Refractive Status in Eyes Implanted with Toric and Nontoric Intraocular Lenses during Combined Cataract Surgery and Microhook Ab Interno Trabeculotomy

摘要

Purpose . To compare the refractive status between eyes implanted with toric and nontoric intraocular lenses (IOLs) during combined cataract surgery and microhook ab interno trabeculotomy ( μ LOT), a minimally invasive glaucoma surgery (MIGS). Methods . Twenty eyes of 20 patients who had open-angle glaucoma, cataract, and preexisting regular corneal astigmatism exceeding 1.5 diopters (D) and underwent combined μ LOT and phacoemulsification were recruited retrospectively. Ten eyes were implanted with a toric IOL and 10 eyes with a nontoric IOL. The primary outcomes were the uncorrected visual acuity (UCVA) and refractive cylinder at 3 months postoperatively. Results . The mean UCVA of the toric IOL group (logarithm of the minimum angle of resolution (logMAR), 0.23?±?0.25) was significantly better than that of the nontoric IOL group (logMAR, 0.45?±?0.26) at 3 months postoperatively ( ). The mean absolute residual refractive cylinder of the nontoric IOL group (2.25?±?0.62?D) was significantly greater than that of the toric IOL group (1.30?±?0.68?D) ( ). Postoperatively, 60% of eyes in the toric IOL group and 10% in the nontoric IOL group had an absolute refractive astigmatism level of 1.5?D or less. Surgically induced astigmatism (0.77?±?0.43?D for toric group and 0.60?±?0.32?D for nontoric group) and IOP reduction (33.9?±?15.6% for toric group and 29.4?±?11.7% for nontoric group) were not different between groups. Conclusions . Use of toric IOL during combined cataract surgery and μ LOT is possible and better than not, but physician should prevent their patient of persisting residual astigmatism. The study was registered at https://www.umin.ac.jp/ , and the clinical trial accession number is https://clinicaltrials.gov/ct2/show/UMIN000043141 .