Abstract
Introduction
Toric intraocular lenses (IOLs) effectively correct astigmatism, but their benefit at low levels of corneal astigmatism remains uncertain. We compared visual and refractive outcomes between non-toric and toric IOLs in patients with low corneal astigmatism.Methods
This was a real-world comparative cohort study. We analysed 804 eyes undergoing cataract surgery for which the Barrett Toric Calculator recommended an IOL with 1 dioptre (D) of toricity. Postoperative uncorrected distance visual acuity (UDVA), refractive astigmatism and corrected distance visual acuity (CDVA) were compared between non-toric and toric IOL groups, with pre-specified subgroup analyses by astigmatism magnitude and axis.Results
Baseline corneal astigmatism was lower in the non-toric group than in the toric group (median 0.4 versus 0.7 D; P Conclusions
In eyes with low corneal astigmatism, 1 D toric IOLs reduced postoperative refractive astigmatism, particularly in eyes with against-the-rule (ATR) astigmatism and at higher levels of baseline corneal astigmatism, but did not improve uncorrected or corrected visual acuity overall. In eyes with WTR astigmatism, non-toric IOLs achieved better uncorrected vision. These findings suggest a statistically significant refractive benefit of low-power toric IOLs that is most evident in ATR eyes, while the functional visual benefit in this population remains uncertain and axis-dependent.