Early phacoemulsification experience with toric iol

  • 464 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
464
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
10
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide
  • THE DRAWBACKS OF LRI INCLUDE LACK OF PERCISION, Varied healing response, limited cylindrical correction, undercorrection , overcorrection, perforation, wound gap, loss of BSCVA, regression, neurotrophic effect with corneal erosion. Disadvantages of PRK and LASIK include regression, haze, dry eye, DLK, under or over correction

Transcript

  • 1. Early experience of phacoemulsification cataract surgery with Toric IOLS Hany EL-Defrawy Tariq Ayoub Hadi Zambarakji
  • 2. Magnitude of the problem The prevalence of astigmatism increases with age Approximately 50% of the population older than 60 years has more than 1D of astigmatism 22% of cataract surgery candidates have pre-existing astigmatism exceeding 1.5 D (Hoffer KJ,1980), (Ferrer-Blasco et al 2009)
  • 3. What are the treatment options? Peroperative Postoperative
  • 4. Surgical options Astigmatic keratotomy Limbal relaxing incisions PRK LASIK Toric IOLs
  • 5. What are the Disadvantages of othermodalities? LRI Astigmatic keratotomy PRK LASIK
  • 6.  Purpose: To evaluate toric IOL efficacy in treating corneal astigmatism Method: Retrospective pilot study of 7 patients (11 eyes) who underwent phacoemulsification and Toric IOL at WX
  • 7. • Inclusion criteria1. Visually significant cataract2. Regular corneal astigmatism 3D or more3. Pharmacologic mydriasis of at least 6 mm to allow intraoperative and postoperative visualisation of axis marks4. Intact capsular bag for in the bag implantation at the end of surgery• Exclusion criteria1. Corneal scarring2. Advanced glaucoma3. Significant macular disease4. Irregular astigmatism
  • 8. Preoperative assessment1. Complete ophthalmic examination2. Logmar UCVA and BCVA3. Manifest Refraction4. Slitlamp examination5. Keratometry and Biometry using IOLMaster6. Toric cylindrer power and axis placement was provided by manufacturer.
  • 9. Postoperative follow up Allpatients were evaluated at one day to assess the lens position A refraction was done at one day and one month One patient required reposition of the IOL
  • 10. Toric IOL1. Reversible and adjustable2. Predictable and effective
  • 11. Surgical tips Preoperative reference marking ? Intraoperative reference marking Incision location Meticulous removal of OVD with attention to avoid rotation of the IOL Lens alignment
  • 12. Results Preoperative Preoperative Post Postoperative spherical cylinder operative cylinder error spherical errorMean -2.55 -3.20 Mean -0.069 -0.91Standard 5.28 0.93 Standard 0.63 0.56deviation deviation Range -1.25 to 0.75 -2.25 to -0.25Range -14 to 4.25 -5 to 1.5
  • 13. Paired T testP =0.141>0.05
  • 14. Paired T testP<0.001
  • 15. Refraction(pre-Operation)Spherical 0 -15 -13 -11 -9 -7 -5 -3 -1 1 3 5 -1 -2 -3 -4 -5 -6 Cylindrical
  • 16. Refraction(post-Operation)Spherical 0 -1.5 -1 -0.5 0 0.5 1 -0.5 -1 -1.5 -2 -2.5 Cylindrical
  • 17. Refraction(pre & post-Operation)Spherical 0 -15 -13 -11 -9 -7 -5 -3 -1 1 3 5 -1 -2 -3 -4 -5 -6 Cylindrical Spherical(pre) Cylindrical(pre) Spherical(post) Cylindrical(post)
  • 18. Paired T testP<0.001
  • 19. Drawbacks of this study Small sample size and not powered Non comparative We did not assess the IOL position after 1 month A recent study showed the toric IOL misalignment from the intended axis occurs mostly during the first month (Mingo Botin etal J Cataract and refractive surgery 2010)