Vision and Balance Changes After Bilateral Implantation of Toric IOLs

Cataracts are the major cause of blindness in the world. Cataract surgery, being the most performed surgery in the world today, provide correction by extracting the natural lens from its capsular bag and replaced by an artificial intraocular lens (IOL) implantation. In the UK, almost all patients undergoing cataract surgery by the NHS are given monofocal intraocular lenses (IOLs) which do not correct corneal astigmatic error. It is estimated that around 20% of the population has over 1.50DC of corneal astigmatism. Uncorrected astigmatism not only increase spectacle dependency and reduce quality of life post surgically, but it also adversely affects the overall economic costs. Specialised toric IOLs offer the opportunity to correct pre-existing corneal astigmatism. Previous work has shown a link between reduced vision and balance or mobility. Full correction of refractive error may have greater impact on lifestyle than previously thought.

Inclusion Criteria:bilateral significant corneal astigmatism >1.0Don waiting list for bilateral cataract surgery in NHSExclusion Criteria:pre-existing eye pathology which may be aggravated by intraocular implantprevious intraocular/ corneal surgeryHistory of uveitis, glaucoma, proliferative diabetic retinopathy or IDDM, pseudoexfoliation, macular degeneration that may affect potential best corrected visual acuity of 20/40 or betterMicropthalmiacorneal decompensation or endothelial insufficiencypars planitishigh myopiaparticipants using a systematic medication that is known to cause ocular side effectsparticipated in a concurrent clinical trial or have participated in an opthalmology clinical trial within the last 30 daysunable or not willing to cooperate for the follow up periodpregnant womenunable to give informed consentunable to walk with or without walking aids independently for at least 20munable to walk up/down stairs independently using aids or handrail