Management of Cataract in Patients with Irregular Astigmatism with Regular Central Component by Phacoemulsification Combined with Toric Intraocular Lens Implantation.

Purpose: To evaluate visual acuity (VA) and refractive status in patients with cataract and irregular astigmatism with a regular central component after phacoemulsification with implantation of a toric intraocular lens (IOL).

Methods: Patients with cataract associated with irregular astigmatism with a regular central component were enrolled. All patients underwent phacoemulsification and toric IOL implantation. Postoperative visual acuity, residual astigmatism, toric IOL rotation, higher-order aberration, and objective and subjective visual quality were measured 3 months after surgery.

Results: Twenty-three eyes were included in the study. The logMAR corrected and uncorrected distance visual acuity values were decreased at 3 months postoperatively (  <  0.005). The preoperative average corneal astigmatism and postoperative residual astigmatism were 1.15-6.97 D (1.99 ± 1.26 D) and 0-2.75 D (0.65 ± 0.57 D), respectively. The average IOL rotation was 3.17 ± 2.01°. Some objective indicators of visual quality, including the modulation transfer function (  <  0.05), Strehl ratio (  <  0.005), 100% VA (  <  0.005), 20% VA (  <  0.005), and 9% VA (  <  0.005), were significantly higher than the corresponding preoperative values. The objective scatter index (  <  0.005) was significantly lower than that before surgery. The postoperative VF-14 scale score was 83.99 ± 14.58.

Conclusion: Toric IOL implantation has a good corrective effect on certain specific types of corneal irregular astigmatism with cataract. This effect can be attributed to its ability to correct the regular component of irregular astigmatism. The indications for toric IOL implantation could be expanded to some extent, thereby bringing benefit to more patients.