Use of the Toric Intraocular Lens for Keratoconus Treatment

Abstract

A 50 year old man presented to Eye clinic University clinical centre Tuzla with bilateral visual impairment. Clinical examination revealed low visual acuity and keratoconus in both eyes, white cataract in right eye and diabetic retinopathy in left eye. Ultrasonography examination was normal. The patient underwent Trypan blue capsule staining, phacoemulsification and implantation of intraocular lens Alcon AcrySof SN60T9 16 D spherical and 6.0 D cylinder power. Phacoemulsification went uneventful and early postoperative recovery was successful. Visual acuity improved to 0,8 and fundus examination revealed background diabetic retinopathy. Postoperative follow up two years after surgery showed no signs of keratoconus progression and visual acuity maintained the same.

Premium intraocular lenses: The past, present and future

“… 29 , 30 , 31 On the other hand, when considering toric IOL implantation, a minimal amount of corneal astigmatism of 1.25 D should be present before the surgery. 9 , 32 Regular astigmatism is most suitable for toric IOL implantation; however, irregular astigmatism in cases of keratoconus, 33 or after keratoplasty 34 can also be successfully treated with toric IOL implantation. For patients with regular corneal astigmatism which require spectacle independence, toric multifocal IOLs should be discussed.…”

Presbyopia Correction During Cataract Surgery with Multifocal Intraocular Lenses

“…These lenses are capable of correcting both presbyopia and astigmatism. Invention of multifocal toric IOLs was based on very good results in astigmatic correction with monofocal toric IOLs, which showed to be safe and effective in correcting astigmatism and improving vision even in cataract patients with very high astigmatism such as topographically stable keratoconus, pellucid marginal degeneration, and post-penetrating keratoplasty astigmatism [28][29][30]. The systematic literature review shows that spectacle independence for patients treated with four brands of monofocal toric IOLs increased from 15 to 85% of those who never wore spectacles [1].…”

Phacosurgery features in keratoconus

“…Учитывая наличие астигматизма при КК, возможности торических ИОЛ выглядят предпочтительнее, однако их применение в ряде случаев может быть лимитировано степенью астигматизма и выраженностью его иррегулярности. В серии исследований сообщается об удовлетворительных результатах имплантации торических ИОЛ при наличии нескольких дооперационных условий -клинически стабилизированного КК, относительно высоких показателей корригированной остроты зрения и соответствия манифестной клинической рефракции (в особенности оси цилиндра как основного условия корректного расположения ИОЛ) с параметрами кератотопографии [24,31,[33][34][35][36][37][38][39]. В отдельных исследованиях были получены следующие средние результаты уменьшения астигматизма и улучшения корригированной остроты зрения после имплантации торических ИОЛ: 2,59 дптр и 0,47 [35]; 3,5 дптр и 0,55 [39]; 4,5 дптр и 0,23 [37] соответственно.…”