Outcomes of Pseudophakic Toric Intraocular Lens Implantation in Keratoconic Eyes With Cataract

Abstract

Pseudophakic toric IOLs are an effective option and provide good vision in eyes with stable mild to moderate keratoconus and cataract.

Surgical management of astigmatism with toric intraocular lenses

“…Furthermore, when choosing the IOL toricity, it is desirable to leave patients with slight with-the-rule astigmatism, due to the normal tendency for astigmatism to drift against-the-rule with advancing age. Thus, leaving this slight with-the-rule astigmatism prolongs the period of time in which the patient's corneal astigmatism is compensated by the toric IOL (15,23,33,48) .…”

“…The final visual outcomes attained with toric IOLs depend on several factors, including the visual potential of the eye. The ideal patients for toric IOL implantation are those with regular astigmatism, although previous papers have also shown good outcomes in cases of stable, mild central irregular astigmatism, such as patients with mild to moderate stable keratoconus (23) , pellucid marginal degeneration (24) and post-corneal transplant (25) . In these cases, it is important to have a fairly symmetrical power and alignment of the astigmatism within the cornea's central 4 mm.…”

Visual and Refractive Outcome of Lens Extraction or Cataract Surgery Combined with Limbal Relaxing Insicion in Keratoconic Eyes

“…There were improvements in the UDVA and CDVA in most studies about cataract surgery on keratoconic eyes 3,4,19 . The uncorrected cylinder and irregular astigmatism will degrade the visual image, and the CDVA would still be reduced.…”

“…Corneal transplants routinely provide good vision, but the healing time is slow, and visual recovery may require monthly follow-up. A refractive lens exchange with a toric or phakic IOL implantation are the other choices for this purpose 19,20 . Another choice is phacoemulsification for both the cataracts and large spherical errors for patients in the presbyopic age range with keratoconus 3,4,9 .…”

Mini-incision cataract surgery and toric lens implantation for the reduction of high myopic astigmatism in patients with pellucid marginal degeneration

“…The use of toric IOLs to treat nonnaturally occurring astigmatism has been reported. 13,14 Unusual clinical conditions have been treated with toric IOL technology. A hydrophilic acrylic with hydrophobic surface toric IOL was used to correct astigmatism in 12 cases of stable mild to moderate keratoconus and cataract, after phacoemulsification with good results.…”