Long-term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism

PurposeTo evaluate the long-term clinical outcomes and rotational stability of toric intraocular lenses (IOLs) to correct preexisting astigmatism in cataract patients.SettingKitasato University Hospital, Kanagawa, Japan.DesignProspective observational study.MethodsPhacoemulsification with implantation of a toric IOL (Acrysof IQ toric SN6AT) was performed in cataract patients with corneal astigmatism. The postoperative follow-up was up to 2 years.ResultsThis study enrolled 378 eyes of 302 patients with a mean age of 63.4 years ± 16.9 (SD). The corrected distance visual acuity 3 months postoperatively was 20/25 or better in 94.7% of eyes. The mean refractive cylinder was −1.92 ± 1.45 diopters (D) preoperatively, −0.59 ± 0.62 D 3 months postoperatively (322 eyes), and −0.67 ± 0.90 D at 2 years (73 eyes). There were statistically significant differences between the preoperative and 3-month postoperative measurements (P<.001, Wilcoxon signed-rank test). The mean IOL misalignment was 4.1 ± 3.0 degrees 2 years postoperatively. The mean IOL rotation was 4.5 ± 4.9 degrees within 1 day postoperatively. The rotation was more than 20 degrees in 6 eyes, all of which had an axial length (AL) of more than 25.0 mm. All rotations occurred within 10 days postoperatively.ConclusionsToric IOLs were effective in reducing preexisting corneal astigmatism and had overall good rotational stability. A large degree of IOL rotation might occur in eyes with a relatively long AL, especially during the early postoperative period. The 6 rotated IOLs were implanted to correct with-the-rule astigmatism.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned.