Comparison of Visual
Outcomes With Toric IOL and
With Limbal Relaxing Incisions
in Cataract Surgery
Eriko Fukuyama, MD
Fukuyama Eye Clinic
Fukuoka, Japan
The author has no financial interest in the subject matter of this e-poster.
Purpose
• To compare cylindrical changes
between a toric intraocular lens
(IOL) and limbal relaxing incisions
(LRIs) to correct preexisting
astigmatism in patients underwent
cataract surgery.
Patients
• We prospectively reviewed the medical records
of 20 patients who underwent primary cataract
surgery for bilateral cataract with corneal
astigmatism 1 dioptor and over at Fukuyama
Eye Clinic from August 2009 to August 2010.
They underwent implantation of a AcrySof IQ
Toric IOL in one eye (group A) and with
implantation of a AcrySof IQ IOL with LRIs in a
fellow eye (group B).
• Mean age :75.5±5.6
• Male : Female= 15 : 5
Surgical Methods
Group A：
Incision: Coaxial MICS (2.4mm)
IOL: ACRYSOF® IQ Toric aspheric IOL
Group B：
LRIs: Fukuyama LRI Nomogram, 1 Pair
Incision: Coaxial MICS (2.4mm)
IOL: ACRYSOF® IQ aspheric IOL
Results
• The mean corneal astigmatism measured by
keratometer before the surgery was 1.89 dioptors
in group A and 1.73 dioptors in group B. After the
treatment, the mean corneal astigmatism was 1.89
dioptors in group A and 0.81 dioptors in group B,
and the mean refraction astigmatism was 0.73
dioptors in group A and 0.51 dioptors in group B at
six months after the surgery.
• The UDVA and CDVA were similar in both groups.
The corneal shape measured by topography was
stabilized earlier in group A than in group B.
Change in Corneal Cylinder (Keratometory)
D
(n=20)
(n=20)
**
**：
Wilcoxon rank-sum
test
P Value<0.02
Post-Op
Change in Refractive Cylinder
D
(n=20)
(n=20)
**：
Wilcoxon rank-sum
test
P Value: 0.0034
**
Post-Op
Change in induced corneal cylinder (D)
Induced Corneal Cylinder
(via Topography)
2.5
T-IOL (n=20)
LRIｓ (n=20)
2
1.5
1
0.5
0
１W
２W
１M
３M
Post-Op
６M
Change in Corneal Cylinder (Keratometory)
LRIｓ
T-IOL
（D)
Corneal cylinder (Post-Op 6 Months
Corneal cylinder (Post-Op 6 Months
（D)
(n=20)
(n=20)
（D)
Corneal
Cornealcylinder
cylinder(Pre-Op)
(Pre-Op)
（D)
Corneal cylinder (Pre-Op)
Change in Refractive Cylinder
T-IOL
LRIｓ
（D)
Refractive cylinder (Post-Op 6 Months
Refractive cylinder (Post-Op 6 Months
（D)
(n=20)
(n=20)
（D)
Corneal cylinder (Pre-Op)
（D)
Corneal cylinder (Pre-Op)
Comparison of Toric IOLs with LRIs
LRI
High-precision correction
Toric IOL
△
○
△
○
△
○
High-order aberration
△
○
Asymmetric astigmatism
○
△
Complication:
over collection
rare
none
Complication:
Irregular astigmatism
rare
none
Stability of Refraction
Early restoration of VA
Conclusion
• Both a toric IOL and LRIs are useful to
correct preexisting astigmatism in
patients having cataract surgery.
• A toric IOL excels LRIs in the early
stabilization of the corneal shape.