Clinical Outcomes of Toric Intraocular Lenses in Patients with Fuchs Endothelial Corneal Dystrophy

• Published in: Ophthalmology and therapy 2023-06, Vol.12 (3), p.1747-1755
• Main Authors: Blau-Most, Michal, Levy, Adi, Assia, Ehud I., Kleinmann, Guy
• Format: Article
• Language: English
• Subjects: Cornea; Dystrophy; Fuchs; Internal Medicine; Intraocular lens; Medicine; Medicine & Public Health; Ophthalmology; Original Research; Toric
• ISSN: 2193-8245; 2193-6528
• DOI: 10.1007/s40123-023-00700-5

Introduction Implantation of toric intraocular lenses (IOLs) in patients with Fuchs endothelial corneal dystrophy (FECD) is still considered relatively contraindicated, without sufficient clinical evidence. Therefore, this study was designed to evaluate the results of toric IOL implantation in patients with FECD. Methods A retrospective case–control study of 28 eyes of FECD patients and 84 eyes of healthy control patients who received toric IOLs during routine cataract surgery was performed. The outcome measures were uncorrected and corrected distance visual acuity, spherical equivalent, and refractive residual astigmatism. Results The mean postoperative uncorrected and corrected distance visual acuity in the FECD eyes compared to the control eyes were 0.15 ± 0.14 vs. 0.13 ± 0.17, respectively ( P  = 0.32), and 0.05 ± 0.08 vs. 0.06 ± 0.10, respectively ( P  = 0.95). The spherical equivalent in the FECD eyes compared to the control eyes was − 0.29 ± 0.43 vs. − 0.21 ± 0.50, respectively ( P  = 0.19). The preoperative corneal centroid astigmatism in the FECD eyes compared to the control eyes was 0.85 D@93° ± 2.42° vs. 0.23 D@68° ± 2.50°, respectively ( P  = 0.43), and the mean preoperative corneal astigmatism magnitude was 2.26 ± 1.1 D vs. 2.28 ± 1.03 D, respectively ( P  = 0.82). A trend toward higher postoperative refractive centroid astigmatism was found in the FECD eyes compared with the control eyes: 0.24 D@28° ± 0.57° vs. 0.03 D@127° ± 0.53°, respectively ( P  = 0.09). However, the mean refractive astigmatism magnitude was similar in FECD eyes and the healthy control eyes: 0.52 ± 0.31 D vs. 0.42 ± 0.31 D, respectively ( P  = 0.44) ( D diopters). Conclusion The postoperative refractive astigmatism (both centroid astigmatism and mean magnitude astigmatism) was no higher than 0.52 D in both groups. Therefore, FECD patients without corneal edema can be considered for toric IOLs.