Comparison between Toric and Non-Toric Intraocular Lenses in Patients with Corneal Astigmatism: A One-Year Multicenter Study

Objective: To compare the clinical results obtained with a toric intraocular lens (IOL) and non-toric IOL in eyes with corneal astigmatism. Methods: This multicenter retrospective study included eyes with corneal astigmatism ranging from 0.75 diopter (D) to 3.00 D that were implanted with a toric IOL and a non-toric IOL. Non-toric IOLs were implanted before toric IOLs were approved, and the eyes were divided into three groups (T3, T4, or T5) depending on the preoperative degree of corneal astigmatism. Residual refractive cylinder, uncorrected distance visual acuity (UDVA), and contrast sensitivity were compared more than 1 year after implantation. Results: The toric group included 149 eyes (mean patient age, 73.7 ± 7.9 years standard deviation, SD) and the non-toric group included 121 eyes (mean patient age, 76.2 ± 5.9 years). One year postoperatively, the respective residual refractive cylinder values and ± SD of the toric/non-toric groups were -0.61 ± 0.43/-1.45 ± 0.98 D (all eyes), -0.58 ± 0.42/-1.14 ± 0.70 D (T3), -0.59 ± 0.42/-1.63 ± 0.99 D (T4), and -0.67 ± 0.47/-2.18 ± 1.27 D (T5). The respective logarithm of the minimum angle of resolution UDVA values was 0.00 ± 0.12/0.16 ± 0.20 (all eyes), 0.00 ± 0.11/0.13 ± 0.18 (T3), 0.00 ± 0.13/0.25 ± 0.23 (T4), and 0.00 ± 0.11/0.17 ± 0.16 (T5). The toric group had better cylinder and UDVA outcome values; the difference between the groups reached significance (p<0.0001). In the toric group, the IOL rotation after implantation was 4.3 ± 4.0 degrees. Conclusion: Toric IOLs reduced the residual refractive cylinder in cases with corneal astigmatism between 0.75 and 3.00 D, and this effect was similar among different toric models. Toric IOLs are useful to improve the UDVA after cataract surgery.