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Effect of two different preoperative calculation schemes on visual outcomes of patients after toric intraocular lens implantation

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Abstract

Purpose

To compare the postoperative visual outcomes of two different preoperative corneal incision schemes in TECNIS toric intraocular lens (IOL) implantation.

Methods

In this randomized controlled study, patients with preoperative corneal astigmatism greater than 1.0 diopter (D) were included. These patients were grouped according to the different preoperative schemes: steep-axis group and minimum-residual refractive astigmatism group. The outcome measurements were the residual refractive astigmatism, visual acuity, changes of corneal astigmatism, and high-order aberration at 1 month postoperatively.

Results

This study consisted of 90 eyes (45 eyes steep-axis group, 45 eyes minimum-residual refractive astigmatism group). 1 month after surgery, the refractive astigmatism was statistically lower in the minimum-residual refractive astigmatism group compared with the steep-axis group (0.58 ± 0.40D vs 0.38 ± 0.37D, P = 0.021). The minimum-residual refractive astigmatism group had a smaller difference vector (0.56 ± 0.38D vs 0.36 ± 0.35D; P = 0.047) and a smaller prediction error (0.60 ± 0.44D vs 0.37 ± 0.35D; P = 0.004). In the steep-axis group, corneal astigmatism significantly decreased compared with preoperative value (1.65 ± 0.57D vs 1.17 ± 0.64D; P < 0.001). In the minimum-residual refractive astigmatism group, the changes of corneal astigmatism before and after surgery were not significant. Moreover, total aberration and second astigmatism in ocular aberration were lower in the minimum-residual refractive astigmatism group compared with the steep-axis group (1.86 ± 1.09 vs 1.37 ± 0.95; P = 0.035 and 0.47 ± 0.28 vs 0.31 ± 0.19; P = 0.015, respectively).

Conclusion

Minimum-residual refractive astigmatism incision had better astigmatism correction and more accurate prediction. The corneal astigmatism was stable 1 month after surgery. It might lead to better visual quality in the early postoperative stage.

Trial registration number for prospectively registered trials: clinicaltrials.gov NCT04006912, 07/02/2019.

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Data availability

The datasets used and/or analyzed in the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Dr. Zhe Xu for English Language Editing.

Funding

This study was supported by National Natural Science Foundation of China (81800809).

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Authors and Affiliations

  1. Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China

    Xuewen Yu, Jingwen Wang, Xueqi Lin, Dejian Xu, Shuang Ni, Siting Sheng & Wen Xu

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  1. Xuewen Yu
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  2. Jingwen Wang
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  4. Dejian Xu
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Contributions

The research design was created by WX. All members participated in data collection, data analysis was performed by XWY, JWW and XQL. All members participated in drafting and critical revisions of the manuscript. All members have read and approved the final manuscript.

Corresponding author

Correspondence to Wen Xu.

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The authors declare no competing interests.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study was approved by the Ethics Committee of the Second Affiliated Hospital, Zhejiang University School of Medicine (No: yan2019-079).

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Yu, X., Wang, J., Lin, X. et al. Effect of two different preoperative calculation schemes on visual outcomes of patients after toric intraocular lens implantation. Int Ophthalmol 43, 491–501 (2023). https://doi.org/10.1007/s10792-022-02447-7

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  • DOI: https://doi.org/10.1007/s10792-022-02447-7

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