The Effects of Axis-flip of the Refractive Cylinder on vision and patient reported outcome measures following Toric Intraocular Lens implantation
Naderi, K., Jameel, A., Chow, I. , Hull, C. ORCID: 0000-0002-2205-4443 & O’Brart, D. (2024). The Effects of Axis-flip of the Refractive Cylinder on vision and patient reported outcome measures following Toric Intraocular Lens implantation. Journal of Cataract & Refractive Surgery, doi: 10.1097/j.jcrs.0000000000001530
Abstract
Purpose:
To investigate the effects of cylinder axis-flip following toric intraocular lens (TIOL) implantation on vision and patient reported outcome measures (PROMs).
Setting:
Teaching hospital in the United Kingdom.
Design:
Post-hoc analysis of data from patients who participated in a prospective randomised study of TIOLs.
Methods:
Axis-flip was defined as a change in post-operative refractive cylinder axis of 900 +/- 22.50 from the pre-operative biometric axis. Uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), residual refractive cylinder (RC), and CATPROM-5 and EQ5D3L quality of life (QOL) scores were analysed.
Results:
At 6 months, axis flip occurred in 29 (34.5%) of 84 eyes, of which 28 had with-the-rule astigmatism (WTR) pre-operatively. Mean (+/-standard deviation) UDVA (logMAR) was 0.13 (0.16) in flipped cases (FC) and 0.10 (0.14) in un-flipped cases (UF) (p=0.88). BDVA was 0.01 (0.11) in FC and was 0.00 (0.09) in UF (p=0.68). Mean RC was 0.74 dioptres (D) (0.41) in FC and 0.93D (0.47) in UF (p=0.08). Mean CATPROM-5 score was -6.22.98 (2.56) in FC and -5.52 (3.03) in UF (p=0.29). Mean EQ5D3L calibrated score was 0.89 (0.19) in FC and 0.85 (0.19) in UF (p=0.35). Retrospectively applying coefficients of adjustment to account for posterior corneal astigmatism (PCA), suggested that 6 eyes (21%) of FC with WTR might have avoided axis-flip.
Conclusions:
Axis flipping following TIOL implantation did not adversely influence visual acuity or PROMs scores. Most FC had WTR pre-operatively. Adjusting for PCA might have reduced axis flip in some of these eyes.
Publication Type: | Article |
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Additional Information: | Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS |
Publisher Keywords: | Cataract Surgery, Toric Intraocular lenses, Refractive Axis, Posterior corneal astigmatism |
Subjects: | R Medicine > RE Ophthalmology |
Departments: | School of Health & Psychological Sciences School of Health & Psychological Sciences > Optometry & Visual Sciences |
SWORD Depositor: |
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