This study evaluates the outcome of toric sulcus fixated lenses (MS 614/714 TPB (Human Optics, Germany) in 21 eyes with high astigmatism. The cases included previous penetrating keratoplasty (n=15), post cataract surgery astigmatism (n=3), rotation of in-the-bag toric IOL (n=1), undetected keratoconus following cataract surgery (n=1) and congenital astigmatism (n=1). A 71% reduction in astigmatism was achieved and 13 eyes (65%) achieved a spherical equivalent within 1.0 dioptres. Five eyes required a secondary axis adjustment. Three eyes developed postoperative corneal oedema, of which one required a transplant. A further two eyes developed graft failure necessitating explantation of the IOL and a re-graft. Other complications included transient intraocular pressure rise (n=2) and pigment dispersion (n=2). The authors did not evaluate binocular function following treatment. The failure to achieve a higher proportion nearer to the target refraction is explained by the lack of dioptric range, surgically induced astigmatism and case complexity.
Piggyback toric IOLs in complex cases
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