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Changes in astigmatism and corneal higher-order aberrations after phacoemulsification with toric intraocular lens implantation for mild keratoconus with cataract

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To assess the changes in astigmatism and higher-order aberrations (HOAs) after toric intraocular lens (IOL) implantation for mild non-progressive keratoconus with cataract.

Methods

We prospectively examined 19 eyes of 19 consecutive keratoconic patients (mean age ± standard deviation, 63.1 ± 9.1 years) who underwent phacoemulsification with toric IOL implantation. We determined uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive astigmatism, corneal astigmatism, corneal HOAs and astigmatic axis rotation both preoperatively and 3 months postoperatively.

Results

Logarithm of the minimal angle of resolution (logMAR) UDVA was significantly improved from 1.14 ± 0.50 preoperatively to 0.46 ± 0.33 postoperatively (Wilcoxon signed-rank test, p < 0.001). LogMAR CDVA was also significantly improved from 0.27 ± 0.45 preoperatively to −0.01 ± 0.09 postoperatively (p < 0.001). In 5 of 6 eyes in which the target refraction was emmetropia, postoperative UDVA was better than 20/32. The achieved spherical equivalent correction was within ±0.5 diopters (D) of the targeted correction in 13 (68 %) eyes and 1.0 in 18 (95 %) eyes. The refractive astigmatism was significantly decreased from −1.92 ± 1.73 D preoperatively to −0.70 ± 0.60 D postoperatively (p = 0.006). The corneal astigmatism changed from 2.89 ± 1.30 D preoperatively to 2.98 ± 1.09 D postoperatively (p = 0.492), which was not statistically significant. The corneal HOAs for a 4-mm pupil was changed from 0.47 ± 0.23 µm preoperatively to 0.52 ± 0.26 µm postoperatively (p = 0.211), which was not statistically significant.

Conclusions

According to our experience, toric IOL implantation for mild keratoconic patients having rigid gas-permeable lens intolerance appears to be effective for reducing refractive astigmatism without a significant induction of corneal HOAs.

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References

  1. Thebpatiphat N, Hammersmith KM, Rapuano CJ, Ayres BD, Cohen EJ. Cataract surgery in keratoconus. Eye Contact Lens. 2007;33:244–6.

    Article  PubMed  Google Scholar 

  2. Navas A, Suárez R. One-year follow-up of toric intraocular lens implantation in forme fruste keratoconus. J Cataract Refract Surg. 2009;35:2024–7.

    Article  PubMed  Google Scholar 

  3. Visser N, Gast ST, Bauer NJ, Nuijts RM. Cataract surgery with toric intraocular lens implantation in keratoconus: a case report. Cornea. 2011;30:720–3.

    Article  PubMed  Google Scholar 

  4. Jaimes M, Xacur-García F, Alvarez-Melloni D, Graue-Hernández EO, Ramirez-Luquín T, Navas A. Refractive lens exchange with toric intraocular lenses in keratoconus. J Refract Surg. 2011;27:658–64.

    Article  PubMed  Google Scholar 

  5. Nanavaty MA, Lake DB, Daya SM. Outcomes of pseudophakic toric intraocular lens implantation in keratoconic eyes with cataract. J Refract Surg. 2012;28:884–9.

    Article  PubMed  Google Scholar 

  6. Alió JL, Peña-García P, Abdulla Guliyeva F, Soria FA, Zein G, Abu-Mustafa SK. MICS with toric intraocular lenses in keratoconus: outcomes and predictability analysis of postoperative refraction. Br J Ophthalmol. 2014;98:365–70.

    Article  PubMed  Google Scholar 

  7. Hashemi H, Heidarian S, Seyedian MA, Yekta A, Khabazkhoob M. Evaluation of the results of using toric IOL in the cataract surgery of keratoconus patients. Eye Contact Lens. 2015;41:354–8.

    Article  PubMed  Google Scholar 

  8. Rabinowitz YS. Keratoconus. Surv Ophthalmol. 1998;42:297–319.

    Article  CAS  PubMed  Google Scholar 

  9. Krumeich JH, Kezirian GM. Circular keratotomy to reduce astigmatism and improve vision in stage I and II keratoconus. J Refract Surg. 2009;25:357–65.

    Article  PubMed  Google Scholar 

  10. Miyata K, Miyai T, Minami K, Bissen-Miyajima H, Maeda N, Amano S. Limbal relaxing incisions using a reference point and corneal topography for intraoperative identification of the steepest meridian. J Refract Surg. 2011;27:339–44.

    Article  PubMed  Google Scholar 

  11. Miyake T, Kamiya K, Amano R, Iida Y, Tsunehiro S, Shimizu K. Long-term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism. J Cataract Refract Surg. 2014;40:1654–60.

    Article  PubMed  Google Scholar 

  12. Thibos LN, Horner D. Power vector analysis of the optical outcome of refractive surgery. J Cataract Refract Surg. 2001;27:80–5.

    Article  CAS  PubMed  Google Scholar 

  13. Kim MH, Chung TY, Chung ES. Long-term efficacy and rotational stability of AcrySof toric intraocular lens implantation in cataract surgery. Korean J Ophthalmol. 2010;24:207–12.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kamiya K, Shimizu K, Kobashi H, Igarashi A, Komatsu M, Nakamura A, et al. Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for the correction of high myopic astigmatism in eyes with keratoconus. Br J Ophthalmol. 2015;99:177–83.

    Article  PubMed  Google Scholar 

  15. Kamiya K, Shimizu K, Miyake T, Igarashi A. Assessment of anterior, posterior, and total central corneal astigmatism in eyes with keratoconus. Am J Ophthalmol. 2015;160:851–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, University of Kitasato School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Kazutaka Kamiya, Kimiya Shimizu & Toshiyuki Miyake

Authors
  1. Kazutaka Kamiya
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  2. Kimiya Shimizu
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  3. Toshiyuki Miyake
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Corresponding author

Correspondence to Kazutaka Kamiya.

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Conflicts of interest

K. Kamiya, None; K. Shimizu, None; T. Miyake, None.

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Kamiya, K., Shimizu, K. & Miyake, T. Changes in astigmatism and corneal higher-order aberrations after phacoemulsification with toric intraocular lens implantation for mild keratoconus with cataract. Jpn J Ophthalmol 60, 302–308 (2016). https://doi.org/10.1007/s10384-016-0449-x

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  • DOI: https://doi.org/10.1007/s10384-016-0449-x

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