Effectiveness of cataract phacoemulsification with toric intraocular lenses in addressing astigmatism after keratoplasty.

Abstract

PURPOSE:

To assess the effectiveness of toric intraocular lenses (IOLs) in the management of post-keratoplasty astigmatism.

SETTING:

Public university hospital, Auckland, New Zealand.

DESIGN:

Retrospective case series.

METHODS:

The study analyzed post-keratoplasty eyes after cataract surgery and toric IOL (Acrysof SN60AT or T-flex 623T/573T) implantation.

RESULTS:

Twenty-six eyes were included. The mean age at cataract surgery was 57.1 years ± 11.2 (SD). Previous keratoplasty was penetrating (84.6%) or deep anterior lamellar (15.4%). Keratoconus (73.1%) was the major indication for keratoplasty. The mean IOL cylinder power was 6.85 ± 3.02 diopters (D). No IOL required postoperative realignment. The mean follow-up was 14 ± 11 months. The mean refractive spherical equivalent decreased significantly, from -3.67 ± 5.76 D to -0.58 ± 1.71 D (P=.01). The mean refractive astigmatism also decreased significantly, from -5.49 ± 3.72 D to -2.61 ± 2.10 D (P<.01). There was a significant improvement in the mean uncorrected distance visual acuity (UDVA) (from 1.12 ± 0.67 logMAR to 0.45 ± 0.39 logMAR) and in the mean corrected distance visual acuity (CDVA) (from 0.70 ± 0.66 logMAR to 0.15 ± 0.16 logMAR) from preoperatively to the last follow-up (both P<.01). Postoperatively, the UDVA and CDVA were 20/40 or better in 61.5% of eyes and 92.3% of eyes, respectively.

CONCLUSION:

Cataract surgery with toric IOL implantation was safe and effective in significantly reducing corneal astigmatism and improving visual acuity in a large cohort of post-keratoplasty eyes.

• Authors: David Lockington, Ellen F Wang, Dipika V Patel, Sacha P Moore, Charles N J McGhee
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 40 Issue 12 Pg. 2044-9 (Dec 2014) ISSN: 1873-4502 [Electronic] United States
• PMID: 25283612 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Astigmatism (etiology, surgery)
• Female
• Humans
• Keratoconus (surgery)
• Keratoplasty, Penetrating (adverse effects)
• Lens Implantation, Intraocular
• Lenses, Intraocular
• Male
• Middle Aged
• Phacoemulsification (methods)
• Postoperative Complications
• Pseudophakia (physiopathology)
• Refraction, Ocular (physiology)
• Retrospective Studies
• Treatment Outcome
• Visual Acuity (physiology)