Correction of high astigmatism with toric intraocular lens in eyes with corneal transplant.

Abstract

To evaluate the results of toric intraocular lens (IOL) implantation during cataract surgery in eyes with high regular astigmatism associated with prior penetrating keratoplasty (PK). A retrospective data analysis of patients with prior PK, who underwent uncomplicated cataract surgery with hydrophobic toric single piece IOL (EyeCryl Toric®, Biotech Vision Care, Luzern, Switzerland). A total of 18 eyes of 18 patients were included in the study. The mean age was 53.4 ± 12.4 (25-70) years. The mean follow-up period was 15.5 (4-24) months. The mean best corrected visual acuity (BCVA) significantly increased from 1.36 ± 1.0 logMAR to 0.31 ± 0.17 logMAR (p < .001) pre- and post-operative 4 weeks, respectively. There was no significant change in mean BCVA during follow-up; mean BCVA was 0.32 ± 0.17 logMAR at the last visit. The mean pre-operative topographic astigmatism was 6.52 ± 1.80 diopters (D). The mean manifest refraction astigmatism was decreased from 6.55 ± 1.62 D to 2.80 ± 1.43 D (p˂0.001). The mean Surgically induced astigmatism (SIA) was 3.74 ± 0.77 D according to vector analysis. There was no patient with graft rejection or failure, the mean endothelial cell loss rate was 12.75 ± 3.76% (7-17%). There was no patient requiring IOL reposition. Toric IOL implantation during cataract surgery provides an option to correct astigmatism in post-PK eyes with high regular astigmatism. When appropriate patients are selected it is a safe method to achieve significant improvements in visual acuity and astigmatism.