LAUSR

PURPOSE To evaluate the astigmatism reducing effect of toric intraocular lenses (IOLs) for low amounts of corneal astigmatism. SETTING Hanusch hospital, Vienna, Austria. DESIGN Randomized, masked, controlled trial with bilateral comparison. METHODS Patients scheduled for bilateral cataract surgery and a corneal astigmatism in both eyes between 0.75 and 1.5 D were included in this study. The first eye was randomized to receive either a toric IOL or a non-toric IOL, and the contralateral eye received the other type of IOL. At the follow-up visits, optical biometry, corneal measurements with tomography and topography, autorefraction, subjective refraction, corrected and uncorrected distance visual acuity (CDVA/UDVA) with ETDRS charts and a questionnaire were performed. RESULTS Fifty-eight eyes were included in the study. Post-operative median uncorrected distance visual acuity was 0.00 (LogMAR) in the toric eyes and 0.10 in the non-toric eyes (p=0.03). The median corrected distance visual acuity was 0.00 in both groups (p=0.60). Median residual astigmatism determined by subjective refraction and autorefraction in the toric eyes was 0.25 D (diopters) and 0.50 D, respectively, (p=0.04) and 0.50 D and 1.00 D in the non-toric eyes, respectively (p<0.001). CONCLUSION The use of a toric IOL appears to be appropriate from a threshold value of approximately 0.75 D pre-operative corneal astigmatism. Further studies in a larger patient population are needed to confirm these results.