Highly toric IOLs associated with greater refractive surprise

This retrospective study found that highly toric IOLs result in greater myopic change from preoperative predictions than nontoric IOLs and toric IOLs with less toricity.

Some studies have suggested that toric IOL patients have more myopia postoperatively than what was predicted preoperatively.

To this end, the authors retrospectively compared predicted and remnant spherical equivalent in patients who underwent cataract surgery with toric vs. nontoric IOL implantation. They included 121 eyes that received either a nontoric IOL, the Acrysof IQ SN60WF (Alcon Laboratories, Fort Worth, Texas), or one of three toric IOLs of varying toricity: the Acrysof SA6AT3, SA6AT4 or SA6AT5.

They found that greater toricity caused a larger gap between the goal diopter and the actual spherical equivalent errors, with the most toric IOLs (the SN6AT4 and AT5) showing the largest myopic changes‑about 0.3D on average.