Comparison of clinical outcomes and capsular bag stability between plate-haptic and C-loop haptic toric IOLs in cataract eyes

Abstract

Objective

To compare the refractive outcomes and rotational stability between a plate-haptic toric intraocular lens (IOL) and a C-loop haptic toric IOL in cataract eyes with corneal astigmatism.

Methods

This was a prospective, randomised, controlled study. 72 patients (72 eyes) with cataracts and corneal astigmatism were randomly divided into 2 groups (Group A: C-loop haptic; Group B: plate-haptic) and underwent phacoemulsification combined with toric IOL implantation at Changzhou Third People's Hospital. The uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA) and residual astigmatism (RAS) were assessed at 1 day, 1 week, 1 month, 3 months postoperatively, while the degree of toric IOL rotation was recorded at 1 week, 1 month, 3 months postoperatively. The correlation between IOL rotation and RAS, intraocular pressure (IOP), axial length (AL), anterior chamber depth (ACD), and white-to-white (WTW) distance was analyzed. Patient satisfaction was evaluated in both groups 3 months postoperatively. Independent sample t-test was used for comparison between the two groups, and repeated measures analysis of variance (ANOVA) was employed to assess changes in IOL rotation, RAS and visual acuity at various postoperative time points. Pearson correlation analysis was used to assess the relationships between continuous variables.

Results

A total of 72 eyes (36 per group) were included with no significant difference in patient characteristics between the two groups. The average postoperative degree of toric IOL rotation in Group A at 1-week, 1-month, and 3-month was greater than that in Group B (8.38 ± 4.19°vs 4.45 ± 2.40°, 7.78 ± 6.87°vs 3.95 ± 2.14°, and 8.23 ± 4.72°vs 4.09 ± 2.12°, respectively, all P < 0.05). Postoperative RAS and spherical equivalent (SE) were better in Group B than Group A (all P < 0.05). More patients in Group B achieved RAS within 0.50D than in Group A (23 vs 14). RAS was positively correlated with IOL rotation in both groups. Patients in Group B achieved a better UDVA than in Group A, whereas no statistical difference in BDVA was found between groups. No significant correlations were found between toric IOL rotation and IOP, AL, ACD, and WTW distance either in Group A or Group B (all P > 0.05). Patient satisfaction was referred as high or very high by 75.0% of patients in Group B compared to 50.0% in Group A. More patients in Group B gained distance spectacle independence than Group A (20 vs 10). No eye-threatening complications were observed intraoperatively or postoperatively. No patients required IOL repositioning during follow-up.

Conclusions

The plate-haptic toric IOL demonstrated superior rotational stability and astigmatism correction than C-loop haptic toric IOL within 3 months postoperatively, which implied that the plate-haptic toric IOL might be a better choice for patients with cataract and corneal astigmatism.