ASCRS 2024: Ultra-low cylinder powered toric versus non-toric lenses in cataract surgery

At this year's ASCRS meeting in Boston, Massachusetts, we spoke with Adam Muzychuk, MD, BSc, FRCSC. He told Ophthalmology Times Europe about his presentation, titled "Outcomes of an ultra-low cylinder powered (0.90) toric versus non-toric in low astigmatic patients undergoing cataract surgery." In this video, he provides highlights from the lecture.

Editor's note: The below transcript has been lightly edited for clarity

I'm Adam Muzychuk. I'm fellowship-trained in cornea and external disease. I practice in private practice in Calgary, Alberta and I have university affiliation with the University of Calgary. I'm here today to talk about outcomes of a an ultra-low cylinder power toric IOL versus a non-toric control. A large study in 2021 demonstrated that 0.5 diopters or more of refractive astigmatism is visually significant.

This is a landmark paper that said that we should be maximally treating all refractive cylinder where we can. What's not known is, even if we should treat it, how accurately are we able to, and can we do it with the equipment that we already have in our office? We utilize the IOLMaster 500 [ZEISS Meditec] along with the Storz Bubble Marker [Bausch + Lomb], which, in other words, is very basic equipment that is available essentially to any surgeon who's deploying toric lenses. In terms of outcomes of the study, patients who underwent implantation with the 0.90 toric had a significantly greater reduction in astigmatism postoperatively, almost three times as many eyes had plano cylinder outcomes, twice as many had outcomes within a quarter diopter, and 92.2% of eyes with the 0.90 toric were within a half a diopter of plano cylinder.

The importance of this study is there are still regulatory regions, such as the United States, where 0.90 diopter torics do not exist due to regulatory requirements that have not yet passed, as well as 1.0 diopters. The importance of this is that these lenses work. They're highly effective in reducing visually significant postoperative cylinder, where maximal correction is shown to have important effects for vision. Where [these lenses are] approved, we have better visual performance for patients, fewer laser enhancements, and overall more satisfied patients.