Correction of pseudophakic astigmatism after penetrating keratoplasty with supplementary IOL's

BACKGROUND: To assess the efficacy and safety of implanting a secondary toric intraocular lens in the ciliary sulcus to correct pseudophakic ametropia after penetrating keratoplasty. MATERIAL AND METHODS: The Sulcoflex is designed for implantation into the ciliary sulcus in pseudophake eyes. It is a single-piece implant made of hydrophilic acrylic. Optic- and haptic-edges are round. IOL has a large total diameter of 14 mm. The optic has a diameter of 6.5 mm and a concave/convex shape for perfect fit on the anterior, convex surface of the primary IOL. The haptic is angulated, and has an undulated design to preclude IOL rotation. A toric version of the Sulcoflex IOL (653 T) was implanted into the ciliary sulcus of pseudophakic eyes after corneal transplantation. All IOLs were implanted by injector through a 2.75 mm clear cornea incision. After surgery UCVA, BCVA and the position of the IOL were assessed. Additionally Scheimpflug and slit-lamp photography were performed. RESULTS: Uncorrected distance visual acuity improved in all cases. There were no significant intraoperative or postoperative complications. In our series all the IOLs are good centred and rotation stabile. CONCLUSIONS: In conclusion, the correction of pseudophakic ametropia after penetrating keratoplasty with the Sulcoflex Pseudophakic Supplementary IOL offers a safer and less traumatic option than IOL exchange. Secondary IOL implantation is reversable and predictable.