• This study found that UDVA after monofocal IOL implantation in eyes with simple myopic against-the-rule (ATR) astigmatism was worse than in eyes with simple myopic with-the-rule (WTR) astigmatism. Additionally, UDVA was significantly influenced by cylindrical refractive power in eyes with ATR astigmatism but not in eyes with WTR astigmatism.

    The study included 25 eyes (25 patients) with ATR astigmatism and 18 eyes (18 patients) with WTR astigmatism that had undergone uneventful phacoemulsification with monofocal aspherical IOL (SN60WF, Alcon Laboratories, Fort Worth, Texas) implantation in the capsular bag for uncomplicated age-related cataracts. UDVA was significantly better in the WTR group. There were no significant differences in other parameters measured between groups. The UDVA was significantly correlated with spherical equivalent refractive error and cylindrical refractive power in the ATR group but not in the WTR group.

    The authors say that pseudophakic eyes with simple myopic WTR astigmatism might potentially have better distance visual performance than those with simple myopic ATR astigmatism. Based on the results of this study, they suggest that ATR astigmatism is a good candidate for surgical correction with toric IOL implantation or other procedures.