Efficacy of Toric Intraocular Lens versus Opposite Clear Corneal Incision on Astigmatism Correction in Cataract Surgery

Aim: To study the role of opposite clear corneal incision (OCCI) and toric IOL in correcting pre-existing astigmatism and to compare their efficacy for correcting pre-existing astigmatism in phacoemulsification in cataract surgery. Material and Methods: The study was a prospective study conducted in a tertiary care hospital in North India and included 50 eyes of 50 patients of age >40 years with visually significant cataract and pre-existing regular corneal astigmatism from 1.0 D to 3.0 Ddivided into two groups of 25 each. Group 1 had toric IOL implantation and Group 2underwent paired 3.20 mm OCCIs on the steep axis with spherical IOL implantation. UCVA & BCVA, refraction and toric IOL axis rotation were measured postoperatively on day 1, day 7, I month, 2 month and 3 month. Results: In our analysis 84% and 76% eyes in gp 1 and gp 2, resp., had uncorrected visual acuity (UCVA) of 6/9 or better .96% eyes in both the groups attained 6/9 or better best corrected visual acuity (BCVA) at 3 month post-operatively. Mean refractive cylinder decreased significantly from preop to postop, 2.19 ± 0.45 D to 0.26 ± 0.36 D in group 1 (Toric) and 1.58 ± 0.45 D to 0.43 ± 0.38 D in group 2 (OCCI). The mean reduction in refractive cylinder was 1.93D in the toric IOL group and 1.15D in OCCI group. There was statistically significant difference in correcting astigmatism in the two groups. Conclusion- Toric IOL implantation achieved an enhanced effect over OCCIs in treating pre existing astigmatism in patients undergoing cataract surgery. No significant toric IOL axis rotation was noted in any eye.