Global eye care company Alcon highlights the publication of a large retrospective study reflecting the real-world clinical practice in cataract surgery. The research highlights the significant burden of preoperative astigmatism that tends to worsen following cataract surgery with a standard monofocal intraocular lens (IOL), while astigmatism corrective procedures such as using toric IOLs are infrequently performed.
Published in British Journal of Ophthalmology, the study findings show that 78% of eyes presented for cataract surgery had at least minimal clinically relevant astigmatism of 0.5D. The study sampled 110,468 eyes from 76,910 patients aged 65 and older from eight NHS ophthalmology clinics in the UK, and aims to reflect real world clinical practice in terms of patient visits, treatment decisions and data collection.
A substantial proportion of eyes have more severe astigmatism of at least 1.0D (42%) and 2.0 D (11%). After surgery, refraction cylinder measurements were available for 39,744 (36%) eyes receiving standard monofocal IOLs, of which 90% had post-operative astigmatism ≥0.5D and 58% ≥1.0D. Toric IOLs or additional surgical procedures such as limbal relaxing incisions or opposite clear corneal incisions to reduce astigmatism were used in less than 1% of cases.
Results also indicated that astigmatism burden is not reduced after surgery with implantation of standard monofocal IOLs. It was also indicated that uncorrected distance visual acuity worsens as residual astigmatism increases – which suggests that if left uncorrected, astigmatism can significantly affect patients’ visual outcomes limiting their quality of life. However, in the vast majority of cases (>99%) patients did not receive astigmatism corrective co-procedures.
To address the disability related to poor vision for patients with pre-operative astigmatism, some European health authorities such as Poland and Hungary have recognized the value of toric lenses by voting in favour of their reimbursement. Moreover, after a thorough review of evidence, the French National Authority for Health (HAS), an independent public scientific authority in Europe that evaluates healthcare products, procedures, services and technologies from a medical and economic standpoint, issued an opinion last year recommending the use of Alcon toric IOL vs monofocal IOLs in the interest of public health.
Read the full news release from Alcon.