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

IntroductionImplantation 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.MethodsA 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.ResultsThe 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 degrees +/- 2.42 degrees vs. 0.23 D@68 degrees +/- 2.50 degrees, 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 degrees +/- 0.57 degrees vs. 0.03 D@127 degrees +/- 0.53 degrees, 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).ConclusionThe 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.

Automated summary

This study aimed to evaluate the outcomes of toric IOL implantation in patients with Fuchs endothelial corneal dystrophy (FECD). The results showed no significant difference in visual acuity and refractive error between FECD patients and healthy control patients. Therefore, FECD patients without corneal edema can be considered for toric IOLs.