Comparison of the Astigmatic Power of Toric Intraocular Lenses Using Three Toric Calculators
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Purpose: To compare the astigmatic power of toric intraocular lenses (IOLs) obtainedfrom the AcrySof, TECNIS, and iTrace toric calculator in patients with preoperativewith-the-rule (WTR) or against-the-rule (ATR) corneal astigmatism. Materialsand Methods: Fifty eyes with cataract and corneal astigmatism greater than 0.75 diopters were enrolled in each group (WTR and ATR). Keratometric values were measured using autokeratometry, an IOLMaster, and an iTrace, which incorporatedcorneal topography and ray-tracing aberrometry. Based on measured keratometricvalues, the astigmatic power of each toric IOL was calculated using three toriccalculators. Results: Bland-Altman plots showed good agreement between six pairwise corneal astigmatism values in both groups. The TECNIS calculator tended to suggest a higher astigmatic power of the toric IOL than the AcrySof calculator. With the higher astigmatism and keratometric values from the IOLMaster, in both groups, calculations from the AcrySof and TECNIS calculators resulted in higher calculated astigmatic powers than those from same calculators with autokeratometry-measured values, demonstrating good agreement. With the higher calculated astigmaticpower values, the values from the iTrace toric calculator using keratometric valuesobtained from iTrace ray tracing wavefront aberrometry or iTrace simulated keratometry showed fair to moderate agreement with those from the other calculator-keratometry pairs in both groups. Conclusion: To achieve the best refractive outcomeafter toric IOL implantation, understanding the differences in keratometric valuesbetween instruments and in calculated astigmatic power among toric calculator programs is necessary. Moreover, systemic analysis of each toric calculator in conjunctionwith postoperative data is required.
Abstract
Purpose: To compare the astigmatic power of toric intraocular lenses (IOLs) obtainedfrom the AcrySof, TECNIS, and iTrace toric calculator in patients with preoperativewith-the-rule (WTR) or against-the-rule (ATR) corneal astigmatism. Materialsand Methods: Fifty eyes with cataract and corneal astigmatism greater than 0.75 diopters were enrolled in each group (WTR and ATR). Keratometric values were measured using autokeratometry, an IOLMaster, and an iTrace, which incorporatedcorneal topography and ray-tracing aberrometry. Based on measured keratometricvalues, the astigmatic power of each toric IOL was calculated using three toriccalculators. Results: Bland-Altman plots showed good agreement between six pairwise corneal astigmatism values in both groups. The TECNIS calculator tended to suggest a higher astigmatic power of the toric IOL than the AcrySof calculator. With the higher astigmatism and keratometric values from the IOLMaster, in both groups, calculations from the AcrySof and TECNIS calculators resulted in higher calculated astigmatic powers than those from same calculators with autokeratometry-measured values, demonstrating good agreement. With the higher calculated astigmaticpower values, the values from the iTrace toric calculator using keratometric valuesobtained from iTrace ray tracing wavefront aberrometry or iTrace simulated keratometry showed fair to moderate agreement with those from the other calculator-keratometry pairs in both groups. Conclusion: To achieve the best refractive outcomeafter toric IOL implantation, understanding the differences in keratometric valuesbetween instruments and in calculated astigmatic power among toric calculator programs is necessary. Moreover, systemic analysis of each toric calculator in conjunctionwith postoperative data is required.
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