Implantation of toric intraocular lens in patients with cataract after radial keratotomy: clinical and functional

Abstract

Implantation of toric intraocular lenses (TIOLs) in patients with cataracts after radial keratotomy (RK) remains a challenging task due to changes in corneal optical properties, instability of keratometric data, and the specifics of IOL power calculation. Purpose. To evaluate the clinical and functional results of toric IOL implantation in patients with cataracts and a history of RK. Material and methods. An analysis of the results of surgical treatment of 15 patients (23 eyes) with implantation of monofocal TIOLs was conducted. A comprehensive ophthalmological examination was performed using optical biometry and Pentacam AXL keratotopography. IOL power was calculated using the EVO Calculator in the “Radial Keratotomy” mode based on the EKR (3 mm). Patients were divided into 2 groups based on residual astigmatism as measured by an autorefractometer: ≤1 D, >1 D. Results. All patients experienced improved visual acuity with and without correction, as well as a significant reduction in the cylindrical component of refraction, following surgery. In patients with irregular corneal changes, partial astigmatism reduction (40–50%) was achieved while maintaining satisfactory visual function. Conclusion. TIOL implantation is effective for regular and irregular corneal astigmatism, but the greatest predictability and correction effectiveness are achieved with regular astigmatism.