Posters

A case of an RLE in an eye with irregular astigmatism and how it was managed with a Rayner toric IOL and Astigmatismfix.com calculator

Poster Details

First Author: T.Kohnen GERMANY

Co Author(s): K. Varna-Tipka                    

Abstract Details

Purpose:

Case analysis. Refractive lens exchange to offer patient sharper vision in the intermedia distance possibly without his spectacles.

Setting:

University Clinic Frankfurt, Goethe University, Theodor-Stern-Kai 7 | 60590 Frankfurt am Main, Germany

Methods:

A 50-year-old had penetrating keratoplasty in both eyes in 1995 caused by keratoconus disease. In 2012, he underwent a FALAK by residual astigmatism. At the time, the refractive error was OD:-0,75sph/-3,50cyl/50° and OS: -1,25sph/-9,50 cyl/100°. Endothelial cell density was OD:827 cells/mm² and OS:909 cells/mm², Pentacam findings showed an asymmetrical astigmatism in both eyes and pachymetry was OD: 531µm and OS:583µm. In 2017, he requested a lens exchange to achieve better visual acuity in intermediate distance, if possible without spectacles. A femtosecond-laser-assisted-RLE was conducted. It was expected that in OS a residual astigmatism would be postoperatively about -2.00D.

Results:

One week postoperatively the UCVA OD was 0.50logMAR and OS: 0,80LogMAR, with residual refractive error of OD:-0,75/-0,75/33° and OS: +1,75sph/-6.50cyl/133°. The IOL Position in OS was 12 ° off axis, so we used, Astigmatismfix.com, to predict the residual error after a theoretical IOlrotation. This showed that the ideal toric lens would correct 14.88 D of astigmatism at 22°, and rotating the IOL 168° clockwise should minimize the astigmatism. The expected residual refraction (+cyl) was -3.44 sph/+3.88/21°(or+0,25 sph/-3,75 cyl/111°). The rotation was completed the next day. Six weeks after the IOL rotation the residual refractive error on OS was: +0.75 sph/-3,00cyl/156°.

Conclusions:

By difficult refractive cases it is wise to consult the Astigmatismfix.com online Calculator to gain an overall picture of the residual astigmatism before proceeding with another surgery.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented