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Correction of High Corneal Astigmatism in Cataract Patients with a Foldable Toric Intraocular Lens

1Dejaco-Ruhswurm I., 2Kaminski S., 1Italon C., 1Pieh S., 1Kahraman G., 1Skorpik C.,
1Universitätsklinik für Augenheilkunde und Optometrie, Refraktive Ambulanz, AKH Wien (Wien )
2Universitätsklinik für Augenheilkunde und Optometrie, AKH Wien (Wien )

Purpose: To determine the efficacy and stability of an individually manufactured toric silicone posterior chamber IOL (Fa. Schmidt) for correction of high corneal astigmatism in cataract patients.
Methods: Since January 2001 we implanted the foldable toric silicone posterior chamber IOL with a Z-haptic (MicroSil 6116 TU, Fa. Schmidt) in 15 eyes of ten patients (Three of them after penetrating keratoplasty). The implantation of this lens is performed with a pair of tweezers, or optionally with a microinjector. The cylindric power of this intraocular lens is individually manufactured, depending on keratometric astigmatism. Outcomes of refractive astigmatism, Snellen visual acuity -without (sc), with spherical correction (sphc) and with best correction (bc)- keratometry and IOL rotation were evaluated. The minimum follow-up was 6 months.
Results: Mean preoperative refractive astigmatism was +3.70 ± 1.47 D, the mean keratometric astigmatism was +4.94 ± 3.51 D (Zeiss) und +5.23 ± 3.37 D (TMS-1). The mean cylindrical power of the IOL was +5.47 ± 2.64 D. Postoperatively the mean refractive astigmatism was reduced to +0.68 ± 0.75 D. Keratometric astigmatism was +4.62 ± 3.32 D (Zeiss) and +4.50± 3.29 D (TMS-1), respectively. Visual acuity was 0.55 sc, 0,7 sphc and 0,8 bc. In no case we observed a significant rotation of the toric lens (> 5 degrees).
Conclusions: Our first results after implantation of the foldable toric silicone posterior chamber IOL with a Z-haptic showed effective and stable correction even in cases of high corneal astigmatism.

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