Optimizing outcomes with toric intraocular lenses.

Abstract:

:Toric intraocular lenses (IOLs) are the procedure of choice to correct corneal astigmatism of 1 D or more in cases undergoing cataract surgery. Comprehensive literature search was performed in MEDLINE using "toric intraocular lenses," "astigmatism," and "cataract surgery" as keywords. The outcomes after toric IOL implantation are influenced by numerous factors, right from the preoperative case selection and investigations to accurate intraoperative alignment and postoperative care. Enhanced accuracy of keratometry estimation may be achieved by taking multiple measurements and employing at least two separate devices based on different principles. The importance of posterior corneal curvature is increasingly being recognized in various studies, and newer investigative modalities that account for both the anterior and posterior corneal power are becoming the standard of care. An ideal IOL power calculation formula should take into account the surgically induced astigmatism, the posterior corneal curvature as well as the effective lens position. Conventional manual marking has given way to image-guided systems and intraoperative aberrometry, which provide a mark-less IOL alignment and also aid in planning the incisions, capsulorhexis size, and optimal IOL centration. Postoperative toric IOL misalignment is the major factor responsible for suboptimal visual outcomes after toric IOL implantation. Realignment of the toric IOL is needed in 0.65%-3.3% cases, with more than 10° of rotation from the target axis. Newer toric IOLs have enhanced rotational stability and provide precise visual outcomes with minimal higher order aberrations.

journal_name

Indian J Ophthalmol

authors

Kaur M,Shaikh F,Falera R,Titiyal JS

doi

10.4103/ijo.IJO_810_17

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1301-1313

issue

12

eissn

0301-4738

issn

1998-3689

pii

IndianJOphthalmol_2017_65_12_1301_219870

journal_volume

65

pub_type

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