Document Detail


Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism.
MedLine Citation:
PMID:  23348728     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report visual and refractive outcomes, and endothelial cell loss following primary and secondary 'piggyback' toric intraocular lens (IOL) implantation in patients with high post-penetrating keratoplasty (PK) astigmatism.
METHODS: Prospective case series. Nine eyes of nine patients with post-PK astigmatism were consecutively recruited for implantation of a customized toric IOL. Six underwent simultaneous phacoemulsification (PE) and three pseudophakic eyes had a secondary 'piggyback' toric IOL implanted in the ciliary sulcus. Mean follow-up time was 17.2±7.7 months. Pre- and post-operative uncorrected (UDVA) and best-corrected (BDVA) distance visual acuities and refractive errors were collected for comparison. Cartesian astigmatic vectors were calculated to identify a change in the magnitude of astigmatism pre- compared to postoperatively. Pre- and post-operative endothelial cell counts were also collected for analysis.
RESULTS: UDVA (logMAR) improved from 1.13±0.51 preoperatively to 0.48±0.24 postoperatively (P-value=0.003). There was no significant change in BDVA (P-value=0.905) from 0.31±0.27 to 0.26±0.19. Corneal astigmatism preoperatively was 6.57±4.40 diopters (D). Post-operative refractive cylinder was 0.83±1.09 D compared to 3.89±4.01 D preoperatively (P=0.039). Analysis of astigmatic Cartesian x and y coordinates found a significant reduction postoperatively compared to preoperatively (P=0.005 and P=0.002), respectively. Mean endothelial cell loss was 9.9%.
CONCLUSION: Implantation of a customized primary or secondary 'piggyback' toric IOL serves as an effective modality in treating patients with high post-PK astigmatism.
Authors:
S Srinivasan; D S J Ting; D A M Lyall
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Publication Detail:
Type:  Journal Article     Date:  2013-01-25
Journal Detail:
Title:  Eye (London, England)     Volume:  27     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-11     Completed Date:  2013-09-10     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  531-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Astigmatism / etiology,  physiopathology,  surgery*
Cohort Studies
Female
Humans
Keratoplasty, Penetrating / adverse effects*
Lens Implantation, Intraocular / methods*
Lenses, Intraocular*
Male
Middle Aged
Prospective Studies
Refraction, Ocular / physiology
Visual Acuity / physiology
Comments/Corrections

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