title: Pseudophakic eye with obliquely crossed piggyback toric intraocular lenses.
abstract: A 72-year-old man presented with high astigmatism (2.25 -5.0 x 45) induced by long-term rotation of a toric intraocular lens (IOL). Corneal astigmatism was 3.78 diopters (D). The corrected distance visual acuity (CDVA) was 20/32. Because of the risk of repositioning, a secondary toric IOL of -3.0/6.0 D especially designed for sulcus implantation was piggybacked through 3.5 mm sutureless clear-corneal incision with a cylindrical axis obliquely crossed with that of the primary IOL. Eight months postoperatively, the corneal astigmatism was 5.04 D. The CDVA was 20/25 with a refraction of 1.0 -2.5 x 70. No interlenticular opacification or significant rotation or decentration of the secondary toric IOL was observed. The refractive properties of this pseudophakic eye were analyzed using a mathematical approach. The calculated postoperative refraction was 0.84 -1.7 x 47. A piggyback toric IOL can be implanted in an obliquely crossed style that allows a secondary toric IOL to correct astigmatism induced by long-term toric IOL rotation.
authors.affiliation: Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Haiying
authors.initials: H
authors.lastname: Jin
authors.forename: Il-Joo
authors.initials: IJ
authors.lastname: Limberger
authors.forename: Andreas F M
authors.initials: AF
authors.lastname: Borkenstein
authors.forename: Angela
authors.initials: A
authors.lastname: Ehmer
authors.forename: Haike
authors.initials: H
authors.lastname: Guo
authors.forename: Gerd U
authors.initials: GU
authors.lastname: Auffarth
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology*; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology