Author:
Ching Geoffrey,Shunmugam Maheshver,Mandal Niraj,Ismail Amir,Lin David T. C.,Moloney Gregory,Holland Simon P.
Abstract
PURPOSE:
To describe a patient with irregular astigmatism who developed highly symptomatic monocular vertical diplopia after receiving a toric intraocular lens (IOL) at the time of surgery.
METHODS:
Data collected for this case report included pre-operative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity, refraction, mean keratometry, topographic astigmatism, and pachymetry.
RESULTS:
The patient's vertical diplopia was corrected safely. UDVA improved from 20/40 to 20/20, refraction improved from −0.50 −1.00 × 155° to −1.00 −0.87 × 160°, and mean keratometry changed from 45.18 to 45.08 diopters (D). Topographic astigmatism changed from −1.02 D @ 165° to −1.30 D @ 170°, and central pachymetry decreased from 506 to 491 µm.
CONCLUSIONS:
Monocular vertical diplopia after toric lens implantation in a patient with keratoconus may be corrected with lens exchange for a non-toric lens and subsequent SmartSurfACE photorefractive keratectomy (SCHWIND eyetech-solutions).
[
Journal of Refractive Surgery Case Reports.
2022;2(3):e60–e62.]
Reference6 articles.
1. Cataract surgery in eyes with keratoconus
2. Management of irregular astigmatism with rigid gas permeable contact lenses;Jupiter DG;CLAO J,2000
3. Hardten DR, Berdahl JP, Kramer BA. Correcting astigmatic surprises following toric intraocular lens implantation. In: Azar DT, Alió JL, Cortina MS, Hallak JA. Surgical Management of Astigmatism. Jaypee Brothers Medical Publishers; 2020:154–163.
4. Combined corneal CXL and photorefractive keratectomy for treatment of keratoconus: a review
5. Corneal endothelial damage after simultaneous PRK and corneal cross-linking in stable keratoconus