
Irregular Astigmatism

Purpose. To evaluate visual acuity (VA) and refractive status in patients with cataract and irregular astigmatism with a regular central component after phacoemulsification with implantation of a toric intraocular lens (IOL). Methods. Patients with cataract associated with irregular astigmatism with a regular central component were enrolled. All patients underwent phacoemulsification and toric IOL implantation. Postoperative visual acuity, residual astigmatism, toric IOL rotation, higher-order aberration, and objective and subjective visual quality were measured 3 months after surgery. Results. Twenty-three eyes were included in the study. The logMAR corrected and uncorrected distance visual acuity values were decreased at 3 months postoperatively (p < 0.005). The preoperative average corneal astigmatism and postoperative residual astigmatism were 1.15–6.97 D (1.99 ± 1.26 D) and 0–2.75 D (0.65 ± 0.57 D), respectively. The average IOL rotation was 3.17 ± 2.01°. Some objective indicators of visual quality, including the modulation transfer function (p < 0.05), Strehl ratio (p < 0.005), 100% VA (p < 0.005), 20% VA (p < 0.005), and 9% VA (p < 0.005), were significantly higher than the corresponding preoperative values. The objective scatter index (p < 0.005) was significantly lower than that before surgery. The postoperative VF-14 scale score was 83.99 ± 14.58. Conclusion. Toric IOL implantation has a good corrective effect on certain specific types of corneal irregular astigmatism with cataract. This effect can be attributed to its ability to correct the regular component of irregular astigmatism. The indications for toric IOL implantation could be expanded to some extent, thereby bringing benefit to more patients.

scholarly journals Stability and clinical outcomes of a new one piece toric intraocular lens with anchor-wing haptics

2020 ◽  
Author(s):  
Iichiro Sugita ◽  
Tomoichiro Ogawa ◽  
Kazuo Ichikawa ◽  
Takahide Okita ◽  
Kazuno Negishi ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
University Hospital ◽  
Primary Analysis ◽  
Toric Intraocular Lens ◽  
Private Hospitals ◽  
Safety And Efficacy ◽  
Iol Implantation ◽  
Age Related ◽  
Uncorrected Visual Acuity ◽  
The Mean

Abstract Background: To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics.Methods: The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at a university hospital and two private hospitals in Japan. The following IOL cylinder powers were evaluated: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was uncorrected visual acuity (UCVA) with spherical addition at 6 months postoperatively, and the primary analysis calculated the proportion of eyes with UCVA with spherical addition of 0.1 logMAR or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results: This study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all IOL powers, UCVA with spherical addition of 0.1 logMAR or better was achieved in 90% [95% confidence interval (CI): 80-96] of eyes. The mean IOL rotation was 5.3±4.3° at 12 months postoperatively. The mean magnitude of rotation ranged from 1.9° to 2.5° between each postoperative examination from 1 day to 12 months. There were no vision-threatening intraoperative or postoperative complications for the duration of the study.Conclusions: The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts.Trial registration: This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered. (https://clinicaltrials.gov/ct2/show/NCT03242486)

Neovaskulinės amžinės geltonosios dėmės degeneracijos gydymo ranibizumabu 24 mėnesių morfologiniai ir funkciniai pokyčiai

2015 ◽  
Vol 21 (3.2) ◽  
pp. 413-416
Author(s):  
Vilma Jūratė Balčiūnienė ◽  
Rosita Lažaunykaitė
Keyword(s):  
Visual Acuity ◽  
Macular Thickness ◽  
Age Related Macular Degeneration ◽  
Central Macular Thickness ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Before And After ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment – naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt’s rings C optotypes). Optical coherence tomography images were obtained using the spectral – domain OCT (NIDEK RS – 3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after – 0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 μm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 μm (p &lt; 0.001). Before second injection central macular thickness was 273.57 ± 87.49 μm, after – 234.51 ± 58.96 μm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 μm, after – 219.10 ± 42.26 μm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p &lt; 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study’s results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month.

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