Efficacy of astigmatic correction after femtosecond laser-guided cataract surgery using intraoperative aberrometry in eyes with low-to-moderate levels of corneal astigmatism

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To evaluate the efficacy of astigmatic correction with two types of toric intraocular lenses (IOLs) after femtosecond laser-assisted cataract surgery (FLACS) in eyes with low-to-moderate corneal astigmatism using intraoperative aberrometry for optimizing the position of the toric IOL.


Retrospective study includes a total of 99 eyes of 73 patients with anterior keratomeric astigmatism ≤ 3 D and undergoing FLACS (Catalys, Johnson & Johnson Vision) with implantation of a monofocal (Ankoris, PhysIOL) or a multifocal toric IOL with the same platform (Pod FT, PhysIOL). In all cases, intraoperative aberrometry was used (Optiwave refractive analysis, ORA, system, Alcon). Visual and refractive outcomes were evaluated preoperatively and at 4 months after surgery with vector analysis of astigmatic changes.


A total of 89.9%, 93.9% and 97.0% showed a postoperative sphere, cylinder and spherical equivalent within ± 0.50 D, respectively. Mean difference vector (DV) was 0.22 ± 0.27 D, mean magnitude of error (ME) was 0.13 ± 0.29 D, and mean angle of error (AE) was 1.52 ± 11.64°. Poor correlations of preoperative corneal astigmatism with DV (r = − 0.032, p = 0.833), ME (r = − 0.344, p = 0.001) and AE (r = − 0.094, p = 0.377) were found. Likewise, no statistically significant differences were found between monofocal and multifocal toric IOL subgroups in DV (p = 0.580), ME (p = 0.702) and AE (p = 0.499).


The combination of FLACS and intraoperative aberrometry to optimize the position of a toric IOL allows a very efficacious correction of preexisting low-to-moderate corneal astigmatism.

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The author David P Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471.

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Correspondence to David P. Piñero.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Orts, P., Piñero, D.P., Aguilar, S. et al. Efficacy of astigmatic correction after femtosecond laser-guided cataract surgery using intraoperative aberrometry in eyes with low-to-moderate levels of corneal astigmatism. Int Ophthalmol (2020).

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  • Intraoperative aberrometry
  • Toric IOLs
  • Corneal astigmatism
  • Femtosecond laser-assisted cataract surgery
  • Vector analysis