title: Effectiveness of cataract phacoemulsification with toric intraocular lenses in addressing astigmatism after keratoplasty.
abstract: OBJECTIVE
  To assess the effectiveness of toric intraocular lenses (IOLs) in the management of post-keratoplasty astigmatism.
  
  
  METHODS
  Public university hospital, Auckland, New Zealand.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  The study analyzed post-keratoplasty eyes after cataract surgery and toric IOL (Acrysof SN60AT or T-flex 623T/573T) implantation.
  
  
  RESULTS
  Twenty-six eyes were included. The mean age at cataract surgery was 57.1 years ± 11.2 (SD). Previous keratoplasty was penetrating (84.6%) or deep anterior lamellar (15.4%). Keratoconus (73.1%) was the major indication for keratoplasty. The mean IOL cylinder power was 6.85 ± 3.02 diopters (D). No IOL required postoperative realignment. The mean follow-up was 14 ± 11 months. The mean refractive spherical equivalent decreased significantly, from -3.67 ± 5.76 D to -0.58 ± 1.71 D (P=.01). The mean refractive astigmatism also decreased significantly, from -5.49 ± 3.72 D to -2.61 ± 2.10 D (P<.01). There was a significant improvement in the mean uncorrected distance visual acuity (UDVA) (from 1.12 ± 0.67 logMAR to 0.45 ± 0.39 logMAR) and in the mean corrected distance visual acuity (CDVA) (from 0.70 ± 0.66 logMAR to 0.15 ± 0.16 logMAR) from preoperatively to the last follow-up (both P<.01). Postoperatively, the UDVA and CDVA were 20/40 or better in 61.5% of eyes and 92.3% of eyes, respectively.
  
  
  CONCLUSIONS
  Cataract surgery with toric IOL implantation was safe and effective in significantly reducing corneal astigmatism and improving visual acuity in a large cohort of post-keratoplasty eyes.
authors.affiliation: From the Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Lockington
authors.affiliation: From the Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Ellen F
authors.initials: EF
authors.lastname: Wang
authors.affiliation: From the Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Dipika V
authors.initials: DV
authors.lastname: Patel
authors.affiliation: From the Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Sacha P
authors.initials: SP
authors.lastname: Moore
authors.affiliation: From the Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. Electronic address: c.mcghee@auckland.ac.nz.
authors.forename: Charles N J
authors.initials: CN
authors.lastname: McGhee
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology