[Toric intraocular lenses for correction of persistent corneal astigmatism after penetrating keratoplasty]

Abstract

Purpose: Cataract extraction with implantation of toric intraocular lenses (tIOL) is a new surgical option for correction of residual astigmatism following penetrating keratoplasty and cataract with only minimal direct manipulation of the graft.

Patients and methods: We implanted an individually manufactured backtoric tIOL in 11 eyes of 9 patients. TIOL power calculation was done using vergence transformation in a paraxial space.

Results: Implantation and intraoperative alignment of tIOL were uneventful in all patients. Uncorrected visual acuity increased from 0.1+/-0.06 preoperatively to 0.47+/-0.18 (p=0.006) postoperatively. Best-corrected visual acuity changed from 0.23+/-0.18 preoperatively to 0.6+/-0.14 postoperatively (p=0.002). The refractive cylinder could be reduced from 7.0+/-2.6 D to 1.63+/-1.5 D (p=0.001) after surgery. We observed a small mean deviation from the target axis of 4.1+/-2.9 degrees (0-8 degrees ) after a mean follow-up time of 3.5 (2-7) months.

Conclusion: TIOL implantation is a promising option for correction of high astigmatism following penetrating keratoplasty with only minimal direct surgical manipulation of the graft. Regular and symmetric corneal topography is essential for successful implantation of tIOL.