Advertisement

International Ophthalmology

, Volume 39, Issue 9, pp 1965–1972 | Cite as

Outcomes of toric supplementary intraocular lenses for residual astigmatic refractive error in pseudophakic eyes

  • Cameron A. McLintockEmail author
  • James McKelvie
  • Zisis Gatzioufas
  • Jessica J. Wilson
  • David C. Stephensen
  • Andrew J. G. Apel
Original Paper
  • 74 Downloads

Abstract

Purpose

To evaluate rotational stability and visual and refractive outcomes of supplementary toric IOLs (Sulcoflex Toric 653T, Rayner Intraocular Lenses Ltd) for residual astigmatic refractive error in pseudophakic eyes.

Methods

A retrospective interventional case series was conducted in a single surgeon practice. Charts of patients who had Sulcoflex Toric supplementary IOLs inserted between June 2009 and September 2015 were reviewed. Outcomes were compared between eyes with and without prior corneal transplant. Patients with at least 3-months follow-up were included.

Results

In 51 eyes, mean UDVA improved from 20/86 to 20/43 (p = 0.002), though UDVA was better in eyes without corneal grafts (20/31) than eyes with (20/62). The proportion of eyes achieving 20/20 UDVA was 43%, 61% and 17% overall, in eyes with prior graft and in eyes with no prior graft, respectively. Sixty-four percentage achieved a spherical equivalent of within 0.5D of target (84% no graft, 34% prior graft). Fifty-three percentage of eyes achieved a cylinder of within 0.5D of target (no graft: 73%, prior graft: 0%). Mean lens rotation was 8.23° on day 1, and mean maximal rotation during follow-up was 17.63°. Sixty-two percentage of IOLs required repositioning. Of those that required repositioning, this was conducted a mean of 2.3 times. The mean final IOL rotation (following repositioning if required) was 6.17°.

Conclusion

Sulcoflex Toric supplementary IOLs result in good visual and refractive outcomes in eyes with no prior corneal graft. However, outcomes are sub-optimal in eyes with prior corneal transplantation, and the majority of lenses require repositioning.

Keywords

Astigmatism Toric Supplementary Intraocular lens 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Ethical standard

All procedures performed were in accordance with the ethical standards of the involved institutions and with the 1964 Declaration of Helsinki and its later amendments. Ethics approval was obtained from the Metro South Human Research Ethics Committee (Brisbane, Australia). Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Lehmann RP, Houtman DM (2012) Visual performance in cataract patients with low levels of postoperative astigmatism: full correction versus spherical equivalent correction. Clin Ophthalmol 6:333–338.  https://doi.org/10.2147/OPTH.S28241 Google Scholar
  2. 2.
    Wilkins MR, Allan B, Rubin G, Moorfields IOLSG (2009) Spectacle use after routine cataract surgery. Br J Ophthalmol 93(10):1307–1312.  https://doi.org/10.1136/bjo.2008.151829 CrossRefGoogle Scholar
  3. 3.
    Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J (2016) Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis. Ophthalmology 123(2):275–286.  https://doi.org/10.1016/j.ophtha.2015.10.002 CrossRefGoogle Scholar
  4. 4.
    Brick DC (1999) Risk management lessons from a review of 168 cataract surgery claims. Surv Ophthalmol 43(4):356–360CrossRefGoogle Scholar
  5. 5.
    Jin GJ, Merkley KH, Crandall AS, Jones YJ (2008) Laser in situ keratomileusis versus lens-based surgery for correcting residual refractive error after cataract surgery. J Cataract Refract Surg 34(4):562–569.  https://doi.org/10.1016/j.jcrs.2007.11.040 CrossRefGoogle Scholar
  6. 6.
    Kojima T, Horai R, Hara S, Nakamura H, Nakamura T, Satoh Y, Ichikawa K (2010) Correction of residual refractive error in pseudophakic eyes with the use of a secondary piggyback toric Implantable Collamer Lens. J Refract Surg 26(10):766–769.  https://doi.org/10.3928/1081597X-20100512-02 CrossRefGoogle Scholar
  7. 7.
    Kim P, Briganti EM, Sutton GL, Lawless MA, Rogers CM, Hodge C (2005) Laser in situ keratomileusis for refractive error after cataract surgery. J Cataract Refract Surg 31(5):979–986.  https://doi.org/10.1016/j.jcrs.2004.08.054 CrossRefGoogle Scholar
  8. 8.
    Kuo IC, O’Brien TP, Broman AT, Ghajarnia M, Jabbur NS (2005) Excimer laser surgery for correction of ametropia after cataract surgery. J Cataract Refract Surg 31(11):2104–2110.  https://doi.org/10.1016/j.jcrs.2005.08.023 CrossRefGoogle Scholar
  9. 9.
    Hirnschall N, Gangwani V, Crnej A, Koshy J, Maurino V, Findl O (2014) Correction of moderate corneal astigmatism during cataract surgery: toric intraocular lens versus peripheral corneal relaxing incisions. J Cataract Refract Surg 40(3):354–361.  https://doi.org/10.1016/j.jcrs.2013.08.049 CrossRefGoogle Scholar
  10. 10.
    Gills JP, Van der Karr MA (2002) Correcting high astigmatism with piggyback toric intraocular lens implantation. J Cataract Refract Surg 28(3):547–549CrossRefGoogle Scholar
  11. 11.
    Falzon K, Stewart OG (2012) Correction of undesirable pseudophakic refractive error with the Sulcoflex intraocular lens. J Refract Surg 28(9):614–619.  https://doi.org/10.3928/1081597X-20120809-01 CrossRefGoogle Scholar
  12. 12.
    Felipe A, Artigas JM, Diez-Ajenjo A, Garcia-Domene C, Alcocer P (2011) Residual astigmatism produced by toric intraocular lens rotation. J Cataract Refract Surg 37(10):1895–1901.  https://doi.org/10.1016/j.jcrs.2011.04.036 CrossRefGoogle Scholar
  13. 13.
    Garzon N, Poyales F, de Zarate BO, Ruiz-Garcia JL, Quiroga JA (2015) Evaluation of rotation and visual outcomes after implantation of monofocal and multifocal toric intraocular lenses. J Refract Surg 31(2):90–97.  https://doi.org/10.3928/1081597X-20150122-03 CrossRefGoogle Scholar
  14. 14.
    Iwase T, Tanaka N (2005) Elevated intraocular pressure in secondary piggyback intraocular lens implantation. J Cataract Refract Surg 31(9):1821–1823.  https://doi.org/10.1016/j.jcrs.2005.06.034 CrossRefGoogle Scholar
  15. 15.
    Chang DF, Masket S, Miller KM, Braga-Mele R, Little BC, Mamalis N, Oetting TA, Packer M, Committee ACC (2009) Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture. J Cataract Refract Surg 35(8):1445–1458.  https://doi.org/10.1016/j.jcrs.2009.04.027 CrossRefGoogle Scholar
  16. 16.
    Gayton JL, Apple DJ, Peng Q, Visessook N, Sanders V, Werner L, Pandey SK, Escobar-Gomez M, Hoddinott DS, Van Der Karr M (2000) Interlenticular opacification: clinicopathological correlation of a complication of posterior chamber piggyback intraocular lenses. J Cataract Refract Surg 26(3):330–336CrossRefGoogle Scholar
  17. 17.
    Ferreira TB, Pinheiro J (2015) Clinical results with a supplementary toric intraocular lens for the correction of astigmatism in pseudophakic patients. Eur J Ophthalmol 25(4):302–308.  https://doi.org/10.5301/ejo.5000564 CrossRefGoogle Scholar
  18. 18.
    Khan MI, Muhtaseb M (2011) Performance of the Sulcoflex piggyback intraocular lens in pseudophakic patients. J Refract Surg 27(9):693–696.  https://doi.org/10.3928/1081597X-20110512-01 CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.The Eye Health CentreBrisbaneAustralia
  2. 2.Princess Alexandra HospitalBrisbaneAustralia
  3. 3.Queen Victoria HospitalEast GrinsteadUK

Personalised recommendations