Transitional conic toric intraocular lens for the management of corneal astigmatism in cataract surgery

Francisco Bandeira,1 Merce Morral,2 Daniel Elies,2,3 Sergio Eguiza,2 Spyridoula Souki,2 Felicidad Manero,2 Jose L Güell2–4 1Cornea and External Disease Department, Federal University of São Paulo, São Paulo, Brazil; 2Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain; 3European School for Advanced Studies in Ophthalmology (ESASO), Lugano, Switzerland; 4Ophthalmology, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain Synopsis: Transitional toric intraocular lens (IOL) was developed to improve refractive outcomes in cataract surgery. We report refractive, vectorial outcomes, and stability of spherical equivalent over 12 months after implantation of this IOL.Purpose: To evaluate visual and refractive outcomes of a transitional conic toric intraocular lens (IOL) (Precizon®) for the correction of corneal astigmatism in patients undergoing cataract surgery.Setting: The Ocular Microsurgery Institute (IMO), a private practice in Barcelona, Spain.Design: This is a retrospective, non-randomized study.Methods: Retrospective chart review of 156 patients with preoperative regular corneal astigmatism >0.75 diopters (D) who underwent consecutive phacoemulsification and Precizon toric IOL implantation between January 2014 and December 2015 was performed. Two groups were divided according to attempted residual refraction: group 1 with emmetropia and group 2 with mild myopia for monovision. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refraction were analyzed preoperatively and 3, 6, and 12 months postoperatively.Results: Precizon toric IOL was implanted in 97 eyes of 61 patients. Six months postoperatively, none of the eyes lost any line of CDVA. In all, 98% of the eyes were within ±1.00 D of attempted spherical correction. The mean preoperative keratometric cylinder was 1.92 ± 1.04 D (range 0.75–6.78), and the mean postoperative refractive cylinder was 0.77 ± 0.50 D (range 0–2.25), with 81% of the eyes with ≤1.00 D of residual cylinder. Two IOLs required realignment due to intraoperative positioning error. Eleven eyes required enhancement with corneal refractive surgery.Conclusion: Preexisting regular corneal astigmatism was effectively and safely corrected by the implantation of the transitional conic toric IOL in patients undergoing cataract surgery. Keywords: corneal astigmatism, refractive astigmatism, keratometry, cataract surgery, toric intraocular lens, biometry, phacoemulsification