Cataract surgery with toric intraocular lenses can optimize uncorrected postoperative visual acuity in patients with marked corneal astigmatism.

PURPOSE: To study the change in visual acuity and refraction after cataract surgery using a toric posterior chamber intraocular lens in patients with astigmatism after penetrating keratoplasty.

METHODS

A retrospective case note analysis of cataract surgery involving toric lens implants performed at the Norfolk and Norwich University Hospital was conducted. The pre- and postoperative visual acuities and refractions were recorded.

RESULTS

Seven consecutive patients are described (5 men and 2 women) with a mean age of 62 years. They all underwent penetrating keratoplasty, and in every case, all sutures were removed (mean, 11.2 months before cataract surgery). A marked improvement in both unaided visual acuity and astigmatism was shown after the procedure. The average preoperative unaided acuity was 6/120 (range, 6/24 to counting fingers) compared with a postoperative unaided visual acuity average of 6/15 (6/9-6/24). The average preoperative cylinder was 10.12 D (range, 3.40-17.89 D); postoperatively, this fell to 2.75 D (range, 0.75-4.25).

CONCLUSIONS

Cataract surgery with toric intraocular lenses allows the correction of high degrees of regular corneal astigmatism. We discussed the potential advantages and complications of performing toric lens cataract surgery as a secondary procedure.