Clinical results after spherotoric intraocular lens implantation using the bag-in-the-lens technique

PurposeTo evaluate the clinical results after implantation of a spherotoric intraocular lens (IOL) using the bag-in-the-lens (BIL) technique.SettingAntwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium.DesignEvidence-based manuscript.MethodsConsecutive eyes with cataract and corneal astigmatism had implantation of a spherotoric BIL intraocular lens (IOL). The IOL was centered based on the patient’s pupillary entrance using Purkinje reflexes of the surgical microscope light.ResultsThe study enrolled 52 eyes of 35 patients (23 women) with corneal astigmatism ranging from 0.90 to 6.19 diopters (D). The toric power was between 1.00 D and 8.00 D. One-third of eyes had an additional ocular comorbidity (including amblyopia) that could influence the clinical outcomes; 5.2% had an irregular astigmatism up to 15 degrees. Twelve eyes had high myopia (axial length [AL] >26 mm) and 5 eyes, high hyperopia (AL <21 mm). The mean preoperative corrected distance visual acuity was 0.58 ± 0.25 (SD). Postoperatively, the uncorrected distance visual acuity (UDVA) was 0.5 or better in 92% of eyes, the mean UDVA was 0.85 ± 0.21 D, the mean magnitude of error was 0.05 ± 0.49 D, and the mean angle of error was 0.29 ± 0.89 degree. Astigmatism correction was successful in 82% of eyes.ConclusionSpherotoric BIL IOL implantation yielded outcomes similar to those with other spherotoric IOLs, even in eyes with ocular comorbidity or irregular astigmatism up to 15 degrees.Financial DisclosureDrs. Gobin and Van Looveren and Mr. Mathysen have no financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.