Effect of Toric Intraocular Lens Implantation on Visual Acuity and Astigmatism Status in Eyes Treated with Microhook Ab Interno Trabeculotomy.

Research paper by Sho S Ichioka, Kaoru K Manabe, Aika A Tsutsui, Yasuyuki Y Takai, Masaki M Tanito

Indexed on: 09 Oct '20Published on: 09 Oct '20Published in: Journal of glaucoma


PRéCIS:: Use of toric intraocular lenses is a reasonable option for better visual outcomes when a combined minimally invasive glaucoma surgery and cataract surgery is performed in eyes with corneal astigmatism. To assess the efficacy of toric intraocular lenses (IOLs) in combined cataract and minimally invasive glaucoma surgery (MIGS), visual and refractive outcomes were compared between eyes implanted with non-toric and toric IOLs during microhook ab interno trabeculotomy triple procedures. Glaucomatous eyes with preexisting corneal astigmatism exceeding -1.5 diopter (D) implanted with non-toric (n=10) or toric (n=10) IOLs were evaluated retrospectively. The uncorrected visual acuity (UCVA) and refractive astigmatism preoperatively and 3 months postoperatively were compared. Preoperatively, the groups had similar logarithm of the minimum angle of resolution (logMAR) UCVAs and refractive astigmatism. Postoperatively, the logMAR UCVA (toric, 0.07±0.07; non-toric, 0.33±0.30; P=0.0020) was significantly better and the refractive astigmatism (toric, -0.63±0.56 D; non-toric, -1.53±0.74 D; P=0.0110) significantly less in the toric group. The toric group had postoperative improvements in the logMAR UCVA (-0.58, P=0.0039) and refractive astigmatism (+1.45 D, P=0.0195). Vector analyses showed the postoperative centroid magnitude of refractive astigmatism was less in the toric group (0.23 D at 83°) than the non-toric group (1.03 D at 178°). Postoperatively, 70% of eyes in the toric group had 1.0 D or less refractive astigmatism compared with 10% in the non-toric group. Surgically induced astigmatism (non-toric group, 0.62 D at 10°; toric group, 0.50 D at 113°) and intraocular pressure reduction (22% in both groups) did not differ between groups. Better visual outcomes may be achieved with toric IOLs when a combined MIGS/cataract surgery is performed in eyes with corneal astigmatism.