title: Transscleral fixation of a toric intraocular lens to correct aphakic keratoplasty with high astigmatism.
abstract: A 71-year-old man with penetrating keratoplasty (PKP) and aphakia in the right eye and a preoperative refraction of +20.0 -11.0 x 38 and logMAR visual acuity of 20/60 presented to our hospital. The capsular support was absent because of previous complicated intracapsular cataract extraction. The implanted IOL was a custom-made Rayner 570T with +20.5 diopters (D) sphere and +11.0 D cylinder. The IOL's special haptics allowed it to be safely fixated in the sagittal plane. The postoperative refraction was +1.0 -2.0 x 5 with logMAR acuity of 20/60. Follow-up of 2 years revealed no IOL decentration. Transscleral fixation of a toric IOL requires exact outlining. Our case shows that this is possible and can result in improved visual rehabilitation.
authors.affiliation: Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, International Vision Correction Research Centre, Heidelberg, Germany.
authors.forename: Andreas F M
authors.initials: AF
authors.lastname: Borkenstein
authors.forename: Andreas
authors.initials: A
authors.lastname: Reuland
authors.forename: Il-Joo
authors.initials: IJ
authors.lastname: Limberger
authors.forename: Tanja M
authors.initials: TM
authors.lastname: Rabsilber
authors.forename: Gerd U
authors.initials: GU
authors.lastname: Auffarth
mesh_terms: D000368:Aged; D001036:Aphakia, Postcataract / Q000601:surgery*; D001251:Astigmatism / Q000209:etiology / Q000534:rehabilitation*; D019781:Corneal Topography; D006801:Humans; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014786:Vision Disorders / Q000209:etiology / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology