Secondary IOL may treat refractive errors after keratoplasty

Issue: January 10, 2016

A supplementary sulcus-fixated IOL may help reduce spherical and astigmatic refractive errors in pseudophakic eyes that underwent keratoplasty, according to a study.

The retrospective study reviewed 10 pseudophakic post-keratoplasty eyes after implantation of the custom-designed sulcus-fixated supplementary piggyback Sulcoflex IOL (Rayner) to correct refractive errors. Eight eyes received the toric IOL (model 653T), and two eyes received the aspheric IOL (model 653L).

Mean follow-up was 12.2 months.

All eyes had improvement in uncorrected distance visual acuity after surgery, with 70% of eyes achieving 20/40 or better. Five eyes showed improved corrected distance visual acuity by at least one line, with all eyes achieving 20/40 or better and 70% of eyes achieving 20/25 or better.

In the eight eyes that received the toric IOL, mean refractive astigmatism significantly decreased by 84% from 5.7 D preoperatively to 0.9 D postoperatively. Postoperative refractive astigmatism was within 1 D of predicted astigmatism in seven eyes in the toric IOL group.

No eyes lost lines of uncorrected or corrected distance visual acuity, with no keratoplasty rejection or failure complications.

“Establishment of a stable refraction is critically important for these patients before consideration of a secondary IOL procedure,” the study authors said. “In addition, vision should be satisfactorily corrected by orthogonal lenses preoperatively, because if irregular astigmatism is significant, this component will not be addressed by an IOL.” – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

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Source:

Meyer JJ, et al. Cornea. 2015;doi:10.1097/ICO.0000000000000506.