Toric Intraocular Lenses in the Correction of Astigmatism During XXXX Surgery: A Systematic Review and Meta-analysis.

@entity940 @entity1 @entity231
TOPIC: We performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during @entity231 surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were evaluated as surgical complications and residual @entity940 . CLINICAL RELEVANCE: Postoperative @entity940 is an important cause of suboptimal UCDVA and need for distance spectacles. Toric IOLs may correct for preexisting corneal @entity940 at the time of surgery. METHODS: We performed a systematic literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (   relaxing incision) in @entity1 with regular corneal @entity940 and age-related @entity231 . We assessed the risk of bias using the Cochrane Risk of Bias tool. We assessed the quality of evidence across studies using the GRADE profiler software (available at: www.gradeworkinggroup.org). RESULTS: We included 13 RCTs with 707 eyes randomized to toric IOLs and 706 eyes randomized to non-toric IOLs; 225 eyes had a relaxing incision. We found high-quality evidence that UCDVA was better in the toric IOL group (logarithm of the minimum angle of resolution [logMAR] mean difference,  -0.07; 95% confidence interval [CI],  -0.10 to  -0.04) and provided greater spectacle independence (risk ratio [RR], 0.51; 95% CI, 0.36-0.71) and moderate quality evidence that toric IOL implantation was not associated with an increased risk of complications (RR, 1.73; 95% CI, 0.60-5.04). Residual @entity940 was lower in the toric IOL group than in the non-toric IOL plus relaxing incision group (mean difference, 0.37 diopter [D]; 95% CI,  -0.55 to  -0.19). CONCLUSIONS: We found that toric IOLs provided better UCDVA, greater spectacle independence, and lower  amounts of residual @entity940 than non-toric IOLs even when relaxing incisions were used.
