Efficacy of 4-Haptic Bitoric Intraocular Lens Implantation in Asian Patients with Cataract and Astigmatism

PURPOSE: To determine the efficacy of 4-haptic bitoric intraocular lens (IOL) implantation in Asian patients with cataract and astigmatism. METHODS: A total of 19 eyes with ≤25.0 mm axial length and ≥0.75 diopters (D) corneal astigmatism were included in this prospective non-comparative study. All subjects underwent phacoemulsification with implantation of an AT Torbi 709M IOL. Visual and refractive outcomes as well as toric IOL axis were evaluated during a 3-month follow-up. Errors in predicted residual spherical equivalent were calculated by subtracting predicted residual spherical equivalent from postoperative refraction. RESULTS: Uncorrected and corrected distance visual acuity improved significantly 3 months after surgery, from 0.43 to 0.05 and from 0.24 to −0.05, respectively. Mean refractive cylinders also decreased significantly, from −1.91 preoperatively to −0.54 D 3 months after surgery. Mean J0 and J45 decreased 3 months postoperatively, from 0.26 to 0.03 D and from 0.24 to −0.06 D, respectively. After 3 months, mean absolute IOL rotation was 1.81°. Errors in predicted residual spherical equivalent showed a hyperopic shift of 0.35 D. CONCLUSIONS: Implantation of 4-haptic bitoric IOL proved to be effective for correcting astigmatism in Asian eyes during cataract surgery.

Comparison of the Clinical Outcomes of Two Types of Toric Intraocular Lens

PURPOSE: In this study evaluated clinical outcomes and higher-order aberrations in patients with implanted Tecnis ZCT toric intraocular lens (IOL) (Abbott Medical Optics Inc., Santa Ana, CA, USA) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG, Jena, Germany) in eyes with low to moderate corneal astigmatism. METHODS: We conducted a retrospective study of 32 consecutive eyes of 26 patients with a visually significant cataract and moderate corneal astigmatism (higher than 1.25 diopter [D] and lower than 4.5 D) undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics Inc.) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG). Phacoemulsification was performed by the same experienced surgeon using 2.2 mm temporal incision. Visual, refractive and aberrometric changes were evaluated during a 3-month follow-up. Power vector analysis of Cartesian astigmatism (J0) and oblique astigmatism (J45) was performed. RESULTS: At the 3-month follow-up, corrected distance visual acuity (CDVA) and residual astigmatism showed no statistically significant differences between groups (p = 0.203 and p = 0.364, respectively). Pre- and postoperative J0 were 0.71 +/- 0.84 and 0.05 +/- 0.39 in the Tecnis Toric group and, 0.88 +/- 1.27 and -0.02 +/- 0.16 in the AT TORBI group, respectively, which showed statistically significant differences (p = 0.029 and p = 0.032, respectively). Pre- and post-operative differences of J0 and J45 were not statistically significant (p = 0.234 and p = 0.603, respectively). No eye had IOL rotation > or =10degrees. Ocular aberrometry values were statistically significantly differenct between the groups, except for spherical aberration, which was higher in the AT TORBI group (p = 0.0047). CONCLUSIONS: Both IOLs showed good postoperative uncorrected distance visual acuity, CDVA and refractive results in this study. Rotational stability was excellent for both IOLs until the 3-month follow-up.