Turkiye Klinikleri Journal of Ophthalmology

.: CASE REPORTS
Cataract Surgery and Customized Toric Intraocular Lens Implantation in Patients with Cataract and High Astigmatism After Penetrating Keratoplasty
Penetran Keratoplasti Sonrası Katarakt ve Yüksek Astigmatizması Olan Hastalarda Katarakt Cerrahisi ve Kişiye Özel Torik Göz İçi Lens İmplantasyonu
Derya DOĞANAYa , Cem ÇANKAYAb , Selim DOĞANAYc
aÇekirge State Hospital, Clinic of Ophthalmology, Bursa, Türkiye
bİnönü University Faculty of Medicine, Department of Ophthalmology, Malatya, Türkiye
cUludağ University Faculty of Medicine, Department of Ophthalmology, Bursa, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(2):128-32
doi: 10.5336/ophthal.2023-100669
Article Language: EN
Full Text
ABSTRACT
 Phacoemulsification and implantation of a customized toric intraocular lens (IOL) Acriva BB T UDM 611 was performed in 3 eyes of 3 patients with cataract and more than 13 diopters of astigmatism after penetrating keratoplasty at least 6 months after complete suture removal. Pre- and postoperative uncorrected and corrected visual acuity, manifest refractions, corneal topographies, autorefractometric keratometry values, posterior segment examinations and intraocular pressure measurements were performed in all patients. The corneal astigmatism was a relatively regular bow-tie pattern in all three patients. Astigmatic changes were also evaluated. No complications were observed during surgery or at follow-up. Customized toric IOL implantation seems to be a predictable and safe procedure in patients with cataract and high astigmatism after penetrating keratoplasty. Longer follow-up is required to confirm these predictable clinical results, particularly with regard to IOL misalignment and bag stability.

Keywords: Penetrating keratoplasty; cataract; customized toric intraocular lens; astigmatism
ÖZET
 Penetran keratoplasti sonrası kataraktı ve 13 diyoptriden fazla astigmatizması olan 3 hastanın 3 gözüne, sütürlerin tamamen alınmasından en az 6 ay sonra fakoemülsifikasyon ve kişiye özelleştirilmiş torik göz içi lensi (GİL) ''Acriva BB T UDM 611'' implantasyonu yapıldı. Tüm hastaların ameliyat öncesi ve sonrası düzeltilmemiş ve düzeltilmiş görme keskinlikleri, manifest refraksiyonları, kornea topografileri, otorefraktometrik keratometri değerleri, arka segment muayeneleri ve göz içi basınç ölçümleri yapıldı. Ameliyat sonrası ölçümler ve komplikasyonlar kaydedildi. Korneal astigmatizma her üç hastada da nispeten düzenli bir papyon modeliydi. Astigmatik değişiklikler de değerlendirildi. Ameliyat sırasında veya takipte herhangi bir komplikasyon gözlenmedi. Penetran keratoplasti sonrası katarakt ve yüksek astigmatizması olan hastalarda özelleştirilmiş torik GİL implantasyonu öngörülebilir ve güvenli bir prosedür gibi görünmektedir. Bu öngörülebilir klinik sonuçların, özellikle de GİL rotasyonu ve kapsüler bag stabilitesi açısından doğrulanması için daha uzun süreli takiplere ihtiyacı vardır.

Anahtar Kelimeler: Penetran keratoplasti; katarakt; kişiye özel torik göz içi lensi; astigmatizma
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