The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital
Abstract Aims To determine if a standardised Toric Allocation Pathway (TAP) improved visual and refractive outcomes for patients undergoing cataract surgery at a tertiary referral teaching hospital. Methods Demographic, visual, and refractive data from all patients who underwent cataract surgery and...
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BMC
2025-03-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-025-03907-1 |
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| author | Muhammad Azaan Khan Dominic McCall Chameen Samarawickrama |
| author_facet | Muhammad Azaan Khan Dominic McCall Chameen Samarawickrama |
| author_sort | Muhammad Azaan Khan |
| collection | DOAJ |
| description | Abstract Aims To determine if a standardised Toric Allocation Pathway (TAP) improved visual and refractive outcomes for patients undergoing cataract surgery at a tertiary referral teaching hospital. Methods Demographic, visual, and refractive data from all patients who underwent cataract surgery and toric intraocular lens (IOL) insertion with an emmetropic target between January 2015 and December 2019 were retrospectively collected and separated into pre-TAP and TAP groups. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), postoperative spherical equivalent refraction (SER) and postoperative cylinder were compared using multivariate regression analysis and Mann-Whitney U testing. Results A total of 118 eyes were divided into pre-TAP (n = 59, 50%) and TAP (n = 59, 50%) groups. Case-mix and surgeon rank was comparable between the two groups (all variables p > 0.05). The TAP group outperformed the pre-TAP group in postoperative mean UDVA (6/7.5 ± 0.13 LogMAR vs. 6/9 ± 0.19 LogMAR, p = 0.049, respectively) and residual cylinder (0.47 ± 0.54D vs. 0.87 ± 0.78D, p < 0.001). As well, the TAP group was more consistent, with significantly smaller standard deviations for all outcomes. Consequently, a higher proportion of patients achieved a SER of ≤ 0.5D from emmetropia in the TAP group (78% vs. 58%, p < 0.001). Conclusions The TAP improved the visual and refractive outcomes for patients with regular astigmatism while minimising inappropriate implantation of toric IOLs. It is ideal for large teaching hospitals and provides a framework for developing surgeons in correctly selecting patients who would most benefit from toric IOLs. |
| format | Article |
| id | doaj-art-5b9b41bad05442d3b1e81f980d03781b |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | BMC Ophthalmology |
| spelling | doaj-art-5b9b41bad05442d3b1e81f980d03781b2025-08-20T01:57:49ZengBMCBMC Ophthalmology1471-24152025-03-012511710.1186/s12886-025-03907-1The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospitalMuhammad Azaan Khan0Dominic McCall1Chameen Samarawickrama2Translational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical ResearchUniversity of SydneyTranslational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical ResearchAbstract Aims To determine if a standardised Toric Allocation Pathway (TAP) improved visual and refractive outcomes for patients undergoing cataract surgery at a tertiary referral teaching hospital. Methods Demographic, visual, and refractive data from all patients who underwent cataract surgery and toric intraocular lens (IOL) insertion with an emmetropic target between January 2015 and December 2019 were retrospectively collected and separated into pre-TAP and TAP groups. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), postoperative spherical equivalent refraction (SER) and postoperative cylinder were compared using multivariate regression analysis and Mann-Whitney U testing. Results A total of 118 eyes were divided into pre-TAP (n = 59, 50%) and TAP (n = 59, 50%) groups. Case-mix and surgeon rank was comparable between the two groups (all variables p > 0.05). The TAP group outperformed the pre-TAP group in postoperative mean UDVA (6/7.5 ± 0.13 LogMAR vs. 6/9 ± 0.19 LogMAR, p = 0.049, respectively) and residual cylinder (0.47 ± 0.54D vs. 0.87 ± 0.78D, p < 0.001). As well, the TAP group was more consistent, with significantly smaller standard deviations for all outcomes. Consequently, a higher proportion of patients achieved a SER of ≤ 0.5D from emmetropia in the TAP group (78% vs. 58%, p < 0.001). Conclusions The TAP improved the visual and refractive outcomes for patients with regular astigmatism while minimising inappropriate implantation of toric IOLs. It is ideal for large teaching hospitals and provides a framework for developing surgeons in correctly selecting patients who would most benefit from toric IOLs.https://doi.org/10.1186/s12886-025-03907-1Toric lensAstigmatismCataract surgeryRefractive outcomes |
| spellingShingle | Muhammad Azaan Khan Dominic McCall Chameen Samarawickrama The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital BMC Ophthalmology Toric lens Astigmatism Cataract surgery Refractive outcomes |
| title | The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital |
| title_full | The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital |
| title_fullStr | The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital |
| title_full_unstemmed | The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital |
| title_short | The Toric Allocation Pathway (TAP): outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital |
| title_sort | toric allocation pathway tap outcomes of a standardised pathway for toric lens allocation at a tertiary referral hospital |
| topic | Toric lens Astigmatism Cataract surgery Refractive outcomes |
| url | https://doi.org/10.1186/s12886-025-03907-1 |
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