Efficacy of Toric Intraocular Lens Implantation in Patients Older Than 80 Years with Cataracts and Corneal Astigmatism

INTRODUCTION: This study analyzed the visual outcome following cataract surgery with toric intraocular lenses (IOLs) in patients older than 80 years with corneal astigmatism. METHODS: A total of 159 patients (159 eyes) older than 80 years with corneal astigmatism (≥ 0.75 D) were included. Fifty-three eyes received Acrysof IQ® toric IOLs (SN6AT2–5), while the others received non-toric IOLs: 51 eyes received Acrysof IQ® IOLs (SN60WF) and 55 eyes received A1-UV IOLs. The uncorrected distance visual acuity, corrected distance visual acuity, and refraction (spherical equivalent, refractive cylinder) were assessed at 3 months postoperatively. The prediction error of refractive outcome and percentages of eyes within ± 0.50 D and ± 1.00 D in the toric IOL group obtained using five toric IOL formulas (Barrett predicted posterior corneal astigmatism (PCA), Barrett measured PCA, Kane, EVO 2.0 and Næser–Savini) were compared. RESULTS: At 3 months postoperatively, the average uncorrected distance visual acuity was better in the toric IOL group than the non-toric IOL group (p < 0.001). The mean residual refractive cylinder was lower in the toric IOL group than the non-toric IOL group (p < 0.001). The Næser–Savini formula achieved the lowest mean absolute error (0.39 D) and had the highest percentages of eyes within an absolute error of 0.50 D and 1.00 D (72% and 98%) compared to the other formulas. CONCLUSION: The results demonstrate the efficacy of toric IOL implantation in patients older than 80 years with corneal astigmatism and provide strong evidence for cataract surgeons to encourage such patients to choose toric IOLs.