Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism

Srinivasan, Sathish; Ting, Darren S J; Lyall, Douglas

doi:10.1038/eye.2012.300

Cited by 42 publications

(32 citation statements)

References 20 publications

(30 reference statements)

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“…Toric intraocular lens implantation (phakic or pseudophakic) provides a wider range of correction but lens rotation, increased endothelial cell loss, corneal decompensation, graft rejection, endophthalmitis, and secondary glaucoma are important drawbacks of such procedures [ 27 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

Small Incision Lenticule Extraction for Postkeratoplasty Myopia and Astigmatism

Massoud

Ibrahim

Shehata³

et al. 2016

Journal of Ophthalmology

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Purpose. To evaluate the visual and refractive outcomes after small incision lenticule extraction (SMILE) for treating myopia and myopic astigmatism after penetrating keratoplasty (PKP). Design. Case-series. Methods. Ten eyes of 10 patients with previous PKP and residual myopic astigmatism for whom pentacam imaging and thickness measurements were acceptable for laser vision correction. Manifest refraction (MR), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were obtained preoperatively and one day, one week, and one, 3, and 6 months postoperatively. Cases were operated on the VisuMax® femtosecond laser platform with 500 kHz repetition rate. Results. The mean correction ratio for spherical errors was 0.84 ± 0.19 D and for the mean refractive spherical equivalent (MRSE) was 0.79 ± 0.13 D. Vector analysis showed a mean astigmatism reduction at the intended axis of 67 ± 25.25%, a correction index of 0.81 ± 0.21, and an overall mean percentage of success of astigmatism surgery of 53 ± 37.9%. The postoperative MRSE was stable throughout the 6-month follow-up period. The efficacy index was 0.93 and the safety index was 1.12. Conclusion. SMILE for correction of post-PKP myopia and astigmatism is effective, safe, and stable with moderate accuracy and predictability. Centration of the treatment within the grafts was easily performed.

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Section: Introductionmentioning

confidence: 99%

Small Incision Lenticule Extraction for Postkeratoplasty Myopia and Astigmatism

Massoud

Ibrahim

Shehata³

et al. 2016

Journal of Ophthalmology

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“…Many small studies about implantation of toric IOLs can be found in the literature with excellent results, as observed by Stewart and McAlister [ 4 ], Srinivasan et al [ 5 ], Wade et al [ 6 ], and Muftuoglu et al [ 7 ]. Overall, the endothelial cell loss is between 5 and 10% and the IOL stability is excellent [ 2 , 8 ].…”

Section: Discussionmentioning

confidence: 94%

“…Excellent results can be obtained by secondary sulcus implantation of piggyback toric IOLs in pseudophakic eyes [ 5 , 9 ]. Meyer and McGhee [ 9 ] demonstrated an uncorrected distance visual acuity changing from 1.2 to 0.3 after a year of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

Nuzzi

Monteu²

2017

Case Rep Ophthalmol

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After penetrating keratoplasty (PK), high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL) implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis). We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°). The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

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“…There are relatively few published reports on the use of a secondary sulcus lens for the treatment of postkeratoplasty refractive errors, mainly limited to a few cases 11,14 and a case series. 18 A recent series described favorable results with a 3-piece "additive" sulcus lens for patients with previous keratoplasty and high astigmatism, although 2 eyes developed corneal edema requiring repeat keratoplasty.…”

Section: Discussionmentioning

confidence: 98%