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A. Viestenz, A. Langenbucher, M. Küchle; Implantation of Toric Intraocular Lenses for Correction of High Corneal Astigmatism after Penetrating Keratoplasty . Invest. Ophthalmol. Vis. Sci. 2003;44(13):266.
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Purpose: High postkeratoplasty astigmatism remains a challenge for the surgeon. Cataract extraction with implantation of toric intraocular lenses (IOL) is an alternative to spectacles, contact lenses or refractive laser surgery for correction of high or excessive astigmatism following penetrating keratoplasty in patients with cataract. Methods: After routine phacoemulsification we implanted an individually manufactured backtoric IOL (MS 6116 silicone or MP600TU PMMA, Dr. Schmidt, Germany) in four patients with high postkeratoplasty astigmatism. Biometry was performed with the IOL-Master (Zeiss, Germany) and keratometry was measured with conventional keratometry (Zeiss ophthalmometer). IOL calculation was done using linear geometrical optics. The sphere / cylinder of the IOL ranged between ?3 to +15 / 5 to 20 diopters. Results: Implantation and intraoperative alignment of toric IOL were uneventful in all patients. The graft remained clear during the follow-up time. The refractive cylinder could be reduced in all patients. In patients 1 and 2 we observed changes in the keratometry comparable to the effect of relaxation incisions for refractive surgery. Conclusions: Toric IOL implantation is a new and promising option for correction of high astigmatism without surgical manipulation on the graft. For an enhancement of the IOL prediction scheme, future studies should investigate the topographic changes of the postkeratoplasty cornea with different incision techniques in cataract surgery. View OriginalDownload SlideView OriginalDownload Slide
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