Correction of moderate corneal astigmatism during cataract surgery: Toric intraocular lens versus peripheral corneal relaxing incisions

Purpose To compare the astigmatism‐reducing effect of a toric intraocular lens (IOL) and peripheral corneal relaxing incisions (PCRIs). Setting Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Design Prospective masked bilateral randomized study. Methods Cataract patients with a preoperative corneal astigmatism of 1.0 to 2.5 diopters (D) were included. All patients received a toric IOL in 1 eye and a nontoric IOL plus a PCRI in the other eye. Postoperative follow‐up was at 1 hour, 1 month, and 6 months. The uncorrected distance visual acuity, corrected distance visual acuity, autorefraction (Topcon RM‐8800), and subjective refraction were recorded. The IOL axis was assessed using retroillumination photographs. Results The study enrolled 60 eyes of 30 patients. The mean astigmatism vector reduction was 1.74 D ± 0.64 (SD) in the toric IOL group and 1.27 ± 0.76 D in the PCRI group; the difference was statistically significant (P=.042). The mean absolute rotation of the toric IOL was 2.5 ± 1.8 degrees (maximum 6.3 degrees) in the first 6 postoperative months. Astigmatism increased in the PCRI group between the 1‐month and 6‐month follow‐up (mean 0.38 ± 0.27 D; maximum 1.00 D) (P<.001). Conclusion Toric IOLs and PCRIs both reduced astigmatism; however, toric IOLs reduced astigmatism to a higher extent and they were more predictable. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.