Effectiveness of Toric Monofocal Intraocular Lenses in Cataract Surgery

A recent comprehensive analysis specifically evaluated the effectiveness of toric monofocal intraocular lenses (IOLs) in correcting keratometric astigmatism during cataract surgery. The findings of the study were published in the Journal of Ophthalmology and yielded in-depth insights into visual and refractive outcomes after considering only toric IOLs available in the United States.

This study conducted a meticulous literature survey using the PubMed database up to July 2022 and scrutinized 906 potentially relevant citations. After a rigorous review, 63 citations were selected for full-text analysis, of which 21 studies ultimately met the stringent inclusion criteria. Also, the methodologist assigned each study a level of evidence rating with 12 studies achieving a level I rating and 9 studies rated at level II.

The eyes with toric IOLs displayed remarkable postoperative uncorrected distance visual acuity (UCDVA) when coupled with a commendable reduction in refractive astigmatism and robust rotational stability. Toric IOLs outshone their nontoric monofocal counterparts regardless of the manufacturer by exhibiting superior UCDVA and lower postoperative cylinder values. The study underscored that correcting pre-existing astigmatism with toric IOLs proved more effective and predictable than utilizing corneal relaxing incisions (CRIs), especially in cases of higher astigmatism magnitudes.

The findings suggest toric monofocal IOLs as a powerful solution for neutralizing corneal astigmatism during cataract surgery with enhanced UCDVA and also a significant reduction in postoperative refractive astigmatism compared to non-toric monofocal IOLs. The superiority of toric IOLs over CRIs is especially observed at higher magnitudes of astigmatism, cementing their status as a preferred choice in astigmatic correction during cataract surgery.

Reference

Al-Mohtaseb, Z., Steigleman, W. A., Pantanelli, S. M., Lin, C. C., Hatch, K. M., Rose-Nussbaumer, J. R., Santhiago, M., Olsen, T. W., Kim, S. J., & Schallhorn, J. M. (2023). Toric Monofocal Intraocular Lenses for the Correction of Astigmatism during Cataract Surgery. In Ophthalmology. Elsevier BV. https://doi.org/10.1016/j.ophtha.2023.10.010