Purpose
To evaluate the safety, predictability and efficacy of toric intraocular lens (IOL) placement after cataract surgery to treat high amounts of corneal astigmatism often present after penetrating keratoplasty (PKP).
Methods
Patients with cataracts in the setting of high corneal astigmatism after penetrating keratoplasty were treated with cataract extraction and toric IOL placement. This was a retrospective study of consecutive eyes at an academic medical center. Outcome measures were uncorrected visual acuity (UDVA), corrected visual acuity (CDVA) and astigmatism (manifest and topographical).
Results
20 eyes from 16 patients were studied. Mean patient age was 61.5 years [Stdev 9.3] and mean age of patients PKP at time of cataract surgery and toric IOL placement was 31.3 months [52.2]. Mean UDVA improved from LogMar 0.88 [Stdev 0.49] to 0.22 [0.26], P= 0.0003. Mean spectacle CDVA improved from LogMar 0.32 [ 0.14] to 0.09 [0.14], P=0.0004. Despite a mean pre-operative topographical astigmatism of 4.9 diopters [ 2.1], the mean post-operative manifest astigmatism was 1.54 diopters [1.3]. No episode of graft failure or rotational instability of the IOL was noted on post-operative follow up of 14.3 months [13.0].
Conclusions
Toric IOLs are a safe, predictable and effective method for reduction of post-keratoplasty corneal astigmatism.
Keywords: 682 refractive surgery: other technologies •
567 intraocular lens •
479 cornea: clinical science