Refractive and visual outcomes of plate-haptic toric intraocular lens implantation for astigmatic correction after uncomplicated microincision cataract surgery

Objective: To evaluate visual and refractive outcomes with plate-haptic toric intraocular lens implantation (ph-toric) after uncomplicated microincision cataract surgery (MICS) to correct moderate-to-severe astigmatism. Design: Prospective cross-sectional study. Methods: The study was conducted at a tertiary eye care center in New Delhi, India, on patients with visually-significant cataract and moderate-to-severe astigmatism (>1.00 diopters [D]). Preoperative parameters like visual-acuity, keratometry and astigmatism values and lens power calculation were noted. After MICS via 1.8 mm incision, a ph-toric IOL was implanted. The outcome measures noted were uncorrected and corrected distant visual-acuity (UDVA, CDVA), decrease in astigmatism and rotational stability. Follow-up was done on day 1, day 7, 1-month and 3-months postoperative. Results: This study involved 30 eyes of 30 patients. 27 patients (90%) gained UDVA of 6/ 9 or better. Out of these, 27 patients (90%) achieved CDVA of 6/ 6. Mean CDVA changed from 0.967 ± 0.101 postoperative to 0.176 ± 0.82 preoperatively (p<0.001). The mean preoperative astigmatism was 2.08 ± 0.59 D and the mean postoperative astigmatism was 0.35 ± 0.39 D. The mean correction achieved was 1.28 ± 0.32 D. Statistically significant (p<0.001) correction of astigmatism was observed by use of ph-toric IOL. The mean reduction in astigmatism was 84.16 ± 10.61 with excellent reduction in 43.3%. IOL rotation was <10 degrees in all the eyes. No complications were observed. Patients had satisfaction with the procedure and visual outcomes. Conclusion: Implantation of a plate-haptic toric IOL after uncomplicated MICS via 1.8 mm incision is a feasible and safe option in cataract cases with astigmatism to provide good visual and refractive outcomes. No major drawbacks were observed attributable to ph-toric IOL. Abbreviations: SIA - surgically induced astigmatism, D - diopters, MICS - microincision cataract surgery, ph-toric IOL - plate-haptic toric IOL, IOL - intraocular lens, UDVA - uncorrected distant visual acuity, CDVA - corrected distant visual acuity