Cataract Surgery and Customized Toric Intraocular Lens Implantation in Patients with Cataract and High Astigmatism After Penetrating Keratoplasty

Phacoemulsification and implantation of a customized toric intraocular lens (IOL) Acriva BB T UDM 611 was performed in 3 eyes of 3 patients with cataract and more than 13 diopters of astigmatism after penetrating keratoplasty at least 6 months after complete suture removal. Pre- and postoperative uncorrected and corrected visual acuity, manifest refractions, corneal topographies, autorefractometric keratometry values, posterior segment examinations and intraocular pressure measurements were performed in all patients. The corneal astigmatism was a relatively regular bow-tie pattern in all three patients. Astigmatic changes were also evaluated. No complications were observed during surgery or at follow-up. Customized toric IOL implantation seems to be a predictable and safe procedure in patients with cataract and high astigmatism after penetrating keratoplasty. Longer follow-up is required to confirm these predictable clinical results, particularly with regard to IOL misalignment and bag stability.