Evidence map›Paper›PMID 42544168›Full record

ArticleClinical ophthalmology (Auckland, N.Z.)2026

Aberrometric and Visual Outcomes Following Planned Axis Flip versus No Axis Flip During Toric Intraocular Lens Implantation: A Comparative Observational Study.

Alicia C Espinosa-Moreno, Leire Irusteta-Jiménez, Daniela Pulido-London, Azyadeh Camacho-Ordonez

Abstract read
In one paragraph

Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

4 authors.

Alicia C Espinosa-MorenoAnterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico.ORCID 0009-0009-2836-1629
Leire Irusteta-JiménezAnterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico.ORCID 0009-0009-3231-2942
Daniela Pulido-LondonAnterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico.ORCID 0000-0002-8143-3558
Azyadeh Camacho-OrdonezAnterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico.ORCID 0000-0002-6531-9288

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To compare postoperative aberrometric and visual outcomes between eyes with and without a planned astigmatic axis flip after toric intraocular lens (IOL) implantation. Setting: Instituto de Oftalmologia Conde de Valenciana, Mexico City, Mexico. Design: Comparative observational study. Methods: This study included patients who underwent uneventful cataract surgery with toric IOL implantation to minimize residual astigmatism, eyes were classified into undercorrection without an axis flip and an overcorrection with an axis flip. Postoperative evaluation included uncorrected and best-corrected visual acuity, spherical equivalent refraction, and aberrometry using the Pentacam AXL Wave (Oculus Optikgeräte GmbH). Aberrometric parameters included total higher-order aberrations (HOA), coma, spherical aberration (SA), and trefoil. Intergroup comparisons were performed using independent-samples t-tests with Benjamini-Hochberg false discovery rate correction for multiple comparisons. Multivariate linear regression analyses were performed adjusting for age, sex, preoperative astigmatism magnitude and type, IOL model, and axial length. A p-value < 0.05 was considered statistically significant. Results: Eighty eyes of 80 patients were analyzed (mean age of 67.16 ± 11.49 years). There were no significant differences between planned axis flip and no-axis flip groups in uncorrected distance visual acuity (p = 0.628), best-corrected distance visual acuity (p = 0.685), or spherical equivalent refraction (p = 0.455). Total HOA, coma, and SA were comparable between groups (all p > 0.05). In contrast, the planned axis flip group demonstrated a higher trefoil aberration compared with the no-axis flip group (0.15 ± 0.06 µm vs 0.08 ± 0.09 µm; p < 0.001). Multivariate linear regression analysis confirmed that axis flip was independently associated with higher trefoil aberration (β = 0.075, 95% CI [0.038, 0.111]; p = 0.0001), with no significant associations found for any other aberrometric or visual outcome. Conclusion: Planned astigmatic axis flip during toric IOL implantation was not associated with differences in postoperative visual outcomes, despite a significant increase in trefoil aberration. These findings suggest that planned axis flip does not appear to compromise visual or aberrometric performance and may be considered among the available strategies to minimize residual astigmatism. Prospective studies incorporating functional vision metrics and longer follow-up are needed to confirm these findings.

Indexed as

astigmatism axis flipcataract surgeryocular aberrationspentacam AXL wavetoric intraocular lenstrefoil

Identifiers

PMID42544168
PMCPMC13429128

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.