Toric intraocular lens implantation in children with developmental cataract and preexisting corneal astigmatism

Purpose To evaluate the effect of toric intraocular lens (IOL) implantation on the refractive outcomes in children with cataract and preexisting corneal astigmatism. Methods We included children between the age group of 8–14 years who were randomized into group I (toric) and group II (non-toric), in which toric and spherical IOLs were implanted, respectively, after phacoaspiration. Primary outcome measure was comparison of preoperative keratometric and postoperative refractive cylinder. Secondary outcome measure was comparison of pre- and postoperative visual outcome. Results This study included 21 eyes of 17 children with developmental cataract. The mean spherical power of the toric IOLs implanted in the group I was 22.42 ± 4.84 D (range 12.50–29.00 D) and the mean cylindrical power of toric IOL was 3.37 ± 1.43 D (range 1.50–6.00D). The mean spherical power implanted in non-toric (group II) was 20.70 ± 7.09 D (range 10–31D). Mean preoperative keratometric cylinder in group I was 2.99 ± 0.96 D (range 1.85–5.12 D) and in group II it was 3.35 ± 0.63 D (range 2.03D–4.33 D) (p = 0.31) while the mean refractive cylinder at one year postoperatively in group I was 0.50 ± 0.39 D (range 0.00–1.00 D) and in group II it was 2.05 ± 0.39 D (range 1.25D–2.50 D; p = 0.006). Twelve months postoperatively, group I had a mean spherical equivalent (SE) 0.41 ± 0.26 D (range 0.00–0.88 D) and group II had 1.8 ± 1.03 D (range 0.63–4.00 D) (p = 0.002). Uncorrected distance visual acuity (UDVA) improved from 0.94 log MAR ± 0.51 (range 0.60–2.00) to 0.43 log MAR ± 0.33 (range 0.00–1.00) in the group I at the end of 1 year and in group II, it improved from 1.52 log MAR ± 1.12 to 0.75 log MAR ± 0.70 (range 0.00–2.00) at the end of 1 year. Corrected distant visual acuity (CDVA) improved in group I from 0.72 log MAR ± 0.17 (range 0.48–1.00) to 0.19 log MAR ± 0.26 (range 0.00- 0.78) at the end of one year while in group II, it improved from 1.33 ± 1.08 (range 0.18–3.00) to 0.49 log MAR ± 0.80 (range 0.00–2.00) at the end of 1 year. Conclusions Toric IOL implantation in children significantly reduces postoperative astigmatism and thereby improves visual outcome.