Abstract

DO.17.05

Refractive lens surgery after keratoplasty

Buchwald H.-J.
Department of Ophthalmology, Universität Ulm, Ulm, Germany

Objective: Due to the introduction of small incision techniques and the development of toric intraocular lenses the refractive expectations in the outcome of cataract surgery have become higher in the last decade. The aim is to reach a full visual acuity without glasses, even in cases of higher astigmatism i.e. after perforating keratoplasty.
Results: To correct astigmatism corneal incisions can be performed, either by knife or by femtosecondlaser. In patients with higher astigmatism toric intraocular lenses (IOL) can be used. After cataract surgery or clear lens extraction (CLE) IOL's are implanted in the capsule sac. IOL's are also available for implantation in the sulcus i.e. in cases of pseudophakia or after IOL-explantation. For postoperative success an exact positioning of the toric IOL is important whilst preventing of cyclorotation of the eye in the supine patient. Meanwhile IOL's have improved haptics with excellent postoperative rotational stability.
Conclusions: The development of toric IOL's in recent years have made it possible to correct cases of higher astigmatism on a more individual basis.

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