Toric IOLs can benefit eyes with a history of refractive surgery

Outcomes for cataract surgery with toric IOL in eyes with previous laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) were examined in this study.

Study design

This retrospective consecutive case series examined outcomes for cataract surgery with a toric IOL in eyes with previous myopic (n=56) and hyperopic (n=19) LASIK or PRK. Patients were included if they had preoperative Lenstar biometry, uncomplicated surgery and a CDVA of 20/30 or better starting at postoperative week 3. Alcon monofocal toric, Johnson & Johnson Vision monofocal toric, and Symfony toric IOLs were included. The primary outcome was vector analysis of the preoperative corneal and postoperative refractive astigmatism.

Outcomes

Compared with preoperative corneal astigmatism, postoperative refractive astigmatism significantly decreased. The mean corneal astigmatism was 1.34 D in eyes with prior myopic LASIK or PRK and 1.66 D in eyes with hyperopic LASIK or PRK. The postoperative mean astigmatism was 0.36 D in LASIK eyes and 0.34 D in PRK eyes, with 80% and 84% of eyes having refractive astigmatism of 0.5 D or less. The centroid values were 0.12 D at 152 degrees and 0.05 D at 172 degrees.

Limitations

This was a small study with a retrospective design. Manifest refraction in eyes that have had laser vision correction is not always consistent because of corneal irregularity. The authors excluded eyes with inconsistent or irregular measurements, so this study does not apply to all post-LASIK and PRK eyes.

Clinical significance

With consistent biometry and fairly regular astigmatism, eyes that have had prior laser vision correction can still benefit from a toric IOL.