Scleral sutured toric intraocular lens with pars plana vitrectomy for the correction of corneal astigmatism without capsular support
Matthew R. Starr, Kevin Ferenchak, Rachel Mogil- Ophthalmology
- General Medicine
Abstract
Purpose:
To describe the repair of a patient with bilateral subluxed cataract and corneal astigmatism in the setting of a coloboma of the iris, zonules, lens, and retina. Pre-operatively his best corrected acuity was 20/500 OD and 20/200 OS. His pre-operative refraction was -7.25 +1.00 at 080 OD and -7.75 +3.00 at 040 OS. On corneal topography, he had 1.95D and 1.45D of regular astigmatism in the right and left eye respectively.
Methods:
This technique involves pars plana vitrectomy in combination with the placement of a MX60 toric intraocular lens fixated to the sclera using 8-0 Gore-Tex in line with the axis of steep corneal astigmatism. The lens is affixed through two pair of nasal and temporal sclerotomies, with each pair located 3 mm posterior to the limbus and 5 mm apart, centered along the axis of steep astigmatism.
Results:
Post-operatively the patient was 20/25 uncorrected OD and 20/20 uncorrected OS with a refraction of -0.75 +0.50 at 180 in the OD and -0.75 +1.00 at 180 in the OS.
Conclusion:
Scleral sutured toric intraocular lens placement and pars plana vitrectomy is a viable solution for patients with regular corneal astigmatism and cataract repair in the absence of zonular support.