Combined 25-gauge microincision vitrectomy and toric intraocular lens implantation with posterior capsulotomy

Comparison of Postoperative Axial Rotation of the Toric Intraocular Lens in Cataract Surgery Combined with Vitrectomy versus Cataract Surgery Alone

INTRODUCTION

This study compared the postoperative axial rotation of the toric intraocular lens (T-IOL) after cataract surgery combined with vitrectomy versus cataract surgery alone.

METHODS

This retrospective, non-randomized, observational study enrolled patients who underwent cataract surgery combined with vitrectomy in one eye and cataract surgery alone in the contralateral eye. AcrySof Toric IOLs (Alcon Laboratories) were implanted in both eyes of the same patient. The axial rotation of the T-IOL was analyzed 3 months postoperatively using photographs obtained during and after surgery. In the combined group, T-IOL axial alignment was performed before vitrectomy. Preoperative corneal astigmatism and postoperative residual astigmatism were also compared in both groups.

RESULTS

This study examined 36 eyes of 18 patients (74.7 ± 6.8 years). The axial rotation was 2.94 ± 1.70° in the cataract group versus 3.06 ± 2.34° in the combined group 3 months postoperatively, and the difference lacked significance (p = 0.98). In the combined group, the mean axial rotation during surgery was 2.17 ± 1.80°. Axial rotation within 5° was observed in 17 of 18 eyes (94.4%) in the cataract group and 16 of 18 eyes (88.9%) in the combined group, with no significant difference (p = 0.54). The comparison of postoperative residual astigmatism with preoperative corneal astigmatism revealed a significant improvement from 1.49 ± 0.40 D to 0.39 ± 0.47 D in the cataract group (p < 0.0001) and from 1.61 ± 0.40 D to 0.42 ± 0.43 D in the combined group (p < 0.0001).

CONCLUSIONS

The postoperative axial rotation of the T-IOL in eyes that underwent cataract surgery combined with vitrectomy was stable and comparable to that of eyes that underwent cataract surgery alone.