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Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series

BACKGROUND: Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular cornea...

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Autores principales: Kolozsvári, Bence L., Losonczy, Gergely, Pásztor, Dorottya, Fodor, Mariann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234105/
https://www.ncbi.nlm.nih.gov/pubmed/28086913
http://dx.doi.org/10.1186/s12886-016-0397-8
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author Kolozsvári, Bence L.
Losonczy, Gergely
Pásztor, Dorottya
Fodor, Mariann
author_facet Kolozsvári, Bence L.
Losonczy, Gergely
Pásztor, Dorottya
Fodor, Mariann
author_sort Kolozsvári, Bence L.
collection PubMed
description BACKGROUND: Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular corneal astigmatism and a patient with keratoconus following pars plana vitrectomy. As far as we are aware, there are no reported cases of toric IOL implantation in a vitrectomized eye with keratoconus nor of toric IOL implantation in patients with scleral-buckle-induced regular corneal astigmatism. CASE PRESENTATION: Two patients with myopia and high corneal astigmatism underwent cataract operation with toric IOL implantation after posterior segment surgery. Myopia and high astigmatism (>2.5 diopter) were caused by previous scleral buckling in one case and by keratoconus in the other case. Pre- and postoperative examinations during the follow-up of included uncorrected and spectacle corrected distance visual acuity (UCDVA/CDVA), automated kerato-refractometry (Topcon), Pentacam HR, IOL Master (Zeiss) axial length measurements and fundus optical coherence tomography (Zeiss). One year postoperatively, the UCDVA and CDVA were 20/25 and 20/20 in both cases, respectively. The absolute residual refractive astigmatism was 1.0 and 0.75 Diopters, respectively. The IOL rotation was within 3° in both eyes, therefore IOL repositioning was not necessary. Complications were not observed in our cases. CONCLUSION: These cases demonstrate that toric IOL implantation is a predictable and safe method for the correction of high corneal astigmatism in complicated cases with different origins. Irregular corneal astigmatism in keratoconus or scleral-buckle-induced regular astigmatisms can be equally well corrected with the use of toric IOL during cataract surgery. Previous scleral buckling or pars plana vitrectomy seem to have no impact on the success of the toric IOL implantation, even in keratoconus. IOL rotational stability and refractive predictability in patients with a previous vitreoretinal surgery can be as good as in uncomplicated cases.
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spelling pubmed-52341052017-01-17 Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series Kolozsvári, Bence L. Losonczy, Gergely Pásztor, Dorottya Fodor, Mariann BMC Ophthalmol Case Report BACKGROUND: Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular corneal astigmatism and a patient with keratoconus following pars plana vitrectomy. As far as we are aware, there are no reported cases of toric IOL implantation in a vitrectomized eye with keratoconus nor of toric IOL implantation in patients with scleral-buckle-induced regular corneal astigmatism. CASE PRESENTATION: Two patients with myopia and high corneal astigmatism underwent cataract operation with toric IOL implantation after posterior segment surgery. Myopia and high astigmatism (>2.5 diopter) were caused by previous scleral buckling in one case and by keratoconus in the other case. Pre- and postoperative examinations during the follow-up of included uncorrected and spectacle corrected distance visual acuity (UCDVA/CDVA), automated kerato-refractometry (Topcon), Pentacam HR, IOL Master (Zeiss) axial length measurements and fundus optical coherence tomography (Zeiss). One year postoperatively, the UCDVA and CDVA were 20/25 and 20/20 in both cases, respectively. The absolute residual refractive astigmatism was 1.0 and 0.75 Diopters, respectively. The IOL rotation was within 3° in both eyes, therefore IOL repositioning was not necessary. Complications were not observed in our cases. CONCLUSION: These cases demonstrate that toric IOL implantation is a predictable and safe method for the correction of high corneal astigmatism in complicated cases with different origins. Irregular corneal astigmatism in keratoconus or scleral-buckle-induced regular astigmatisms can be equally well corrected with the use of toric IOL during cataract surgery. Previous scleral buckling or pars plana vitrectomy seem to have no impact on the success of the toric IOL implantation, even in keratoconus. IOL rotational stability and refractive predictability in patients with a previous vitreoretinal surgery can be as good as in uncomplicated cases. BioMed Central 2017-01-13 /pmc/articles/PMC5234105/ /pubmed/28086913 http://dx.doi.org/10.1186/s12886-016-0397-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Kolozsvári, Bence L.
Losonczy, Gergely
Pásztor, Dorottya
Fodor, Mariann
Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
title Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
title_full Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
title_fullStr Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
title_full_unstemmed Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
title_short Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
title_sort correction of irregular and induced regular corneal astigmatism with toric iol after posterior segment surgery: a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234105/
https://www.ncbi.nlm.nih.gov/pubmed/28086913
http://dx.doi.org/10.1186/s12886-016-0397-8
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