ESCRS - PP02.07 - Refractive Predictability Of Astigmatism Correction With A Low Toric Iol In Patients With Ocular Surface Disease

Refractive Predictability Of Astigmatism Correction With A Low Toric Iol In Patients With Ocular Surface Disease

Published 2022 - 40th Congress of the ESCRS

Reference: PP02.07 | Type: Free paper | DOI: 10.82333/x8h4-1b75

Authors: Christian Nilsen 1 , Bjørn Gjerdrum* 1 , Kjell Gunnar Gundersen 1

1Ifocus Øyeklinikk,Haugesund,Norway

Purpose

To compare the refractive predictability astigmatism correction with a low toric IOL in patients with OSD to a control group.

Setting

Private eye clinic in Haugesund, Norway

Methods

Cataract patients with indication for low toric IOLs (T2, 1 D cylinder) were assessed for ocular surface disease (OSD) and assigned to a control group and an OSD group accordingly. Subjects in the OSD group was randomly assigned to receive standard preserved pre-medication without artificial tears (Group 1) or preservative free pre-medication, and artificial tears for two weeks preoperatively (Group 2)

Biometry was performed with Haag-Streit Lenstar 900. Toric IOL calculations were based on the Barret toric calculator. The primary outcome measure was the magnitude of the refractive cylinder prediction error (CPE) 5-6 weeks after surgery. The CPE was calculated as the vector difference of the achieved and the predicted cylindrical refraction.

Results

70 eyes of 57 patients were included. 57% were female and the mean age was 72.9 years.

The mean refractive spherical equivalent and cylinder was -0.04 D and -0.44 DC, respectively, and the mean best corrected visual acuity was -0.03 logMar.

The mean CPE for the control group was 0.52 ± 0.31 DC. This was not statistically different from Group 1 and Group 2 (0.41 ± 0.27 DC, p=0.2  and 0.38 ± 0.22 DC, p=0.1, respectively.

The Refractive cylinder was -0.25 or less in 21%, 38% and 41%, for the control group, Group 1 and Group 2 respectively. This was not statistically significant (p=0.4)

Conclusions

OSD is a known to affect the accuracy of keratometry and the assessment for toric IOLs in cataract surgery. In cataract patients implanted with a low toric lens, the magnitude of cylinder prediction error showed a clear trend (p=0.1) to be lower in subjects with OSD who received preservative free pre-medication and artificial tears before the surgery compared to a control group who received standard preserved pre-medication without artificial tears