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Success found with toric lenses in highly aberrated corneas
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WASHINGTON — For patients with highly aberrated corneas due to pellucid marginal degeneration, penetrating keratoplasty or previous refractive surgery, toric lenses can have optimal results, according to a speaker here.
“These are very difficult patients,” Sheri L. Rowen, MD, said at the American Society of Cataract and Refractive Surgery meeting. “All of these patients want the best lens. How do we offer the premium outcome in these patients, and what can we safely offer?”
A retrospective analysis of 30 eyes with highly aberrated corneas evaluated lens choices and postoperative outcomes; 25 eyes had previous radial keratotomy, three had pellucid marginal degeneration and two had a previous corneal transplant for HSV keratitis. Twenty-two cases underwent cataract surgery, while eight underwent refractive lens exchange.
The RK patients all received the Crystalens AO or Trulign toric lens (Bausch + Lomb). The other patients received a ZCT600 lens (Johnson & Johnson Vision).
Results showed that 43% of patients had uncorrected distance visual acuity of 20/20, while 30% had 20/25, Rowen said. Uncorrected near visual acuity was 20/40 for 50% of patients and 20/20 for 13% of patients.
“Toric lenses appear to be safely used in pellucid marginal and PKP with high amounts of astigmatism as long as multiple topographic measurements line up and you can identify the actual axis,” Rowen said. “These are some of our most tenuous patients but have come to be, I believe, some of our happiest premium patients.” – by Rebecca L. Forand
Reference:
Rowen SL. Surgical outcomes of accommodating IOL in patients with highly aberrated corneas. Presented at: American Society of Cataract and Refractive Surgery annual meeting; April 13-17, 2018; Washington.
Disclosure: Rowen reports she has financial relationships with Alcon, Allergan, Bausch + Lomb, Bio-Tissue, Johnson & Johnson, Ocularis, Omeros, Orasis, Shire, Sun, Tear Film and Ziemer.