To evaluate vector analysis, rotational stability, and refractive and visual outcome of a new toric intraocular lens (IOL) for correction of preexisting corneal astigmatism during routine cataract surgery.
In this prospective, interventional case series, 30 toric, aspheric Bi-Flex T toric IOLs (Medicontur Medical Engineering Ltd., Inc., Zsámbék, Hungary) were implanted in 20 consecutive patients with topographic corneal astigmatism between 1.50 and 4.00 diopters (D) and evaluated within the first year after implantation. Appropriate IOL-toric alignment was facilitated by combined imaging/eye tracking technology. Postoperative evaluation included refraction and uncorrected and corrected distance visual acuities (UDVA, CDVA). For each visit, photodocumentation in retroillumination was performed to evaluate toric alignment and potential toric IOL rotation. Vector analysis of refractive astigmatism was performed using the Alpins method.
At 12 months postoperatively, a reduction of the refractive astigmatism from 1.93 ± 0.90 D (range: 0.50 to 4.00 D) to 0.28 ± 0.61 D (range: 0.00 to 1.50 D) could be found, with patients achieving a mean UDVA of 0.06 ± 0.16 logMAR (range: −0.18 to 0.40 logMAR; Snellen 20/20). Intraoperative to 12-month postoperative comparison of IOL axis alignment showed low levels of rotation (0.2° ± 2.41°; range: +4° to −5°). Vector analysis showed target induced astigmatism of 0.60 D @180°, surgically induced astigmatism of 0.80 D @177°, correction index of 1.02 ± 0.25, and a difference vector of 0.30 D @82°.
Implantation of the new Bi-Flex T IOL was a safe, stable, and effective method to correct preexisting regular corneal astigmatism during cataract surgery.
[J Refract Surg. 2015;31(8):513–520.]
From the Department of Ophthalmology, Paracelsus Medical University Salzburg, Salzburg, Austria.
Supported by the “Fuchs-Foundation for the Promotion of Research in Ophthalmology,” Salzburg, Austria. Medicontur Medical Engineering Ltd., Inc. (Zsámbék, Hungary) financially supports the “Fuchs-Foundation” as the clinical research center of the Department of Ophthalmology of the Paracelsus Medical University Salzburg, Salzburg, Austria.
The authors have no financial or proprietary interest in the materials presented herein.
Study concept and design (AKD, GG); data collection (AB, GJ, TR, CS); analysis and interpretation of data (AB, AKD, GG, CS); writing the manuscript (AB, AD); critical revision of the manuscript (AKD, GG, GJ, TR, CS); statistical expertise (AB, AKD); administrative, technical, or material support (GG); supervision (AKD, GG, CS)
Correspondence: Alexander Bachernegg, MD, Department of Ophthalmology, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, A-5020 Salzburg, Austria. E-mail:
Received: October 16, 2014
Accepted: June 17, 2015