Implantation of bitoric MICS IOL after CO-MICS to correct keratoconus

Article

Case study report

Materials and methods

OD: +2.00 -5.50 72 BCVA: 0.25

OS: +2.25 -3.25 138 BCVA: 0.33

After we had discussed different alternatives we decided to implant a bitoric customized toric IOL: AT. Torbi from Carl Zeiss Meditec (Jena, Germany). All the relevant data were entered into the CZM Online Calculator and a customized bitoric IOL was suggested.

The patient's eye reference axis and target axis were marked with a Tabo scheme CZM ocular with the Nd:YAG Laser. We prefer this method in comparison to any marker because it is much more convenient for the patient and can be less influenced by the patient, by rotating the eyeball or retracting the head. After we had done coaxial microincision phacoemulsification (COMICS, OS3 - Oertli Instrumente, Berneck, Switzerland) we implanted the bitoric IOL through a 1.6 mm incision with a wound assisted on axis technique under irrigation without the use of OVD. The orientation of the IOL was checked with a Breyer screen transparency (STACY).

Aberrometry and subjective refraction was tested 2 weeks postop: we achieved a perfect and acceptable result on the OD respective of OS.

Results

Conclusion

The implantation of customized bitoric MICS IOL through a 1.6 mm incision after CO-MICS seems to be a reliable tool to correct astigmatism in keratoconic cataract eyes.

Dr med. Detlev R.H. Breyer is a specialist in cataract and refractive surgery and is senior surgeon at the Breyer Eye Surgery, Dusseldorf, Germany. He may be reached by Email: d.breyer@breyer-augenchirurgie.de

Dr Breyer is a consultant to Oertli and Carl Zeiss Meditec.

References

1. J. Venter, J. Refract. Surg., 2009;25:759–764.

2. K.Kamiya, J. Refract. Surg., 2008;24:840–842.

Newsletter

Get the essential updates shaping the future of pharma manufacturing and compliance—subscribe today to Pharmaceutical Technology and never miss a breakthrough.

Recent Videos
Jeremiah Tao, MD, FACS, discusses his Egyptian Ophthalmological Society keynote, which focused on risk management and avoiding surgical complications in oculofacial surgery
Omer Trivizki, MD, MBA, a retina specialist from Tel Aviv Medical Center, speaks about VOY-101, a Novel, Complement-Modulating Gene Therapy for Geographic Atrophy at the American Society of Retina Specialists (ASRS) Annual Meeting
João Pedro Marques, MD, MSc, PhD discusses a retrospective study of 800 patients with inherited retinal diseases during the American Society of Retina Specialists (ASRS) annual meeting
© 2025 MJH Life Sciences

All rights reserved.