Toric Lens Visual Outcomes Superior in Combined Cataracts, Corneal Astigmatism

Toric lens visual outcomes after cataract surgery are better than non-toric lens outcomes for patients 80 years and older who have corneal astigmatism, according to research published in Ophthalmology and Therapy. Although toric intraocular lenses (IOLs) are associated with higher patient costs, the visual acuity (VA) improvements they offer could translate into “improved quality of life and postural stability and a reduction in fall-related fractures,” researchers explain. 

The researchers conducted a retrospective study of 159 eyes of 159 patients, comparing toric lens visual outcomes following cataract surgery (n=53, Acrysof IQ^® Toric) and 2 types of non-toric IOL outcomes (n=51, Acrysof IQ^®; n=55, A1-UV) in patients 80 years of age or older with corneal astigmatism (≥0.75 diopters [D]) treated at a single center. Visual outcomes included 3-month postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction (spherical equivalent, refractive cylinder). 

Mean uncorrected toric lens visual outcomes (0.15 logMAR) were better than in the non-toric IOL groups (0.29 logMAR for both IOLs; P <.001). The researchers also found the mean residual refractive cylinder was lower in the toric IOL group (0.58 D) than the non-toric group (1.10 D for the IQ^® IOLs and 1.35 D for the A1-UV IOLs; P <.001). 

“The present study found a significant improvement in postoperative refractive astigmatism and UDVA after toric IOL implantation compared with non-toric IOL implantation in patients older than 80 years with corneal astigmatism,” according to the study authors. “This, in turn, increases the chances of postoperative spectacle independence and decreases the possibility of complications caused by additional correcting astigmatism surgery. Therefore, age should not be a limiting factor in the quest for better visual quality.”

Limitations of the study included the retrospective, single-center design, relatively small sample size of patients older than 80 years, and short follow-up duration. Additionally, the use of VA as the only objective measure of vision limited the study.