Implantation of Hydrophobic Acrylic Toric Intraocular Lens with High-Water Contents Using Swept-Source Optical Coherence Tomography Biometer Integrated with a Surgical Guiding System

Abstract

Purpose

To evaluate postoperative outcomes after implantation of toric intraocular lenses (IOLs) made of high-water-content hydrophobic acrylic material in Japanese patients using a swept-source optical coherence tomography (SS-OCT) biometer integrated with a surgical guiding system.

Patients and Methods

In this prospective observational study, toric IOL models CNW0T3 to CNW0T9 (Alcon) were implanted in 33 eyes of 33 patients and followed-up for one month. Powers and toric models were determined using an SS-OCT biometer ARGOS^® Ver 1.5 (Alcon), and the IOLs were aligned using surgical guidance. Differences between planned and actual axis positions at the end of the surgery (misalignment) and rotations from the end of surgery to one month postoperatively were measured. Additionally, postoperative uncorrected visual acuity, refraction, and residual astigmatism were evaluated.

Results

Mean and median misalignments were 2.3° (standard deviation [SD]: 1.6, 95% confidence interval [CI]: 1.7–2.9) and 2°, and those of postoperative rotation were 2.4° (SD: 2.6, 95% CI: 1.5–3.4) and 2°, respectively. Mean postoperative refraction was 0.06 D (SD: 0.62). Prediction errors within ±0.5 and ±1.0 D were 69.7% and 93.9%, respectively. Mean residual astigmatisms were 0.19 D (SD: 0.41), and mean uncorrected visual acuity was 0.00 logMAR (SD: 0.11), and 64% of the eyes scored 20/20 or better.

Conclusion

Implantation of high-water-content hydrophobic acrylic toric IOLs using SS-OCT biometry integrated with a surgical guiding system effectively corrected corneal astigmatism with accurate IOL alignment in Japanese patients.

Keywords:

• toric intraocular lens
• swept-source optical coherence tomography
• biometry
• surgical guiding system

Data Sharing Statement

The data used and analyzed for this study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

The study protocol was approved by the independent investigational review board of a non-profit organization MINS in Tokyo, Japan, (Approval number: 210235) and performed according to the tenets of the Declaration of Helsinki and Ethical Guidelines for Medical and Biological Research Involving Human Subjects in Japan. Written informed consent was obtained from all the participants.

Consent for Publication

This is not applicable as the manuscript does not contain any participant-identifying information.

Acknowledgments

We thank Dr Kaori Sato for her support in designing the concept of this study and helpful discussion.

Author Contributions

All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Y. Matsumoto has received grants from Alcon Japan Ltd. The other authors report no conflicts of interest in this work.

Additional information

Funding

The study was supported by an investigator-initiated study grant (IIT#69775041) from Alcon Japan Ltd. The funder had no role in the study design; in the collection, analysis or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.