title: Refractive lens exchange with toric intraocular lenses in keratoconus.
abstract: OBJECTIVE
  To report the clinical characteristics and surgical outcomes of patients with nonprogressive keratoconus treated with in-the-bag toric intraocular lens (IOL) implantation.
  
  
  METHODS
  A retrospective review was conducted of the medical records of patients diagnosed with keratoconus treated with refractive lens exchange (RLE) and in-the-bag toric IOL implantation (models T3 to T9, AcrySof SN60TT; Alcon Laboratories Inc). Age, pre- and postoperative uncorrected (UDVA) and corrected distance visual acuity (CDVA), objective and subjective refraction, spherical equivalent refraction, total keratometric power, total astigmatism, axis, and toric IOL model and power were analyzed. All cases had topographic and/or refractive stability for at least 1 year prior to undergoing IOL implantation.
  
  
  RESULTS
  Nineteen eyes of 13 patients (mean age 48.15 ± 6.6 years), including 12 patients with a topographic diagnosis of keratoconus and 1 with pellucid marginal degeneration, were evaluated. Mean follow-up after RLE was 7.89 ± 6.61 months. Mean preoperative sphere was -5.25 ± 6.40 diopters (D), and mean postoperative sphere was 0.22 ± 1.01 D (P<.001). Mean preoperative cylinder was 3.95 ± 1.30 D, which decreased to 1.36 ± 1.17 D postoperatively (P<.001). Mean pre- and postoperative spherical equivalent refractions were -7.10 ± 6.41 D and -0.46 ± 1.12 D, respectively (P<.001). Preoperative mean UDVA was 1.35 ± 0.36 D (20/447 Snellen) and postoperative mean UDVA was 0.29 ± 0.23 D (20/39 Snellen) (P<.001).
  
  
  CONCLUSIONS
  Toric IOL implantation may be an effective therapeutic option in the optical rehabilitation of patients with stable and nonprogressive keratoconus.
authors.affiliation: Department of Cornea and Refractive Surgery, Institute of Opthalmology, Conde de Valenciana, Mexico City, Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: Jaimes
authors.forename: Fiona
authors.initials: F
authors.lastname: Xacur-García
authors.forename: Diana
authors.initials: D
authors.lastname: Alvarez-Melloni
authors.forename: Enrique O
authors.initials: EO
authors.lastname: Graue-Hernández
authors.forename: Tito
authors.initials: T
authors.lastname: Ramirez-Luquín
authors.forename: Alejandro
authors.initials: A
authors.lastname: Navas
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012189:Retrospective Studies; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology