title: Implantation of a custom intraocular lens with a 30-diopter torus for the correction of high astigmatism after penetrating keratoplasty.
abstract: We present a 62-year-old woman who had implantation of an intraocular lens (IOL) with a torus of 30.0 diopters (D) in an eye after penetrating keratoplasty. The patient presented with cataract and a best corrected visual acuity of 20/400. Penetrating keratoplasty was performed in 1975 because of decompensated keratoconus. With a clear but inferiorly decentered corneal graft, visual acuity was limited because of keratoplasty-related high corneal astigmatism of 22.5@156 that could not be successfully treated with spectacles or contact lenses. A custom toric IOL with -30.0 D of cylindrical power was implanted in the capsular bag via a sclerocorneal tunnel incision. Additionally, a spherical IOL of -15.0 D sphere was implanted in the ciliary sulcus. Six months after implantation, the IOLs were still well centered and the uncorrected visual acuity was 20/60.
authors.affiliation: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. tehrani@augen.klinik.uni-mainz.de
authors.forename: Mana
authors.initials: M
authors.lastname: Tehrani
authors.forename: Bernhard
authors.initials: B
authors.lastname: Stoffelns
authors.forename: H Burkhard
authors.initials: HB
authors.lastname: Dick
mesh_terms: D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D002386:Cataract / Q000150:complications; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D018918:Phacoemulsification; D011474:Prosthesis Design; D014792:Visual Acuity