April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Treatment of high astigmatism with customized high toric intraocular lens implantation
Author Affiliations & Notes
  • Alejandro Navas
    Inst of Ophthal "Conde de Valenciana", Mexico City, Mexico
  • Karla Patricia Lopez
    Inst of Ophthal "Conde de Valenciana", Mexico City, Mexico
  • Arturo J Ramirez-Miranda
    Inst of Ophthal "Conde de Valenciana", Mexico City, Mexico
  • Enrique O Graue
    Inst of Ophthal "Conde de Valenciana", Mexico City, Mexico
  • Footnotes
    Commercial Relationships Alejandro Navas, Alcon Laboratories (F), Carl Zeiss Meditec (C), STAAR Surgical (F); Karla Lopez, None; Arturo Ramirez-Miranda, None; Enrique Graue, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4194. doi:
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      Alejandro Navas, Karla Patricia Lopez, Arturo J Ramirez-Miranda, Enrique O Graue; Treatment of high astigmatism with customized high toric intraocular lens implantation. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4194.

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      © ARVO (1962-2015); The Authors (2016-present)

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To describe the visual and refractive outcomes of customized high toric intraocular lens implantation in patients with high amounts of corneal astigmatism.


A retrospective review of clinical consecutive cases was performed including patients with more than 3.0 diopters (D) of corneal astigmatism, aged 40 years and over treated with cataract phacoemulsification or refractive lens exchange (RLE) and in the bag toric IOL implantation AT TORBI 709M or AT LISA toric 909M (Carl Zeiss Meditec AG, Jena, Germany), this IOLs power ranges up to 12 diopters of cylinder. Age, pre- and postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuity, objective and subjective refraction, total astigmatism, residual refractive cylinder, visual stability, efficacy and safety were analyzed.


Fourteen eyes of nine patients (mean age 50.21+7.86 years), including 2 patients with topographic diagnosis of stable keratoconus, 1 with stable pellucid marginal degeneration, 2 after penetrating keratoplasty, 3 with high myopic astigmatism and 1 with high mixed astigmatism. Mean follow-up after phacoemulsification was 6.21+ 2.3 months. Mean preoperative sphere was -7.18+6.26 D, and mean postoperative sphere was +1.12+0.71D, mean preoperative cylinder was -6.17+2.63 D, which decreased to postoperatively -1.82+ 2.11D. Mean pre and postoperative spherical equivalent refractions were -9.94+6.23D and 0.21+1.19D respectively. Preoperative mean UDVA was 1.39+0.65 (20/490 Snellen) and postoperative mean UDVA was 0.30+0.16 (20/39 Snellen).


Our findings suggest that customized toric intraocular lenses may provide excellent visual and refractive outcomes. High toricity IOL implantation could be a safe, predictable and effective treatment for the correction of high and extreme astigmatism.

Keywords: 445 cataract • 428 astigmatism • 567 intraocular lens  

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