Accuracy of astigmatism correction with toric intraocular lens implantation in eyes with previous radial keratotomy

PURPOSE: To evaluate refractive outcomes of toric intraocular lens (IOL) implantation in eyes with previous radial keratotomy (RK). SETTING: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. DESIGN: Retrospective case series. METHODS: Consecutive cases with previous RK and had undergone cataract surgery with toric IOL implantation and met the following criteria were retrospectively reviewed: (1) regular bowtie corneal astigmatism within the central 3.0 mm zone, (2) difference in corneal regular astigmatism magnitude between the IOLMaster and Lenstar of ≤ 0.75 diopters (D), (3) difference in the regular astigmatism meridians from the 2 biometers of ≤15 degrees, and (4) available postoperative manifest refraction at ≥ 8 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism. RESULTS: In 40 eyes of 31 patients with previous RK, preoperatively, the mean magnitude of corneal regular astigmatism was 2.10 ± 0.98 D; 1 (3%) and 2 (10%) eyes had anterior corneal regular astigmatism ≤0.5 D and ≤1.0 D, respectively; and the centroid value was 1.14 D @ 179 degrees ± 2.05 D. Postoperatively, the mean magnitude of refractive regular astigmatism was 0.46 ± 0.44 D; 29 (73%) and 35 (88%) of eyes had refractive regular astigmatism ≤0.5 D and ≤1.0 D, respectively (P < .05); and the centroid value was 0.12 D @ 173 degrees ± 0.63 D (P < .05). CONCLUSIONS: Toric IOLs can be used successfully to treat corneal regular astigmatism in eyes with previous RK.