A simple technique for the accurate surgical alignment of toric phakic and aphakic intraocular lenses (IOLs) is described. The mathematical relationship between toric misalignment and cylinder error is reviewed to demonstrate the importance of toric lens alignment in the setting of increased rotational stability with newer generation lenses. A formula for calculating the exact lens misalignment given a manifest cylinder is also presented.
Soft contact lens wear can induce corneal warpage mimicking keratoconus. Had the standard treatment for keratoconus been implemented before resolution of the warpage, it could have proven injurious to the patient, because the treatment itself could have provided an impetus for the protrusion to remain or perhaps even progress. Our case gives clinicians reason to pause when dealing with contact lens wearers presenting with corneal curvature irregularities such as keratoconus or ectasia, because of the possibility of lens-induced warpage.
Transepithelial PTK guided by ASOCT can allow for the precise and accurate removal of central corneal stromal opacities, resulting in a favorable refractive outcome.
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