IOL + LRI vs Toric IOL for corneal astigmatism during cataract surgery
Research type
Research Study
Full title
Prospective Randomised Controlled Trial comparing Monofocal Intraocular Lenses and Limbal Relaxing Incisions with Toric Intraocular Lenses for correcting Astigmatism up to 2.5 Diopters during standard cataract surgery.
IRAS ID
135670
Contact name
Mayank A Nanavaty
Contact email
Clinicaltrials.gov Identifier
Research summary
This study will compare toric intra-ocular lens (IOL) with monofocal intraocular lenses + limbal relaxing incisions (LRI) in correcting astigmatism in patient undergoing standard cataract surgery.
Astigmatism is unequal curvature of the eye; the eye is oval rather than spherical. Uncorrected astigmatism of greater than approximately 0.75 diopters (D) can cause visual blurring, ghosting of images or halos. Over 20% of patients undergoing cataract surgery have astigmatism which is likely to have been corrected by spectacles.
Cataract surgery involves the replacement of the natural opacifying crystalline lens with a clear artificial plastic intraocular lens (IOL). The lens power can be selected to correct the patient’s glasses prescription. The most widely used IOLs only correct glasses at one distance ie. either near or distance. Residual astigmatism after cataract surgery will need glasses for correction which is undesirable for many patients.
Limbal relaxing incisions (LRI) are circumferential partial thickness cuts to the clear window of the eye (cornea) during surgery. These LRIs can correct corneal astigmatism and have no additional risk of complications.
Alternatively, toric IOLs are available which correct astigmatism inside the eye. They have been available for routine use in the last few years; technology has markedly improved and the lenses have become cheaper.
Studies have suggested toric IOLs provide better vision after cataract surgery than the regular IOLs + LRIs. Toric IOL are widely used in the private practice and increasingly in the NHS. LRIs are cost effective for treating astigmatism however their predictability is believed to be lower than toric IOLs. As there are no randomised controlled trials comparing the outcomes between stndard NHS monofocal lenses + LRIs vs toric IOLs. This research will address this gap in knowledge and accordingly from this research future practice will be able to provide treatment to patients with information about the best outcomes.
REC name
London - London Bridge Research Ethics Committee
REC reference
14/LO/0440
Date of REC Opinion
22 May 2014
REC opinion
Further Information Favourable Opinion