Microincision cataract surgery with toric intraocular lens implantation for correcting moderate and high astigmatism: pilot study.

Purpose: To evaluate the results of microincision cataract surgery (MICS) with toric intraocular lens (IOL) implantation to correct moderate to high astigmatism in patients with cataract.

Setting: Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain.

Methods: This prospective nonrandomized study comprised patients with visually significant cataract and moderate to high astigmatism (>2.00 diopters [D]). After MICS, an Acri.Comfort 646 TLC toric IOL was implanted in the capsular bag. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, residual refractive sphere, residual refractive and keratometric cylinders, and IOL axis alignment were measured after 3 months. Vector analysis of astigmatism was by the Alpins method.

Results: The study included 21 eyes (12 patients). The UDVA was 20/40 or better in 16 eyes (76.1%), and the CDVA was 20/30 or better in 18 eyes (85.7%). The mean refractive cylinder decreased significantly after surgery, from -4.46 D +/- 2.23 (SD) to -0.45 +/- 0.63 D (P<.05). Astigmatism analysis by vectors showed a mean surgically induced astigmatism vector of 0.99 x 1 degrees and a mean difference vector of 0.23 x 8 degrees. The mean index of success was 0.11 +/- 0.15. Ninety-one percent of astigmatism was corrected. The mean IOL axis rotation was -1.75 +/- 2.93 degrees; the rotation was 10 degrees or less in all eyes. No complications occurred.

Conclusion: Implantation of a toric IOL after MICS was a safe, precise, and effective procedure to correct moderate to high astigmatism in cataract patients.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.