[Implantation of toric intraocular lenses for correction of high post-keratoplasty astigmatism].
BACKGROUND
High postkeratoplasty astigmatism remains a challenge for the surgeon. First experiences after implantation of a toric PMMA IOL in three eyes from patients with cataracts are reported.


METHODS
After routine phacoemulsification we implanted an individually manufactured toric PMMA posterior chamber IOL via a sclerocorneal 6-mm tunnel incision in three postkeratoplasty eyes with high, topographically relatively regular astigmatism. One eye with the intraoperative aspect of circular zonular instability also received a capsular tension ring. A complete standard ocular examination was performed pre- and postoperatively including corneal topography, evaluation of anterior chamber depth, ultrasonic biomicroscopy and perimetry.


RESULTS
Implantation and intraoperative alignment of the toric IOL were uneventful. The refractive astigmatisms of 5.0, 6.0 and 7.5 cyl D preoperatively, were reduced to 2.0, 1.75 and 3.0 cyl D, 10 and 12 months postoperation, respectively. The eye with the capsular tension ring showed no morphological or refractive changes during follow-up. In the other two eyes we observed IOL rotation of 20 and 30, respectively after 6 months. There were no posterior capsule opacification or capsular folds in the optical centre.


CONCLUSIONS
Toric IOL technology allows enhancement of IOL surgery with improved refractive outcome. Simultaneous implantation of a capsular tension ring may improve long-term stability.
Klinik für Ophthalmologie, Christian-Albrechts-Universität zu Kiel, Hegewischstrasse 2, 24105 Kiel. mamm@ophthalmol.uni-kiel.de
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Amm
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Halberstadt
D000368:Aged; D001251:Astigmatism / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation; D005260:Female; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications / Q000601:surgery*; D011474:Prosthesis Design; D012029:Refraction, Ocular; D012086:Reoperation
D019904:Polymethyl Methacrylate