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Artisan Toric Lens Implantation for Correction of Postkeratoplasty Astigmatism

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Visual Prosthesis and Ophthalmic Devices

Part of the book series: Ophthalmology Research ((OPHRES))

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Abstract

Although visual function may show substantial improvement after keratoplasty (1), many series after corneal grafting report significant astigmatism of four to five diopters (D) ((2)–(5)). It is well known that patients do not tolerate spectacle correction for more than three to four D of astigmatism or anisometropia. Therefore, contact lenses are fitted in 10–30% of patients, and in keratoconus this value may increase up to 50% (6,7). Contact lenses may be effective in 80% of cases but contact lens intolerance in the postkeratoplasty population may be high owing to ocular problems such as topographical abnormalities, blepharitis and dry eye, poor manual dexterity, occupational problems, and lack of motivation. Surgical correction of postkeratoplasty astigmatism has been performed by corneal relaxing incisions (8,9), wedge resections (10), and intraocular lens (IOL) exchange or piggy-back implantation (11,12). Recently, excimer laser photorefractive keratectomy and laser in situ keratomileusis (LASIK) have been used for corneal tissue ablation. However, photorefractive keratectomy causes significant haze in corneal grafts and induces irregular astigmatism and regression, although recent adjunctive use of mitomycin C may prevent these side-effects ((13)–(16)). LASIK surgery is able to treat a greater range of postkeratoplasty refractive error but the corneal graft thickness and the amount of ametropia and astigmatism suitable for correction, limit the efficacy of the procedure. In addition, wound dehiscence may occur owing to the high vacuum pressure, flap complications in steep corneas, and a high rate of retreatments ((17)–(25)). Recently, the short-term preliminary results of Artisan toric lens implantation for the correction of postkeratoplasty refractive error was published (26).

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands

    Rudy M. M. A. Nuijts MD, PhD & Nayyirih G. Tahzib MD

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  1. Rudy M. M. A. Nuijts MD, PhD
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  2. Nayyirih G. Tahzib MD
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Editor information

Editors and Affiliations

  1. Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT

    Joyce Tombran-Tink PhD

  2. Department of Neural and Behavioral Sciences, Penn State University College of Medicine, Hershey, PA

    Colin J. Barnstable DPhil (Professor and Chair, Director and Co-Director) (Professor and Chair, Director and Co-Director)

  3. Penn State Hershey Neuroscience Research Institute, Penn State University College of Medicine, Hershey, PA

    Colin J. Barnstable DPhil (Professor and Chair, Director and Co-Director) (Professor and Chair, Director and Co-Director)

  4. Penn State Neuroscience Institute, Penn State University College of Medicine, Hershey, PA

    Colin J. Barnstable DPhil (Professor and Chair, Director and Co-Director) (Professor and Chair, Director and Co-Director)

  5. Ophthalmology Department, Harvard Medical School, Veteran’s Administration Hospital, Boston, MA

    Joseph F. Rizzo III MD (Director) (Director)

  6. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Veteran’s Administration Hospital, Boston, MA

    Joseph F. Rizzo III MD (Director) (Director)

  7. Center of Innovative Visual Rehabilitation, Veteran’s Administration Hospital, Boston, MA

    Joseph F. Rizzo III MD (Director) (Director)

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© 2007 Humana Press Inc., Totowa NJ

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Nuijts, R.M.M.A., Tahzib, N.G. (2007). Artisan Toric Lens Implantation for Correction of Postkeratoplasty Astigmatism. In: Tombran-Tink, J., Barnstable, C.J., Rizzo, J.F. (eds) Visual Prosthesis and Ophthalmic Devices. Ophthalmology Research. Humana Press. https://doi.org/10.1007/978-1-59745-449-0_15

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  • DOI: https://doi.org/10.1007/978-1-59745-449-0_15

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