VISUAL PERFORMANCE OUTCOMES IN ATHLETES: A COMPARATIVE STUDY OF TORIC INTRAOCULAR LENSES VS. LIMBAL RELAXING INCISIONS IN REFRACTIVE CATARACT SURGERY

Abstract

Refractive cataract surgery has advanced beyond vision restoration, emphasizing precise astigmatism correction for optimal postoperative visual performance. Astigmatism, affecting nearly 50% of adults over 60, remains a critical factor in achieving superior visual outcomes. This study compares the efficacy of toric intraocular lenses (IOLs) and limbal relaxing incisions (LRIs) in correcting astigmatism during cataract surgery, with implications for enhancing visual performance in athletes and active individuals. Methods: This retrospective study analyzed 100 eyes from patients undergoing cataract surgery with astigmatism correction between July 2022 and May 2024. Patients were divided into two groups: the toric IOL group (52 eyes) and the LRI group (48 eyes). Primary outcomes assessed included uncorrected distance visual acuity (UCVA), best-corrected distance visual acuity (BCVA), corneal astigmatism, surgically induced astigmatism (SIA), and higher-order aberrations (HOAs). Anterior segment parameters, including intraocular pressure, anterior chamber volume, and corneal thickness, were also measured. Results: Both groups showed significant postoperative improvements in UCVA and BCVA. The toric IOL group achieved better UCVA (P < 0.01), though BCVA remained similar across groups (P > 0.05). Corneal astigmatism was reduced in both groups, with the toric IOL group showing greater reduction (P < 0.01). SIA values were comparable, while the toric IOL group exhibited fewer HOAs and minimal changes in anterior segment parameters. Conclusion: Both toric IOL implantation and LRIs effectively correct astigmatism during cataract surgery. However, toric IOLs offer more predictable outcomes, better UCVA, and reduced corneal distortion, making them especially suitable for athletes and physically active individuals requiring optimal visual performance. These findings underscore the clinical advantage of toric IOLs in refractive cataract surgery for enhancing both visual acuity and overall ocular health.