SCLERAL SUTURED TORIC INTRAOCULAR LENS WITH PARS PLANA VITRECTOMY FOR THE CORRECTION OF CORNEAL ASTIGMATISM WITHOUT CAPSULAR SUPPORT.

PURPOSE: To describe the repair of a patient with bilateral subluxed cataract and corneal astigmatism in the setting of a coloboma of the iris, zonules, lens, and retina. Preoperatively, his best-corrected acuity was 20/500 in the right eye and 20/200 in the left eye. His preoperative refraction was -7.25 +1.00 at 080 in the right eye and -7.75 +3.00 at 040 in the left eye. On corneal topography, he had 1.95D and 1.45D of regular astigmatism in the right and left eye, respectively.

METHODS

This technique involves pars plana vitrectomy in combination with the placement of a MX60 toric intraocular lens fixated to the sclera using 8-0 Gore-Tex in line with the axis of steep corneal astigmatism. The lens is affixed through two pairs of nasal and temporal sclerotomies, with each pair located 3 mm posterior to the limbus and 5 mm apart, centered along the axis of steep astigmatism.

RESULTS

Postoperatively, uncorrected visual acuity in this patient was 20/25 in the right eye and 20/20 in the left eye with a refraction of -0.75 +0.50 at 180 in the right eye and -0.75 +1.00 at 180 in the left eye.

CONCLUSION

Scleral sutured toric intraocular lens placement and pars plana vitrectomy is a viable solution for patients with regular corneal astigmatism and cataract repair in the absence of zonular support.