Coaxial MICS with toric IOL improves visual acuity, reduces astigmatism

J Cataract Refract Surg. 2011;37(8):1411-1418.

Coaxial microincision cataract surgery with toric IOL implantation was safe, effective and predictable in eyes with high corneal astigmatism, a study found.

“Although the technique is not difficult, it requires thorough planning and precise execution,” the study authors said. “In corneal astigmatism of 3 D or more, efficacy is better than in mild to moderate cases. Uncorrected distance visual acuity is one of the most important parameters of success for patients and can be significantly improved by using toric IOLs.”

The prospective multicenter study included 40 eyes of 30 patients with corneal astigmatism ranging from 2.75 D to 6 D. Median patient age was 70.2 years.

Mean preoperative logMAR uncorrected distance visual acuity was 0.93, and mean corrected distance visual acuity was 0.41. Mean preoperative refractive cylinder was –3.49 D.

Patients underwent coaxial microincision phacoemulsification through a 2.2-mm posterior limbal incision. AcrySof toric IOLs (Alcon) were inserted with a Monarch injector. Postoperative evaluations were performed at 1 week and 3 months.

Three-month study results showed that mean postoperative uncorrected distance visual acuity was 0.20 and mean corrected distance visual acuity was 0.09. Snellen equivalent uncorrected distance visual acuity was 20/40 or better in 88.9% of eyes; corrected distance visual acuity was 20/25 or better in 72.5% of eyes.

The mean difference between attempted and achieved spherical equivalent refraction was -0.02 D at 1 week and -0.14 D at 3 months.

Mean postoperative refractive cylinder was –0.67 D.

IOL rotation between 1 week and 3 months was insignificant, the authors reported.