Piggyback toric IOL effective for astigmatism

Implanting a customized primary or a secondary piggyback toric IOL post-penetrating keratoplasty (PK) is effective for astigmatism, claims a paper in Eye.

Dr S. Srinivasan et al., Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland, UK, conducted a prospective case series on nine eyes of nine patients with post-PK astigmatism.

Of the patients assessed, six underwent simultaneous phacoemulsification (PE) and three pseudophakic eyes received a secondary 'piggyback' toric IOL implanted in the ciliary sulcus. Outcome measures included Pre- and postoperative uncorrected (UDVA) and best-corrected (BDVA) distance visual acuities and refractive errors.

Change in magnitude of astigmatism pre- and postoperatively were calculated by Cartesian astigmatic vectors. Preoperative and postoperative endothelial cell counts were also assessed.

Preoperative UDVA improved from 1.13±0.51 logMAR to 0.48±0.24 postoperatively. BDVA findings did not present any significant changes from 0.31±0.27 to 0.26±0.19. Preoperative and postoperative refractive cylinder was 0.83±1.09 D and 3.89±4.01 D, respectively.

Astigmatic Cartesian x and y coordinates were significantly reduced and mean endothelial cell loss was 9.9%. Both implantation of a customized primary IOL or a secondary piggyback toric IOL were effective modalities for treating patients with high post-PK astigmatism.

To read the abstract please visit the journal here.