Preliminary Management Of Low-moderate Corneal Astigmatism In Cataract Surgery

Objective:To compare the efficacy of astigmatic correction by using toric intraocular lens(Toric IOL)implantation versus Limbal Relaxing Incisions(LRI)during cataract surgery,and evaluate postoperative visual quality and life quality.Explore the optimal surgical option to manage low to moderate regular corneal astigmatism in cataract surgery.Methods:forty-seven age-related cataract patients(69 eyes)with 1.0-2.0D(diopter,D)regular corneal astigmatism were randomly divided into two groups.Group A with 21 patients(33 eyes)received AcrySof IQ Toric IOL implantation and group B with 26 patients(36 eyes)received LRI with aspherical IOL implantation.Uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),residual astigmatism,modulation transfer function cut off(MTF cut off)at postoperative 1 week,1 month,3 months were observed.Rotational stability of IOL and Surgical Induced Astigmatism(SIA)in group A at postoperative 3 months were observed and subjective outcomes were assessed by Visual function index(VF-14)questionnaire in both groups.Results:At postoperative 3 months,The mean UCVA of group A is better than group B,there were significant differences between two groups(F=7.649,P=0.007).The mean MTF cut off of group A is higher than group B,there were significant differences between two groups(F=5.674,P=0.020),and the mean BCVA demonstrated there were no significant differences between two groups(F=0.4745,P=0.494).There were statistical differences in the mean residual astigmatisms between two groups at postoperative 1 months and 3 months(F=4.496,P=0.038;F=19.582,P=0.000).There were significant differences in astigmatism preoperative and postoperative in both groups(P=0.000).The mean axis rotation of Toric IOL in group A was(4.24±1.7)0at postoperative 3 months and SIA was(0.53±0.16)D.There was no statistical differences in(VF-14)questionnaire scores between two groups at postoperative 3 months(t=0.319,P=0.750).Conclusion:Both Toric IOL implantation and LRI had made obvious effects in correcting low to moderate(1.0-2.0 D)regular corneal astigmatism in cataract surgery.Toric IOL implantation makes better UCVA and astigmatism correction with good rotational stability and Predictability.But two procedures are effective in improving patients' visual quality and life quality.