Clinical outcomes and in vivo wavefront analysis of a toric transcleral plug-fixated intraocular lens using a pyramidal sensor aberrometer.

PURPOSE: To evaluate the visual, refractive, and aberrometric outcomes of a toric (T) FIL-SSF intraocular lens (IOL) implanted in aphakic eyes lacking capsular support.

SETTING

Ospedale Piero Palagi and Azienda Ospedaliera Universitaria Careggi, Florence, Italy.

DESIGN

Multicenter prospective observational case series.

METHODS

Aphakic eyes with regular corneal astigmatism >1 diopter (D) underwent sutureless transscleral fixation of a T FIL-SSF IOL. Preoperative assessment included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, corneal tomography, and biometry. Postoperative visits occurred at 1 day; 7 days; and 1 month, 3 months, and 6 months. At 6 months, vector astigmatism analysis, wavefront aberrometry, and IOL alignment were performed.

RESULTS

15 eyes from 12 patients completed the 6-month follow-up. Mean UDVA improved from 0.96 ± 0.25 to 0.19 ± 0.10 logMAR and CDVA from 0.41 ± 0.32 to 0.04 ± 0.05 logMAR (both P < .01). Mean postoperative spherical equivalent prediction error was -0.12 ± 0.54 D. Mean absolute corneal astigmatism decreased from 2.15 ± 0.54 D to a mean refractive astigmatism of 0.73 ± 0.48 D. Wavefront aberrometry showed total astigmatism of 0.36 ± 0.28 µm, with mean total higher-order aberrations of 0.24 ± 0.08 µm. Mean IOL misalignment was 3.33 ± 3.42 degrees, significantly correlated with residual refractive astigmatism (ρ = 0.71 P < .01).

CONCLUSIONS

T FIL-SSF IOL implantation provided substantial improvements in visual acuity, predictable refractive outcomes, and significant cylinder reduction in aphakic eyes with corneal astigmatism lacking capsular support.