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Cataract surgery with toric intraocular lens implantation in patients with keratoconus

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First Author: M.Vandevenne THE NETHERLANDS

Co Author(s):    V. Webers   M. Vandevenne   N. Visser   N. Bauer   R. Nuijts        

Abstract Details

Purpose:

To evaluate clinical outcomes following toric intraocular lens (IOL) implantation in patients with cataract and keratoconus

Setting:

University Eye Clinic Maastricht, the Netherlands

Methods:

A total of thirty-six eyes of 25 patients with stable mild to moderate keratoconus (Krumeich stage 1 and 2) underwent cataract surgery with toric IOL implantation (Acrysof SN6AT3-T9 or Rayner T-flex). Postoperatively uncorrected and best-corrected distance visual acuity (UDVA and CDVA), manifest refraction spherical equivalent (MRSE), Alpins vector analysis, surgically induced corneal astigmatism, posterior corneal astigmatism and IOL misalignment were evaluated.

Results:

The mean preoperative CDVA was 0.39 ± 0.26logMAR and mean corneal astigmatism 3.88 ± 1.30D (range 1.42 to 6.38D). Postoperatively, UDVA and CDVA were 0.21 ± 0.13logMAR and 0.11 ± 0.11logMAR, respectively. The mean residual refractive astigmatism was -1.27 ± 0.97D and the mean MRSE 0.09 ± 0.82D (range -0.88 to 2.63D). The mean correction index of 1.20 ± 0.21 (range 0.75 to 1.61) and magnitude of error of 0.42D indicate a general overcorrection. In 19% of eyes the magnitude of overcorrection of corneal astigmatism was ≥1.0D. In 4 eyes, a secondary reposition was performed to treat ≥10° of misalignment.

Conclusions:

Cataract surgery with toric IOL implantation is an effective treatment option in patients with mild to moderate, stable keratoconus. However, care should be taken to prevent overcorrection.

Financial Disclosure:

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