Efficacy of Toric intraocular lens implantation in eyes with high myopia: A prospective, case-controlled observational study

The present prospective clinical observational study aimed to evaluate the efficacy of Toric intraocular lenses (IOL) to achieve rotational stability and astigmatism correction in eyes with high myopia. A total of 27 consecutive cataract patients (39 eyes) with pre-existing corneal astigmatism (1.5–3.5 D) were divided into two groups according to their refractive status: One group of 18 eyes with high myopia -(12.5–6.0 D) and another group consisting of 21 eyes with emmetropia or low myopia (−3.0–0.0 D). All eyes underwent cataract phacoemulsification surgeries by the same surgeon, with the implantation of an AcrySof(®) Toric IOL at the pre-designed degree. Uncorrected visual acuity, best corrected visual acuity and phoropter examination results were recorded at the 1st day, 1st week, 1st month and 3rd month after the surgery. By analyzing digital images from slim-lamp photography with a self-designed software, the rotational stability was observed. The contrast sensitivity was also measured. No significant difference in the baseline and post-operative residual astigmatism was identified between the two groups (P>0.05). In addition, no significant difference in the degree of rotation was observed between the two groups. All patients had significantly improved visual quality after the surgery (P<0.05). In conclusion, the present study observed an equal astigmatism-correction efficiency and rotational stability in the two groups. A second auxiliary spot-penetrating incision, removal of visco-elastic substances and tight adherence of the IOL to the posterior capsular membrane are essential for a successful surgery.