ArticleOphthalmology and therapy2026
Outcomes of One Dioptre Toric IOL Correction in Low Corneal Astigmatism: A Comparison with Non-toric IOLs.
Article in Ophthalmology and therapy, 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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Abstract
introductionToric 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.
methodsThis 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.
resultsBaseline corneal astigmatism was lower in the non-toric group than in the toric group (median 0.4 versus 0.7 D; P < 0.001), reflecting surgeon selection within the Barrett-recommended 1 D toric population. Postoperative refractive astigmatism was lower in the toric group (mean 0.31 versus 0.36 D; P = 0.022), a difference smaller than the 0.25 D increment in which subjective refraction was recorded, but UDVA was comparable overall (median 79 versus 78 letters; P = 0.122) as was CDVA (median 85 versus 85 letters; P = 0.235). In the with-the-rule (WTR) astigmatism subgroup, UDVA was better with non-toric IOLs (median 80 versus 77 letters; P = 0.002); against-the-rule and oblique subgroups showed no UDVA differences.
conclusionsIn 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.
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