This document discusses outcomes from a study of 60 eyes that received toric intraocular lenses (IOLs) to correct astigmatism from corneal lattice endothelial dystrophy (CLE). Post-operative outcomes were assessed at 1 week, 1 month, and 3 months. At 3 months, distance vision was within 0.5 diopters of the intended correction in most eyes, with 7% requiring retreatment for residual cylinder over 1 diopter. Near vision was achieved as intended in all but 2 eyes that were pending retreatment. The results suggest toric IOLs are an excellent method for correcting astigmatism in CLE, achieving targeted distance and near vision outcomes in most cases.

1. Toric IOLs for CLE
John Cheung, MD
Everest SurgiCentre
Focus Eye Centre

2. Toric IOLs for CLE
AcrySoft IQ Toric IOL (SN6AT2-9)

3. Toric IOLs for CLE
AcrySoft IQ Toric IOL Calculator

4. Toric IOLs for CLE
AcrySoft IQ Toric IOL Calculator

5. Toric IOLs for CLE
AcrySoft IQ Toric IOL Calculator

6. Toric IOLs for CLE
AcrySoft IQ Toric IOL Calculator

7. Study Cohort
2 CLE Groups
n=30 eyes for Dv
n=30 eyes for Nv
Overall average demographics:
Age:
Sphere:
Cylinder:
IOL Power:
Toricity:
54 ± 7 yrs (38 to 69 yrs)
-2.38 ± 6.43 D (-17.25 to +6.25D)
+1.04 ± 1.24 D (0 to +5.00 D)
20.7 ± 8.60 D (6.0 to 34.0 D)
1.95 ± 1.32 D (1.0 to 6.0 D)

8. Study Cohort
Study Parameters
–
–
–
–
All eyes treated by 1 surgeons (JC)
All with AcrySoft IQ toric IOLs (T2 - T9)
SIA 0.3 D
Incision location: OD is 185° and OS is 5°
Post-op
–
–
–
–
Zymar qid x 1 week
PF qid x 2weeks then bid x 2 weeks
Voltaren qid x 1 month
DFE at 1 month exam

9. Avg Rx (D) over Time
0.75
0.50
SE (D)
0.25
0.00
Distance Rx
+0.23
+0.25
1W
1M
3M
-0.31
-0.25
-0.44
-0.40
Sph Equivalent
Sphere
-0.50
-0.57
-0.75
Cylinder
+0.26
-0.52
-0.44

10. Avg Rx (D) over Time
-1.50
-1.75
Near Rx
SE (D)
-2.00
1W
-2.25
-2.50
-2.75
-3.00
1M
-2.35
-2.39
-2.42
3M
-2.31
Sph Equivalent
Sphere
-2.48
-2.49

11. Avg Cyl (D) over Time
0.75
0.50
SE (D)
0.25
0.00
Near Rx
+0.13
1W
+0.19
1M
-0.25
-0.50
-0.75
* 2 pending retx for residual cyl 1.00 & 1.25 D
Cylinder *
+0.39
3M

12. CLE UCVA (Distance)
100
93
90
85
75
50
63
67
63
47
40
37
25
0
>20/20
>20/25
1 Week
1 Month
>20/40
3 Months

13. CLE UCVA (Distance)
96
100
79
100
83
81
75
58
50
50
48
25
0
>20/20
>20/25
1 Week
Removed retx
1 Month
>20/40
3 Months
100

14. CLE BCVA (Distance)
97
100
75
73
73
73
100
100
100
100 100
100
81
50
25
0
>20/20
Pre-op
>20/25
1 Week
1 Month
>20/40
3 Months
100

15. CLE BCVA (Distance)
100 100
100
100
100
100 100
100
90
79
79
79
75
50
25
0
>20/20
Pre-op
Removed retx
>20/25
1 Week
1 Month
>20/40
3 Months
100

16. CLE BCVA (Near)
100 100
97
100
90
100
93
83
75
57
57
50
40
41
25
0
>20/20
Pre-op
>20/25
1 Week
1 Month
>20/40
3 Months
100

17. SE Intended vs Achieved Dv – 3M
+/- 1.0D
8
0
Achieved SE (D)
2
0
-4
-10
-16
-16
-10
-4
Intended SE (D)
2
8

18. SE Intended vs Achieved Nv – 3M
4
2 pending retx
+/- 0.5D
Achieved SE (D)
3
2
1
0
0
1
2
Intended SE (D)
3
4

19. Cyl Intended vs Achieved – 3M
+/- 0.5D
5
Achieved SE (D)
4
3
2
Distance
1
Near
0
-1
-1
0
1
2
3
Intended SE (D)
4
5

20. CLE Bioptic
WGA PRK will be considered at 3
months post-op
Bioptic rates:
– Distance:
– Near:
17% (7% due to residual cyl)
0% (2 are pending)

21. Summary
Toric IOL for CLE is an excellent method
of correcting astigmatism
On average +0.25 D of residual cyl (7%
retx for residual cyl)
Targeted near vision achieved in all but 2
patients pending retx.

22. Thank You
for your Attention.
Questions?