Nattis A., Zaidman G.W.
Results of Toric IOL Implantation in Post-keratoplasty Patients
Purpose. We studied the variables effecting the outcomes of toric intraocular lens (IOL) implantation during cataract extraction (CE) in post-corneal transplant (CT) patients.
Material and methods. A retrospective chart review of post-CT patients who underwent CE with toric IOL implantation was performed. We analyzed uncorrected (UCVA), best-corrected visual acuity (BCVA), and astigmatism. Effect of age, sex, time to CE, reason for CT, and use of limbal relaxing incisions (LRI) was evaluated. All patients had regular astigmatism prior to CE.
Results. 37 eyes were analyzed. The average age at CE was 57.5 (range 1.587) years. The average time from CT to CE was 100.7 (range 4276) months. Keratoconus was the most common reason for CT (54%), followed by corneal scarring (22%), corneal dystrophy (19%) and graft failure (5%). Average preoperative UCVA and BCVA were 20/100 and 20/40 respectively. Average preoperative astigmatism was 4.97±2.28D. 24% of eyes had LRI performed with CE for excess astigmatism that could not be corrected by the IOL. Average postoperative UCVA improved by 4 Snellen lines (range 19 lines). Mean postoperative BCVA was 20/30. Astigmatism decreased in 90% of eyes (average 2.9±1.5B, range 0.5 - 8.5D). In 10% of eyes, astigmatism increased 0.50D. Outcomes were independent of age, time between CT and CE, and use of LRI. Greater time between CT and CE, male gender, and diagnosis of keratoconus were associated with better outcomes. There were no sightthreatening complications or graft failures.
Conclusion. CE with toric lOL implantation in postCT patients proved a safe and efficacious surgical strategy, as it improved vision and decreased astigmatism in 90% of patients.
Key words: Тoric IOLs; cataract surgery; corneal transplant surgery.
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