Efficacy comparison between toric intraocular lens and aspheric intraocular lens plus steep-axis incision in cataract patients with low corneal astigmatism.

BACKGROUND The present study aimed to evaluate and compare the efficacy of toric intraocular lens (IOL) implantation and aspheric IOL implantation with steep-axis incision for correcting mild to moderate corneal astigmatism in cataract patients. METHODS A prospective, single-center, open label, randomized, two-arm study was designed. Cataract patients with corneal astigmatism of 1.0-2.0D were enrolled and divided into test and control groups. The test group had the AcrySof® IQ Toric IOL implanted and the control group had the AcrySof® IQ IOL implanted with a steep-axis corneal incision. All patients underwent examinations of uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), subjective refraction, and corneal astigmatism before surgery and at the 1-day, 1-month, and 3-month follow-ups. Vector astigmatism analysis was evaluated using the Alpins method. RESULTS We enrolled 26 eyes of 20 patients in the study, with 13 eyes in each group. The test group had better vision than the control group at the 3-month follow-up and had more cases with a UCDVA of 20/20 (10/13 vs. 4/13). The surgically induced astigmatism (SIA) vector of the test group was higher than that of the control group (1.22±0.64 vs. 0.84±0.45). The correction index of the test group was closer to 1 compared to that of the control group (0.7 vs. 0.46). Approximately 85% of patients in the test group had an angle of error within -15° to 15°. However, only 23% of patients in the control group were within that range. CONCLUSIONS Though steep-axis corneal incision was cost-saving and easy-to perform, its astigmatismcorrecting efficacy was not as good as the Toric IOL implantation for cataract patients with low to moderate corneal astigmatism.