Contents

Surgical correction of astigmatism

Edited by:

Last updated: May 17th, 2022

Menu

Summary of Evidence

Evidence

1. Toric intraocular lens

1.1. General

Review

2021 Kane and Chang

Article link | Metrics cited by count

2021
Review

Review of intraocular lens power formulas, biometry and intraoperative aberrometry.{Kane JX, Chang DF. Intraocular Lens Power Formulas, Biometry, and Intraoperative Aberrometry: A Review. Ophthalmology. 2021 Nov;128(11):e94-e114.}

Kane and Chang
Pubmed Journal full text Metrics

cited by count
Review

2021 Keshav and Henderson

Article link | Metrics cited by count

2021
Review

Review of astigmatism management with intraocular lens surgery. Evaluation of these articles also showed improved uncorrected visual acuity with the use of toric IOLs in patients undergoing cataract surgery.{Keshav V, Henderson BA. Astigmatism Management with Intraocular Lens Surgery. Ophthalmology. 2021 Nov;128(11):e153-e163.}

Keshav and Henderson
Pubmed Journal full text Metrics

cited by count

1.2. Alignment of lens

Review

2016 Thulasi et.al.

Article link | Metrics cited by count

2016
Review

Review of intraocular lens alignment methods. {Thulasi P, Khandelwal SS, Randleman JB. Intraocular lens alignment methods. Curr Opin Ophthalmol. 2016 Jan;27(1):65-75. }

Thulasi et.al.
Pubmed Journal full text Metrics

cited by count

1.2.1. Image-guided system versus manual marking

Meta-analysis

2019 Zhou et.al.

Article link | Metrics cited by count

2019
Meta-analysis

Image-guided marking is better than manual marking, resulting in less axis misalignment, a smaller difference vector, and less postoperative astigmatism.{Zhou F, Jiang W, Lin Z, Li X, Li J, Lin H, Chen W, Wang Q. Comparative meta-analysis of toric intraocular lens alignment accuracy in cataract patients: Image-guided system versus manual marking. J Cataract Refract Surg. 2019 Sep;45(9):1340-1345.}

Five studies comprising a total of 257 eyes were analyzed.

Zhou et.al.
Pubmed Journal full text Metrics

cited by count

1.3. Comparison of techniques

1.3.1. Toric vs Aspherical intraocular lens

Systematic review

2016 Kessel et.al.

Article link | Metrics cited by count

2016
Systematic review

Toric IOLs provided better UCDVA, greater spectacle independence, and lower amounts of residual astigmatism than non-toric IOLs even when relaxing incisions were used.{Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J. Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery: A Systematic Review and Meta-analysis. Ophthalmology. 2016 Feb;123(2):275-286.}

Kessel et.al.
Pubmed Journal full text Metrics

cited by count

1.3.2. Toric intraocular lens vs limbal relaxing incisions

Systematic review

2019 Lake et.al.

Article link | Metrics cited by count

2019
Systematic review

Toric IOLs probably provide a higher chance of achieving astigmatism within 0.5 D after cataract surgery compared with LRIs. There may be a small mean difference in postoperative astigmatism, favouring toric IOLs, but this difference is likely to be clinically unimportant. There was no evidence of an important difference in postoperative visual acuity or quality of life between the techniques.{Lake JC, Victor G, Clare G, Porfírio GJ, Kernohan A, Evans JR. Toric intraocular lens versus limbal relaxing incisions for corneal astigmatism after phacoemulsification. Cochrane Database Syst Rev. 2019 Dec 17;12(12):CD012801.}

Analysis of 10 relevant studies including 517 people (626 eyes)

Lake et.al.
Pubmed Journal full text Metrics

cited by count
Clinical trial

2014 Titiyal et.al.

Article link | Metrics cited by count

2014
Clinical trial

Toric IOL implantation was comparable to astigmatic keratotomy (AK) in eyes with moderate astigmatism having phacoemulsification.{Titiyal JS, Khatik M, Sharma N, Sehra SV, Maharana PK, Ghatak U, Agarwal T, Khokhar S, Chawla B. Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification. J Cataract Refract Surg. 2014 May;40(5):741-7.}

Titiyal et.al.
Pubmed Journal full text Metrics

cited by count
Clinical trial

2009 Mendicute et.al.

Article link | Metrics cited by count

2009
Clinical trial

Toric IOL implantation achieved a slight enhanced effect over paired opposite clear corneal incisions (OCCIs) in treating preexisting astigmatism.{Mendicute J, Irigoyen C, Ruiz M, Illarramendi I, Ferrer-Blasco T, Montés-Micó R. Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery. J Cataract Refract Surg. 2009 Mar;35(3):451-8.}

Mendicute et.al.
Pubmed Journal full text Metrics

cited by count

1.3.3. Toric intraocular lens vs monofocal lens + PRK

Clinical trial

2015 Nagpal et.al.

Article link | Metrics cited by count

2015
Clinical trial

PRK yields lesser residual cylinder compared to toric IOL. However, it causes greater postoperative pain and corneal aberrations, and poor glare acuity.{Nagpal R, Sharma N, Vasavada V, Maharana PK, Titiyal JS, Sinha R, Upadhyay AD, Vajpayee RB. Toric intraocular lens versus monofocal intraocular lens implantation and photorefractive keratectomy: a randomized controlled trial. Am J Ophthalmol. 2015 Sep;160(3):479-486.e2. }

Nagpal et.al.
Pubmed Journal full text Metrics

cited by count

References

Comments

Subscribe
Notify of
guest
0 Comments
Inline Feedbacks
View all comments

© 2025 - sourceshed