Toric intraocular lens (IOL) implantation significantly decreased refractive astigmatism postoperatively compared with preoperative corneal astigmatism in patients with previous radial keratotomy, according to research published in the Journal of Cataract & Refractive Surgery.

Researchers conducted a retrospective case series of consecutive patients with previous radial keratotomy to evaluate refractive outcomes following cataract surgery with toric IOL implantation.

A total of 40 eyes of 31 patients (mean age, 68.65 years; range, 59–78) with previous radial keratotomy were included in the study. Preoperatively, the patients had a mean magnitude of corneal regular astigmatism of 2.10±0.98 D. Anterior corneal regular astigmatism of 0.5 D or less and 1.0 D or less was reported in 3% and 10% of eyes, respectively. Among all eyes, the mean centroid value was 1.14 D (at 179 degrees)±2.05 D. 

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Postoperatively, the patients had a mean magnitude of refractive regular astigmatism of 0.46±0.44 D (P <.01). Refractive regular astigmatism of 0.5 D or less and 1.0 D or less was reported in 73% and 88% of eyes (both P <.05 with Bonferroni adjustment). The mean centroid value was 0.12 D (at 173 degrees)±0.63 D (P <.01).

“Toric IOLs can be used successfully to treat corneal regular astigmatism in eyes with previous [radial keratotomy],” according to the researchers.

Limitations of the study included lack of investigation of the astigmatism prediction errors using the Baylor nomogram or other toric IOL calculators or the accuracy of preoperative corneal astigmatism values obtained using different devices, a relatively small sample size (with some patients enrolled in the study for both eyes), and the possibility of fluctuation in visual acuity that may extend for up to 6 months in the eyes of patients with previous radial keratotomy.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  


Canedo ALC, Wang L, Koch DD, Al-Mohtaseb Z. Accuracy of astigmatism correction with toric intraocular lens implantation in eyes with previous radial keratotomy. J Cataract Refract Surg. 2022;48(4):417-420. doi:10.1097/j.jcrs.0000000000000779