Quentin C.-D., Genée D., Meyer-Riemann W.

Universitäts-Augenklinik Göttingen, Robert-Koch-Str. 40, 37075 Göttingen

Background: It is difficult to correct high astigmatism after penetrating keratoplasty or in congenital astigmatism even with the newest laser technology. The toric intraocular lens might be an elegant method to correct it in cases of cataract surgery.
Patients and method: 13 eyes (10 patients) with high astigmatism received a toric intraocular lens into the capsular bag after phacoemulsification of the cataract. 9 eyes had had keratoplasty up to 21 years ago and 4 eyes congenital astigmatism. The age of the patients ranged between 53 to 74 years. In 4 eyes a toric-PMMA lens (MP 600 TU, Dr. Schmidt) and in 9 eyes a foldable toric silicon lens (MS 6116 TU, Dr. Schmidt) was implanted. The follow up is 6 to 32 months (mean: 17.6 ms).
Results: The mean refractive cylinder could be corrected from preoperative 5.5 dpt to 0.93 dpt postoperatively one week after surgery. At last follow up examination the refractive cylinder was 2.15 dpt due to rotation of the toric intraocular lens in the capsular bag in four eyes. The highest corrected astigmatism was 6.25 dpt of refractive cylinder of an eye with keratoplasty.
Conclusion: With an individual toric intraocular lens even astigmatism up to 6.25 dpt could be corrected. The localization of the cylindrical axis is critical specially after penetrating keratoplasty. The problem of rotation of the toric intraocular lens in the capsular bag remains to be solved.

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