COMPARISON BETWEEN ACRYSOF TORIC IOLS AND LIMBAL RELAXING INCISIONS FOR MANAGEMENT OF PREOPERATIVE ASTIGMATISM IN CATARACT PATIENTS

Purpose : The aim of this work is to compare toric intraocular lens (IOL) implantation, and limbal relaxing incisions to treat astigmatism during phacoemulsification.
Design: Prospective randomised comparative study.
Methods: 60 eyes of 60 patients were devided into 2 equal groups. 30 eyes were offered phacoemulsification with toric IOL implantation and 30 were implanted spherical IOLs with limbal relaxing incisions. Postoperative astigmatism and UCVA were measured and compared during week 1 and month 1 and after 3 months.
Results: The mean preoperative BCVA was 0.1 ± 0.15 in toric subgroup, 0.15 ± 0.15 in LRI subgroup. The mean preoperative astigmatism was -2.4 +/-0.7 & -2.7+/- 0.7 respectively. At the first week: The mean postoperative UCVA at one week was 0.72 ± 0.12, 0.61 ± 0.09, in each group respectively. The mean postoperative astigmatism in the first week was -0.5 +/-0.3 & -1.27+/- 0.5 respectively. The mean postoperative UCVA at 1 month was 0.89 ± 0.14, 0.58 ± 0.1. The mean postoperative astigmatism was -0.55+/-0.35& -1.37+/- 0.5 respectively. In the 3 months follow up visit the mean for the postoperative UCVA was 0.9±0.13 and 0.59±0.16 for each subgroup respectively. The mean postoperative astigmatism was -1.25+/-0.25& -1.6+/- 0.5 respectively. There was a highly significant statistical difference between the result of UCVA preoperative and the results of UCVA at the early and last postoperative follow up. The average change of corneal astigmatism in the LRI group 1.1+/-0.6 Dioptres at three months.
Conclusion: From our results, it is evident that LRIs are safe, predictable, and effective method for treating pre-existing astigmatism in cataract surgery. However, regression may occur after surgery. Toric IOL implantation has recently become available as a means of treating astigmatism. Toric IOL implantation was proven to be very effective, stable and safe