Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study

Purpose. To investigate the effectiveness of toric intraocular lenses (IOLs) for treating corneal astigmatism in patients with cataract and previous deep anterior lamellar keratoplasty (DALK). Setting. San Giovanni-Addolorata Hospital, Rome, Italy. Design. Prospective interventional case series. Met...

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Main Authors: Domenico Schiano Lomoriello, Giacomo Savini, Kristian Naeser, Rossella Maria Colabelli-Gisoldi, Valeria Bono, Augusto Pocobelli
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2018/1649576
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author Domenico Schiano Lomoriello
Giacomo Savini
Kristian Naeser
Rossella Maria Colabelli-Gisoldi
Valeria Bono
Augusto Pocobelli
author_facet Domenico Schiano Lomoriello
Giacomo Savini
Kristian Naeser
Rossella Maria Colabelli-Gisoldi
Valeria Bono
Augusto Pocobelli
author_sort Domenico Schiano Lomoriello
collection DOAJ
description Purpose. To investigate the effectiveness of toric intraocular lenses (IOLs) for treating corneal astigmatism in patients with cataract and previous deep anterior lamellar keratoplasty (DALK). Setting. San Giovanni-Addolorata Hospital, Rome, Italy. Design. Prospective interventional case series. Methods. Patients undergoing cataract surgery after DALK for keratoconus were enrolled. Total corneal astigmatism (TCA) was assessed by a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius; CSO, Firenze, Italy). A customized toric IOL (FIL 611 T, Soleko, Rome, Italy) was implanted in all eyes. One year postoperatively, refraction was measured, the IOL position was recorded, and vectorial and nonvectorial analyses were performed to evaluate the correction of astigmatism. Results. Ten eyes of 10 patients were analyzed. The mean preoperative TCA magnitude was 4.92 ± 1.99 diopters (D), and the mean cylinder of the IOL was 6.18 ± 2.44. After surgery, the difference between the planned axis of orientation of the IOL and the observed axis was ≤10° in all eyes. The mean surgically induced corneal astigmatism was 0.35 D at 20°. The mean postoperative refractive astigmatism power was 1.13 ± 0.94 D; with respect to preoperative TCA, the reduction was statistically significant (p<0.0001). The mean change in astigmatism power was 3.80 ± 1.60 D, corresponding to a correction of 77% of preoperative TCA power. Nine eyes out of 10 had a postoperative refractive astigmatism power ≤ 2D. Conclusions. Toric IOLs can effectively correct corneal astigmatism in eyes with previous DALK. The predictability of cylinder correction is partially lowered by the variability of the surgically induced changes of TCA. This trial is registered with NCT03398109.
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spelling doaj-art-2a4401a8a60545aebb528bd7e15fffb32025-02-03T05:59:45ZengWileyJournal of Ophthalmology2090-004X2090-00582018-01-01201810.1155/2018/16495761649576Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective StudyDomenico Schiano Lomoriello0Giacomo Savini1Kristian Naeser2Rossella Maria Colabelli-Gisoldi3Valeria Bono4Augusto Pocobelli5IRCCS Fondazione G.B. Bietti, Rome, ItalyIRCCS Fondazione G.B. Bietti, Rome, ItalyRegions Hospital Randers, Randers, DenmarkAzienda Ospedaliera San Giovanni-Addolorata, Rome, ItalyIRCCS Fondazione G.B. Bietti, Rome, ItalyAzienda Ospedaliera San Giovanni-Addolorata, Rome, ItalyPurpose. To investigate the effectiveness of toric intraocular lenses (IOLs) for treating corneal astigmatism in patients with cataract and previous deep anterior lamellar keratoplasty (DALK). Setting. San Giovanni-Addolorata Hospital, Rome, Italy. Design. Prospective interventional case series. Methods. Patients undergoing cataract surgery after DALK for keratoconus were enrolled. Total corneal astigmatism (TCA) was assessed by a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius; CSO, Firenze, Italy). A customized toric IOL (FIL 611 T, Soleko, Rome, Italy) was implanted in all eyes. One year postoperatively, refraction was measured, the IOL position was recorded, and vectorial and nonvectorial analyses were performed to evaluate the correction of astigmatism. Results. Ten eyes of 10 patients were analyzed. The mean preoperative TCA magnitude was 4.92 ± 1.99 diopters (D), and the mean cylinder of the IOL was 6.18 ± 2.44. After surgery, the difference between the planned axis of orientation of the IOL and the observed axis was ≤10° in all eyes. The mean surgically induced corneal astigmatism was 0.35 D at 20°. The mean postoperative refractive astigmatism power was 1.13 ± 0.94 D; with respect to preoperative TCA, the reduction was statistically significant (p<0.0001). The mean change in astigmatism power was 3.80 ± 1.60 D, corresponding to a correction of 77% of preoperative TCA power. Nine eyes out of 10 had a postoperative refractive astigmatism power ≤ 2D. Conclusions. Toric IOLs can effectively correct corneal astigmatism in eyes with previous DALK. The predictability of cylinder correction is partially lowered by the variability of the surgically induced changes of TCA. This trial is registered with NCT03398109.http://dx.doi.org/10.1155/2018/1649576
spellingShingle Domenico Schiano Lomoriello
Giacomo Savini
Kristian Naeser
Rossella Maria Colabelli-Gisoldi
Valeria Bono
Augusto Pocobelli
Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study
Journal of Ophthalmology
title Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study
title_full Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study
title_fullStr Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study
title_full_unstemmed Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study
title_short Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study
title_sort customized toric intraocular lens implantation in eyes with cataract and corneal astigmatism after deep anterior lamellar keratoplasty a prospective study
url http://dx.doi.org/10.1155/2018/1649576
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