Clinical results after spherotoric intraocular lens implantation using the bag-in-the-lens technique

PURPOSE: To evaluate the clinical results after implantation of a spherotoric intraocular lens (IOL) using the bag-in-the-lens (BIL) technique. SETTING: Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium. DESIGN: Evidence-based manuscript. METHODS: Consecutive eyes with cataract and corneal astigmatism had implantation of a spherotoric BIL intraocular lens (IOL. The IOL was centered based on the patient's pupillary entrance using Purkinje reflexes of the surgical microscope light. RESULTS: The study enrolled 52 eyes of 35 patients (23 women) with corneal astigmatism ranging from 0.90 to 6.19 diopters (D). The toric power was between 1.00 D and 8.00 D. One-third of eyes had an additional ocular comorbidity (including amblyopia) that could influence the clinical outcomes; 5.2% had an irregular astigmatism up to 15 degrees. Twelve eyes had high myopia (axial length [AL] >26 mm) and 5 eyes, high hyperopia (AL <21 mm). The mean preoperative corrected distance visual acuity was 0.58 +/- 0.25 (SD). Postoperatively, the uncorrected distance visual acuity (UDVA) was 0.5 or better in 92% of eyes, the mean UDVA was 0.85 +/- 0.21 D, the mean magnitude of error was 0.05 +/- 0.49 D, and the mean angle of error was 0.29 +/- 0.89 degree. Astigmatism correction was successful in 82% of eyes. CONCLUSION: Spherotoric BIL IOL implantation yielded outcomes similar to those with other spherotoric IOLs, even in eyes with ocular comorbidity or irregular astigmatism up to 15 degrees.