Outcomes of Phacoemulsification With Toric Intraocular Lenses in Addressing Postkeratoplasty Astigmatism

Purpose The aim of this study was to assess the short-term and long-term effectiveness of toric intraocular lenses (IOLs) as a treatment for significant postkeratoplasty astigmatism.Methods : This was a retrospective case review study that analyzes postkeratoplasty eyes after phacoemulsification with toric IOL implantation.<br />Results; Seventy-five eyes were included. Previous surgery was penetrating keratoplasty (50.6%), deep anterior lamellar keratoplasty (34.6%), or automated anterior lamellar therapeutic keratoplasty (14.6%). The mean age at phacoemulsification with toric IOL implantation was 55.0 years (SD: +/- 14.4). The mean follow-up time was 48.2 +/- 26.6 months. Preoperative mean topographic astigmatism was 6.34 +/- 2.70 D (range 2-13.2 D). The mean IOL cylinder power was 6.00 +/- 4.75 D (range 2-12 D). Both mean refractive astigmatism and mean refractive spherical equivalent decreased significantly from -5.30 +/- 1.86 D to -1.62 +/- 1.94 D (P < 0.001) and from -4.00 +/- 4.46 D to -0.25 +/- 1.25 D (P < 0.001), respectively. From preoperative to the last visit, there was a significant improvement in mean uncorrected distance visual acuity (UCVA) (from 1.3 +/- 1.0 logMAR to 0.4 +/- 0.3 logMAR, P < 0.001) and mean corrected distance visual acuity (CDVA) (from 0.7 +/- 0.6 logMAR to 0.2 +/- 0.3 logMAR, P< 0.001). Postoperative UDVA was 20/40 and 20/30 or better in 34% and 21% of eyes, respectively. Postoperative CDVA was 20/40 and 20/30 or better in 70% and 58% of eyes, respectively. <br />Conclusions : Phacoemulsification and toric IOL implantation can effectively reduce moderate to high postkeratoplasty astigmatism, with a corresponding significant visual improvement.