Toric intraocular lenses for cataract patients in the NHS
Research type
Research Study
Full title
Toric intraocular lenses for cataract patients with high astigmatism in a public health care setting: A randomised, controlled study to compare visual performance, refractive outcome, and patient satisfaction with the use of “off the shelf” toric lenses, with a set cylindrical correction of either 1.75 or 3.50 diopters, and combined limbal relaxing incisions and/or off-axis IOL rotation, with fully targeted toric intraocular lens correction.
IRAS ID
265865
Contact name
David O'Brart
Contact email
Sponsor organisation
Guy's & St Thomas' Foundation NHS Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Astigmatism is a usually physiological disorder where the cornea becomes more rugby-ball shaped, causing the individual to have blurred vision requiring corrective spectacles to see clearly. About 15% of individuals in a normal population have at least 2 diopters of astigmatism, which will remain after routine cataract surgery with a standard spherical intraocular lens (IOL).
The implantation of toric IOLs (instead of standard spherical monofocal IOLs) can compensate for pre-existing corneal astigmatism. Toric lOLs have shown to be safe and effective and are used routinely in private practice to optimise visual outcomes after cataract surgery. However, preparing for cataract surgery with toric IOLs is time-consuming and they are more expensive than the standard monofocal lenses. Hence, they are not used routinely for cataract surgery in the NHS.
The aim of this study is to evaluate a simplified, more cost-effective procedure for the use of toric intraocular lenses (within their CE approved functions), with a focus on suitability for NHS cataract surgery. Eligible participants will be randomised, receiving a toric IOL with either a 1.75 or 3.50 diopter (D) correction (“off the shelf” toric IOLs) depending on the degree of pre-operative astigmatism, or a toric IOL individually tailored for each patients’ precise degree of corneal astigmatism. With the “off the shelf” toric IOL group the correction of the astigmatic refractive error will be refined with the use of adjunctive limbal relaxing incisions (LRIs) and/or off axis rotation of the toric IOL so the full amount of corneal astigmatism can be targeted. The clinical outcomes will then be compared between the 2 groups.
This simplified use of toric lenses within the public healthcare sector has the potential to provide astigmatic cataract patients with much better unaided vision, reduced spectacle dependence, better living quality and cheaper costs for spectacles (lower cumulative financial burden).REC name
Wales REC 6
REC reference
19/WA/0272
Date of REC Opinion
3 Oct 2019
REC opinion
Further Information Favourable Opinion