Refractive Outcomes in Keratoconus Patients Following Toric Lens Implantation: A Systematic Review and Single-Group...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Diseases

Background:

• Keratoconus is a progressive corneal ectasia causing irregular astigmatism and blurred vision.
• Toric intraocular lenses (tIOLs) aim to correct pre-existing astigmatism during cataract surgery.
• The efficacy of tIOLs in keratoconus patients with stable disease requires further evaluation.

Purpose of the Study:

• To systematically review and meta-analyze refractive outcomes after tIOL implantation in keratoconus.
• To assess the impact of tIOLs on astigmatic correction and visual acuity.
• To evaluate the safety and complication profile of tIOLs in this patient population.

Main Methods:

• Systematic literature search for studies reporting refractive data pre- and post-tIOL implantation in keratoconus.
• Inclusion of 8 studies with 135 eyes.
• Meta-analysis using random-effects model; quality assessment via MINORS and JBI checklists.

Main Results:

• Significant reduction in postoperative refractive cylinder (2.28 D) and spherical equivalent (4.17 D).
• Substantial improvements in uncorrected (0.87 logMAR) and corrected distance visual acuity (0.19 logMAR).
• Minimal tIOL rotation (<10 degrees) and infrequent, minor complications observed.

Conclusions:

• tIOL implantation is effective for managing astigmatism and enhancing vision in stable keratoconus.
• Standardized reporting is crucial due to methodological heterogeneity and vector analysis limitations.
• Further research with consistent methodology is recommended to optimize outcomes.