Original articleArtisan toric lens implantation for correction of postkeratoplasty astigmatism☆
Section snippets
Patient population
The 16 eyes of 16 patients included in this study could not be corrected by spectacle wear because of anisometropia, because of the magnitude of refractive cylinder, or because the patients were contact lens intolerant. Exclusion criteria were as follows: a preoperative spectacle-corrected visual acuity worse than 20/50, an anterior chamber depth less than 3.0 mm, glaucoma, retinal pathologic features, or an endothelial cell count lower than 500 cells/mm2. Investigational review board approval
Patient population
Thirteen patients were female and 3 were male. The mean age was 67.3±11.9 years (range, 39–81 years). The mean interval between penetrating keratoplasty and toric lens implantation was 48.9±17.7 months (range, 34–90 months), and the interval between suture removal and lens implantation was 21.3±9.6 months (range, 8–37 months). Twelve eyes were pseudophakic after previous implantation of a posterior chamber intraocular lens. The initial diagnosis requiring corneal transplantation was Fuchs'
Discussion
This prospective study of 16 eyes demonstrates the efficacy and stability of the Artisan toric IOL for correction of postkeratoplasty astigmatism. Until now, LASIK seemed to be the preferred technique for correction of anisometropia and astigmatism after keratoplasty (Table 2).16, 17, 18, 19, 20, 21 The use of the Artisan toric IOL, with a power range of 7.5 D of cylinder and −20.5 D of myopia to +12.0 D of hyperopia, provides a wide field for correction of postkeratoplasty astigmatism and
References (44)
The effect of suture removal on postkeratoplasty astigmatism
Am J Ophthalmol
(1988)- et al.
Effect of a standard paired arcuate incision and augmentation sutures on postkeratoplasty astigmatism
J Cataract Refract Surg
(2000) - et al.
Piggybacking intraocular implants to correct pseudophakic refractive error
Ophthalmology
(1999) - et al.
Photorefractive keratectomy for post-penetrating keratoplasty myopia and astigmatism
J Cataract Refract Surg
(2000) - et al.
Excimer laser correction of high astigmatism after keratoplasty
J Cataract Refract Surg
(1996) - et al.
Effect of hinged lamellar keratotomy on postkeratoplasty eyes
Ophthalmology
(2001) - et al.
Laser in situ keratomileusis after penetrating keratoplasty
J Cataract Refract Surg
(2001) - et al.
Laser in situ keratomileusis to correct refractive errors after keratoplasty
J Cataract Refract Surg
(1999) - et al.
Format for reporting refractive surgical data
J Cataract Refract Surg
(1998) - et al.
Determinants of patient satisfaction after cataract surgery in 3 settings
J Cataract Refract Surg
(2000)
Reporting astigmatism data
J Cataract Refract Surg
Astigmatism analysis by the Alpins method
J Cataract Refract Surg
Calculating the surgically induced refractive change following ocular surgery
J Cataract Refract Surg
A randomized paired eye comparison of two techniques for treating moderately high myopiaLASIK and artisan phakic lens
Ophthalmology
Comparison of iris-fixed Artisan lens implantation with excimer laser in situ keratomileusis in correcting myopia between -9.00 and -19.50 dioptersa randomized study
Ophthalmology
Spontaneous wound dehiscence after removal of single continuous penetrating keratoplasty suture
Ophthalmology
Microkeratome-induced reduction of astigmatism after penetrating keratoplasty
Am J Ophthalmol
LASIK after penetrating keratoplasty
Ophthalmology
Toric phakic intraocular lensEuropean multicenter study
Ophthalmology
Endothelial changes in phakic eyes with anterior chamber intraocular lenses to correct high myopia
J Cataract Refract Surg
Endothelial study of iris-claw phakic lensfour year follow-up
J Cataract Refract Surg
Corneal endothelium five years after transplantation
Am J Ophthalmol
Cited by (46)
Post-penetrating keratoplasty astigmatism
2022, Survey of OphthalmologyCitation Excerpt :Tahzib and coworkers263 followed up 36 eyes for 3 years and reported an ECL of 34.8± 26.3% at 3 years. A few cases of graft rejection and failure have also been reported.190,263 If graft failure occurs and the PKP wound is stable, then an endothelial keratoplasty (such as descemet membrane endothelial keratoplasty) can be performed, ideally with minimal change in the corneal astigmatism.
October consultation #3
2018, Journal of Cataract and Refractive SurgeryOctober consultation #5
2018, Journal of Cataract and Refractive SurgeryEffectiveness of cataract phacoemulsification with toric intraocular lenses in addressing astigmatism after keratoplasty
2014, Journal of Cataract and Refractive SurgeryCitation Excerpt :The preoperative SE was successfully neutralized in this study and, as previously noted, all patients had improved CDVA postoperatively. Other published studies of toric IOLs in post-keratoplasty eyes report a postoperative CDVA of 20/40 or better in 50% of eyes22 using posterior chamber toric IOLs and 80.6% of eyes4 and 100 of eyes24 using the Artisan iris-fixated toric IOL. ( The latter 2 studies included a mixture of pseudophakic and phakic eyes.)
Results of toric intraocular lenses for post-penetrating keratoplasty astigmatism
2014, OphthalmologyCitation Excerpt :Significant levels of refractive error may remain uncorrected in eyes with high ametropia that exceeds the limits of corneal surgery. Others have reported on the efficacy of phakic IOL use after keratoplasty.13,14,16,18,31–33 The benefits of phakic IOLs are ease of reversibility, preservation of accommodation, and lower risk of capsular rupture.
Iris-fixated toric phakic intraocular lens for myopic astigmatism
2012, Journal of Cataract and Refractive SurgeryCitation Excerpt :To our knowledge, no previous studies have analyzed the Artiflex toric pIOL. However, the rigid Artisan toric pIOL has been extensively studied.3–14 In a European multicenter clinical study, Dick et al.4 found no loss of CDVA and a gain of 1 or more lines from the preoperative CDVA in 65.7% of eyes; in 88.6% of eyes, the UDVA was 20/40 or better.
- ☆
Manuscript no. 220940.
None of the authors has a financial or proprietary interest in any product or device mentioned.