title: Results of toric intraocular lenses for post-penetrating keratoplasty astigmatism.
abstract: OBJECTIVE
  Evaluate the usefulness of toric intraocular lens (IOL) implantation during cataract surgery in patients after penetrating keratoplasty (PKP).
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  A total of 21 eyes of 16 patients with prior PKP and moderate to high regular astigmatism after full suture removal underwent phacoemulsification and implantation of a single-piece acrylic toric IOL (SN6AT series; Alcon, Fort Worth, TX).
  
  
  METHODS
  Patients underwent comprehensive examinations at standard intervals, including visual acuity, manifest refraction, and corneal topography.
  
  
  METHODS
  Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) expressed as the logarithm of the minimum angle of resolution (logMAR) and manifest refraction astigmatism.
  
  
  RESULTS
  From preoperatively to the last visit (mean, 14.7 ± standard deviation 12.8 months), the 21 eyes had significant improvement in UDVA (logMAR, 0.90 ± 0.48 to 0.23 ± 0.25; P = 0.0001) and CDVA (logMAR, 0.31 ± 0.14 to 0.08 ± 0.13; P = 0.0001). A total of 14 of 21 eyes (67%) and 17 of 21 eyes (81%) had UDVA and CDVA of ≥ 20/30, respectively. Preoperative topographic astigmatism was 4.57 ± 2.05 diopters (D). Postoperative manifest refraction astigmatism was 1.58 ± 1.25 D overall, but lower (0.75 ± 0.54 D) in the T7-T9 subgroup (excluding 1 outlier whose corneal astigmatism doubled after surgery) than in the T4-T6 subgroup (1.88 ± 1.28 D; P = 0.013). A total of 16 of all 21 eyes (76.2%) and 8 of 9 eyes (89%) in the T7-T9 subgroup were within 1 D of postoperative manifest astigmatism as predicted or better.
  
  
  CONCLUSIONS
  Toric IOLs placed during cataract surgery after PKP and full suture removal can reduce manifest refraction cylinder to predictably low levels with corresponding improvement in UDVA and CDVA in patients with moderate to high regular preoperative topographic astigmatism.
authors: Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California. Electronic address: wadem@uci.edu.
authors: Matthew
authors: M
authors: Wade
authors: Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California.
authors: Roger F
authors: RF
authors: Steinert
authors: Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California.
authors: Sumit
authors: S
authors: Garg
authors: Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California.
authors: Marjan
authors: M
authors: Farid
authors: Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California.
authors: Ronald
authors: R
authors: Gaster
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology