Comparison of Visual Outcomes With Toric IOL and With Limbal Relaxing 　Incisions in Cataract Surgery

Eriko Fukuyama, MD

Fukuyama Eye ClinicFukuoka, Japan

The author has no financial interest in the subject matter of this e-poster.

Purpose

• To compare visual outcomes between a toric intraocular lens (IOL) and limbal relaxing incisions (LRIs) to correct preexisting astigmatism in patients having cataract surgery.

Methods

• This prospective study compared the results of bilateral cataract surgery with implantation of a AcrySof IQ Toric IOL in one eye (group A) and with implantation of a AcrySof IQ IOL with LRIs in a fellow eye (group B). Outcome measures were refraction and corneal astigmatism measured using keratometory and topography, uncorrected (UDVA) and corrected (CDVA) distance visual acuities.

手術方法２• LRIsの方法

–切開の深さ：年齢や角膜中心厚に応じて450μｍもしくは 500μｍ

–切開の長さ：福山 LRIノモグラムにより決定

乱視矯正目標 (D)

切開長

0.75 30°

1.00 45°

1.50 60°

2.00 75°

3.00 90°

4.00 120°

乱視矯正目標 (D)

切開長

0.75 60°

1.00 70°

1.50 80°

2.00 90°

3.00 120°

4.00120°、切開の深さ＋ 50μ

ｍ

[倒乱視 ] [直乱視 ]

Results(抄録提出時 )

• The study comprised 16 patients (32 eyes). They had astigmatism more over 1.00 dioptor in their both eyes. The mean corneal astigmatism measured by keratometer before the surgery was 1.76 dioptors in group A and 1.87 dioptors in group B. After the treatment, the mean corneal astigmatism was 1.86 dioptors in group A and 0.42 dioptors in group B, and the mean refraction astigmatism was 0.63 dioptors in group A and 0.38 dioptors in group B at three months after the surgery.

• The UDVA and CDVA were similar in both groups. The corneal shape measured by topography was stabilized earlier in group A than in group B.

Results(改変用 )

• The study comprised 20 patients (40 eyes). They had astigmatism more over 1.00 dioptor in their both eyes. The mean corneal astigmatism measured by keratometer before the surgery was 1.89 dioptors in group A and 1.73 dioptors in group B. After the treatment, the mean corneal astigmatism was 1.89 dioptors in group A and 0.81 dioptors in group B, and the mean refraction astigmatism was 0.73 dioptors in group A and 0.51 dioptors in group B at six months after the surgery.

• The UDVA and CDVA were similar in both groups. The corneal shape measured by topography was stabilized earlier in group A than in group B.

角膜乱視の経時変化　（ケラトメーター）

D

両群共n＝２０Pre １ M ３ M ６ M

0

0.5

1

1.5

2

2.5T-IOL

LRI

D

**

**：両群間に有意差有ウィルコクソンの順位和検定P<0.02

s

術前は両群間に有意差無ウィルコクソンの順位和検定

術後

TMS™による術前－術後の乱視変化

角膜形状解析装置ＴＭＳ™では２つのマップ間の角膜形状解析値の引き算ができるこれを用いると術前から術後へと変化した乱視度数を求めることができる

術前と術後６Mの乱視の比較

角膜乱視（術前） 角膜乱視（術前）

T-IOL LRIｓ

（ D)

自覚屈折乱視

（

術後６　　

）

M

自覚屈折乱視

（

術後６　　

）M

（ D)

0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0 （ D)

（ D)

(n=20) (n=20)

LRIsと T- IOL　　 　 LRI ｓ 　 　 T- IOL

裸眼視力の向上 　　　　　　　○ 　　　　　　　○

角膜乱視の矯正 　　　　　　　○ 　　　　　　　△

非対称性乱視の矯正 　　　　　　　○ 　　　　　　　△

２ D 以上の乱視矯正 　　　　　　　○ 　　　　　　　△

術後角膜形状の早期安定 　　　　　　　△ 　　　　　　　○

合併症 　　　　　　　△ 　　　　　　　○

Conclusion

• Both a toric IOL and LRIs are useful to correct preexisting astigmatism in patients having cataract surgery. A toric IOL excels LRIs in the early stabilization of the corneal shape.

KEYWORDS

• toric intraocular lens• limbal relaxing incisions• astigmatism management