Astigmatism management in cataract surgery with Precizon^® toric intraocular lens: a prospective study

Figures & data

Figure 1 Postoperative digital analysis of Precizon^® toric IOL rotation.

Abbreviation: IOL, intraocular lens.

Table 1 Preoperative data (27 patients, 40 eyes)

Variable	Mean ± SD, median (IQR), absolute number (%)a	Range
Age (years)	63.4±11.1	48, 83
Sex
Female	16 (59.3)
Male	11 (40.7)
Eye
Left	10 (25)
Right	4 (10)
Both	26 (65)
Refractive astigmatism (D)	2.38±0.97	1.0, 5.0
Spherical equivalent	−3.35±3.10	−11.5, 1.88
UDVA (logMAR)	1 (0.79)	0.30, 1.40
BCDVA (logMAR)	0.19 (0.20)	0.0, 0.70
Corneal astigmatism (D)	2.34±0.95	1.12, 4.81
Sphere IOL power (D)	17.6±3.79	10.75, 27.5
Cylinder IOL power (D)	3.28±1.33	1.50, 6.0
Predicted residual astigmatism (D)	0.13±0.16	0.0, 0.81
Endothelial cell count (ECC)	2,458±381	1,724, 3,200

Notes:

a Mean ± SD or median (interquartile range) for Gaussian or not Gaussian variables, respectively.

Abbreviations: BCDVA, best-spectacle corrected distance visual acuity; D, diopter; IOL, intraocular lens; UDVA, uncorrected distance visual acuity; SD, standard deviation; IQR, interquartile range.

Table 2 Postoperative data

Variable	Preop		1 week		1 month		3 months		6 months
	Mean ± SD, median (IQR)a	P-value	Mean ± SD, median (IQR)a	P-value	Mean ± SD, median (IQR)	P-value	Mean ± SD, median (IQR)a	P-value	Mean ± SD, median (IQR)a
Endothelial cell count (cells/mm^2)	2,458±381	<0.05*							2,423±389
Cylinder (D)	2.34±0.95	<0.001*	0.43±0.38	ns*	0.36±0.36	ns*	0.27±0.28	ns*	0.24±0.27
Spherical equivalent (D)	−3.35±3.10	<0.001*	−0.16±0.33	ns*	−0.091±0.29	ns*	−0.025±0.30	ns*	−0.022±0.30
UDVA (logMAR)	1 (0.79)	<0.0125**	0.046 (0.11)	<0.0125**	0.046 (0.078)	<0.0125**	0.020 (0.056)	ns**	0.021 (0.056)
BCDVA (logMAR)	0.19 (0.20)	<0.0125**	0.0 (0.04)	<0.0125**	0.0 (0)	ns**	0.0 (0)	ns**	0.0 (0)

Notes:

a Mean ± SD or median (interquartile range) for Gaussian or not Gaussian variables, respectively.

* P-value significance level (0.05). Comparison between each two consecutive moments.

** Adjusted P-value significance level (0.0125). Bonferroni’s correction for multiple comparisons. Comparisons between each two consecutive moments.

Abbreviations: BCDVA, best-spectacle corrected distance visual acuity; D, diopter; ns, non significant; UDVA, uncorrected distance visual acuity; SD, standard deviation; Preop, preoperative.

Figure 2 Cumulative postoperative distance visual acuities (UDVA – uncorrected; BCDVA – best-spectacle corrected) at 6 months evaluation (6 m) (n=40 eyes).

Figure 3 Astigmatism shift during the follow-up in all 40 eyes implanted with Precizon^® toric IOL during cataract surgery.

Abbreviations: IOL, intraocular lens; Preop, preoperative; w, week; m, month.

Figure 4 Single-angle polar plots for the target-induced astigmatism (TIA) vector at 6 months follow-up.

Abbreviations: Arith mean, arithmetic mean; Ax, Axis.

Figure 5 Single-angle polar plots for the surgically-induced astigmatism (SIA) vector at 6 months follow-up.

Abbreviations: Arith mean, arithmetic mean; Ax, Axis.

Table 3 Astigmatism analysis by Alpins method (40 eyes)

Parameter
Target-induced astigmatism
Arithmetic mean magnitude (D) ± SD	2.34±0.95
Vector mean (D @ degrees)	0.17 @ 89.9
Surgically induced astigmatism
Arithmetic mean magnitude (D) ± SD	2.24±0.84
Vector mean (D @ degrees)	0.16 @ 83.6
Difference vector
Arithmetic mean magnitude (D) ± SD	0.24±0.27
Vector mean (D @ degrees)	0.06 @ 40
Mean magnitude of error (D) ± SD	−0.10±0.28
Mean arithmetic angle of error (degrees) ± SD	−0.70±3.61
Mean absolute angle of error (degrees) ± SD	1.90±0.69
Mean flattening index ± SD	0.99±0.27
Mean correction index ± SD	0.95±0.19
Mean index of success ± SD	0.12±0.14

Abbreviations: D, diopter; SD, standard deviation.

Figure 6 Absolute IOL rotation between observation periods in all 40 eyes implanted with Precizon^® toric IOL during cataract surgery.

Abbreviations: IOL, intraocular lens; w, week; m, month.

Table 4 Postoperative intraocular lens rotation

Variable	Intended axis–1 week		1 week–1 montha		1 month–3 monthsa		3 months–6 monthsa	Intended axis–6 months
	Median (IQR)b	P-valuec	Median (IQR)b	P-valuec	Median (IQR)b	P-valuec	Median (IQR)b	P-value
Rotation	1 (1)	<0.0125	0.0 (1)	ns	0.0 (1)	<0.0125	0 (0)	<0.001

Notes:

a lOL absolute rotation (degrees) between each two consecutive moments.

b Median (IQR).

c Adjusted P-value significance level (0.0125). Bonferroni’s correction for multiple comparisons. Comparisons between each two consecutive moments.

Abbreviations: IOL, intraocular lens; IQR, interquartile range; ns, non significant.