The Effect of Lens Sphere and Cylinder Power on Residual Astigmatism and Its Resolution After Toric Intraocular Lens Implantation. 2017

John P Berdahl, and David R Hardten, and Brent A Kramer, and Richard Potvin

OBJECTIVE To analyze correlations between residual refractive cylinder (and its correction through lens reorientation) with the sphere and cylinder power of the toric intraocular lens (IOL) implanted. METHODS An online toric back-calculator (www.astigmatismfix.com) allows users to input toric IOL planning data, along with postoperative IOL orientation and refractive results; these data are used to determine the optimal orientation of the IOL to reduce refractive astigmatism. This was a retrospective data analysis; aggregate historical data were extracted from this calculator to investigate the relationship between residual refractive astigmatism and IOL cylinder and sphere power. RESULTS A total of 12,812 records, 4,619 of which included IOL sphere power, were available for analysis. There was no significant effect of sphere power on residual refractive astigmatism (P = .25), but lower IOL cylinder powers were associated with significantly lower residual refractive astigmatism (P < .05). The difference between the intended and ideal orientation was higher in the lower IOL cylinder power groups (P < .01). Overcorrection of astigmatism was significantly more likely with higher IOL cylinder power (P < .01), but not with sphere power (P = .33). Reorientation to correct residual refractive cylinder to less than 0.50 diopters (D) was more successful with IOL cylinder powers of 1.50 D or less (P < .01); IOL sphere power had no apparent effect. CONCLUSIONS There were significant effects of IOL cylinder power on residual refractive astigmatism, the difference between intended and ideal orientation, the likelihood of overcorrection, and the likelihood of astigmatism reduction with lens reorientation. IOL sphere power appeared to have no such effects. [J Refract Surg. 2017;33(3):157-162.].

UI MeSH Term Description Entries
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D011474 Prosthesis Design The plan and delineation of prostheses in general or a specific prosthesis. Design, Prosthesis,Designs, Prosthesis,Prosthesis Designs
D012029 Refraction, Ocular Refraction of LIGHT effected by the media of the EYE. Ocular Refraction,Ocular Refractions,Refractions, Ocular
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001251 Astigmatism Unequal or irregular curvature of the CORNEA (Corneal astigmatism) and/or the EYE LENS (Lenticular astigmatism) resulting in REFRACTIVE ERROR. Corneal Astigmatism,Hyperopic Astigmatism,Lenticular Astigmatism,Mixed Astigmatism,Myopic Astigmatism,Oblique Astigmatism,Astigmatism, Corneal,Astigmatism, Hyperopic,Astigmatism, Lenticular,Astigmatism, Mixed,Astigmatism, Myopic,Astigmatism, Oblique,Hyperopic Astigmatisms,Mixed Astigmatisms,Myopic Astigmatisms,Oblique Astigmatisms
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D055095 Optics and Photonics A specialized field of physics and engineering involved in studying the behavior and properties of light and the technology of analyzing, generating, transmitting, and manipulating ELECTROMAGNETIC RADIATION in the visible, infrared, and ultraviolet range. Photonics,Photonics and Optics
D019654 Lens Implantation, Intraocular Insertion of an artificial lens to replace the natural CRYSTALLINE LENS after CATARACT EXTRACTION or to supplement the natural lens which is left in place. Implantation, Intraocular Lens,Implantations, Intraocular Lens,Intraocular Lens Implantation,Intraocular Lens Implantations,Lens Implantations, Intraocular

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