Mid-long-term Rotational Stability And Optical Quality After Toric IOL Implantation In Eyes With Prolonged Axial Length

Objective To compare mid-long-term rotational stability and subject and objective optical quality and satisfaction after Toric IOL implantation in eyes with prolonged axial length.Methods It was a retrospective cohort study.Patients with age-related cataract and corneal astigmatism were enrolled and accepted phacoemulsification combined with implantation of Toric intraocular lens(IOL)in Jinling Hospital during April 2016 to December 2018.55 cases(69 eyes)were divided into two groups according to axial length.Preoperatively and postoperatively,Uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),residual refractive astigmatism,rotational stability of the IOL,optical quality analysis system(OQAS)parameters,questionnaire scores and IOL rotation were evaluated.All data were processed by statistic package deal SPSS 22.0.Results1.Both groups showed significant reduction in UDVA and CDVA after the surgery(P<0.001).There was no significant difference in preoperative UDVA,postoperative UDVA and CDVA between two groups(P>0.05).2.Significant difference between residual refractive astigmatism and preoperative corneal astigmatism was found in both groups by vector analysis(P<0.001).There was no statistically significant difference beween the two groups(P>0.05).3.No significant difference in rotation of Toric IOL axis was found between the two groups(P=0.923).4.Postoperative OQAS parameters(OSI,MTF cutoff,SR,OV100%,OV20%,OV9%)were significantly better in both groups(P<0.001),but there was no significant difference between the two groups(P>0.05).5.Peripheral vision score was significantly lower in group 1(P=0.010).No significant difference in other elements of NEI-VFQ-25,spectacle-independence rate and satisfaction was found(P>0.05).6.OQAS parameters(OSI,MTF cutoff,SR,OV100%,OV20%,OV9%)were positively correlated with multiple sub-scales of NEI-VFQ-25,spectacle-independence rate and satisfaction.Conclusion Toric IOL provided mid-long-termly stable predictability of the refractive results,nice rotational stability,and good optical performance in eyes with prolonged axial length.At the same time,it improved the spectacle independency of cataract patients with astigmatism.