Implantation of Toric Intraocular Lenses for Correction of High Astigmatism after Penetrating Keratoplasty
Viestenz A., Küchle M., Seitz B., Langenbucher A.
Department of Ophthalmology, University of Erlangen-Nürnberg
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 astigmatism following penetrating keratoplasty in patients with cataract.
Method: After routine phacoemulsification we implanted an individually manufactured backtoric IOL (MS 6116 silicone or MP600TU PMMA, Dr. Schmidt, Germany) in five eyes with high postkeratoplasty astigmatism. Biometry was performed with the IOL-Master (Zeiss, Germany) and keratometry was measured with Zeiss ophthalmometer. IOL calculation was done using paraxial raytracing. 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 in all cases. The refractive cylinder could be reduced from preoperative 4.0 - 10.0 D to postoperative 1.5 - 4.0 D. Keratometric cylinder changed slightly from preoperative 4 - 14.5 D to postoperative 4.5 - 13.75 D. Postoperative measured keratometric axis differed no more than 5 degree from the preoperative axis. Best corrected visual acuity improved from 0.1 - 0.5 preoperatively to 0,5 - 0,8 postoperatively.
Conclusions: Toric IOL implantation is a n
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