May 2019

ASCRS NEWS

Correcting astigmatism at the time of cataract surgery: comparing results with toric intraocular lenses and corneal relaxing incisions planned with an image guidance system and intraoperative aberrometer versus manual planning and surgery


by Kerry Solomon, MD, Helga Sandoval, MD, Richard Potvin, OD

J Cataract Refract Surg. 2019;45(5):569–575.
Purpose: To evaluate outcomes when comparing the combination of an image guided system and intraoperative aberrometer to the surgeon’s standard of care in correcting astigmatism using toric intraocular lenses (IOLs) or corneal incisions.
Setting: One site in the U.S.
Design: Prospective randomized contralateral eye study.
Methods: Contralateral eyes of subjects undergoing uncomplicated bilateral cataract surgery and astigmatism correction were randomly assigned to Group A or Group B. Group A received the surgeon’s preferred standard of care. Group B had preoperative planning using an image guidance system, intraoperative aberrometry and laser-assisted cataract surgery. The primary endpoint was the residual refractive astigmatism at 3 months.
Results: A total of 38 eyes were treated with toric IOLs and 40 eyes with corneal astigmatic incisions (CAIs). Toric IOLs resulted in almost 0.25 D less cylinder than CAIs on average (p<0.01) with no difference between groups (p=0.41). There was no statistically significant difference in the MRSE by group (p=0.51). At 3 months, 11% of eyes (4/38) were more than 10 degrees of absolute orientation away from intended, two in Group A and two in Group B. The Verion mean keratometry was 0.16 D higher than for the LENSTAR. The vector difference between the two measures for all eyes was 0.5 D or lower.
Conclusion: The combined use of an image guided system and intraoperative aberrometry did not significantly improve outcomes when compared to the surgeon’s standard of care. There was good agreement in the corneal astigmatism measurements between Verion and LENSTAR Ks.
 

Correcting astigmatism at the time of cataract surgery: comparing results with toric intraocular lenses and corneal relaxing incisions planned with an image guidance system and intraoperative aberrometer versus manual planning and surgery Correcting astigmatism at the time of cataract surgery: comparing results with toric intraocular lenses and
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2019-05-06T14:16:45Z
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