title: Cataract surgery with toric intraocular lens implantation in keratoconus: a case report.
abstract: OBJECTIVE
  We report 2 cases in which cataract extraction with a foldable acrylic toric intraocular lens (IOL) implantation was used to correct (irregular) corneal astigmatism in patients with keratoconus and cataract.
  
  
  METHODS
  Case 1 was a 78-year-old man with cataract and keratoconus in the left eye. He underwent phacoemulsification with a toric IOL [Acrysof SN60T9; cylinder power: 6.0 diopters (D)] implantation. Case 2 was a 64-year-old woman with bilateral cataract and keratoconus. She underwent phacoemulsification with toric IOL implantation in the right (Acrysof SN60T9; cylinder power: 6.0 D) and left eyes (Acrysof SN60T5; cylinder power: 3.0 D). Postoperative follow-up in both cases was 6 months.
  
  
  RESULTS
  In case 1, the uncorrected visual acuity increased from 20/400 to 20/50. The refractive cylinder decreased from -6.0 to -1.5 D, which is a reduction of 75%. In case 2, the uncorrected visual acuity increased from 20/400 to 20/130 in the right eye and from 20/400 to 20/30 in the left eye. Refractive astigmatism decreased by 70% in both eyes. No IOL misalignment or other complications occurred.
  
  
  CONCLUSIONS
  Cataract extraction with toric IOL implantation can be used to correct (irregular) astigmatism and to improve visual functioning in patients with mild to moderate amounts of stable keratoconus and cataract.
authors.affiliation: University Eye Clinic, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Visser
authors.forename: Sacha T J M
authors.initials: ST
authors.lastname: Gast
authors.forename: Noël J C
authors.initials: NJ
authors.lastname: Bauer
authors.forename: Rudy M M A
authors.initials: RM
authors.lastname: Nuijts
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D002386:Cataract / Q000150:complications; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D019591:Pseudophakia / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology