Introduction of a Toric Intraocular Lens to a Non-Refractive Cataract Practice: Challenges and Outcomes

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Surgical Innovation

Background:

• Cataract surgery aims to restore vision, but pre-existing astigmatism can complicate outcomes.
• Toric intraocular lenses (IOLs) are designed to correct astigmatism during cataract surgery.
• Transitioning to toric IOLs in non-refractive practices presents unique challenges.

Purpose of the Study:

• To identify challenges in adopting toric IOLs in a non-refractive cataract practice.
• To evaluate the effectiveness of toric IOLs in reducing residual astigmatism.
• To assess the impact of toric IOLs on patient satisfaction and visual functioning.

Main Methods:

• A single, non-refractive surgeon performed all cataract surgeries with toric IOLs.
• Pre-operative, intra-operative, and post-operative data were analyzed.
• Patient-reported outcomes, including visual functioning and satisfaction, were assessed using validated questionnaires.

Main Results:

• Median difference vector (DV) was 0.93D, significantly lower than the 2.38D anticipated with non-toric IOLs.
• One eye had 0.75D residual astigmatism, compared to an anticipated 3.8D with non-toric IOLs.
• 100% of patients reported satisfaction of ≥ 6/10, with 37.84% entirely satisfied; dysphotopsia symptoms were minimal.

Conclusions:

• Toric IOLs effectively manage astigmatism during cataract surgery, yielding less post-operative astigmatism than non-toric IOLs.
• This approach helps avoid unacceptable levels of post-operative astigmatism.
• Successful implementation in a non-refractive setting is achievable, enhancing patient outcomes.