Accuracy of astigmatism correction with toric intraocular lens implantation in eyes with previous radial keratotomy

Purpose: To evaluate refractive outcomes of toric intraocular lens (IOL) implantation in eyes with previous radial keratotomy (RK). Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. Design: Retrospective case series. Methods: Consecutive cases with previous RK and had undergone cataract surgery with toric IOL implantation and met the following criteria were retrospectively reviewed: (1) regular bowtie corneal astigmatism within the central 3.0 mm zone, (2) difference in corneal regular astigmatism magnitude between the IOLMaster and Lenstar of <= 0.75 diopters (D), (3) difference in the regular astigmatism meridians from the 2 biometers of <= 15 degrees, and (4) available postoperative manifest refraction at >= 8 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism. Results: In 40 eyes of 31 patients with previous RK, preoperatively, the mean magnitude of corneal regular astigmatism was 2.10 +/- 0.98 D; 1 (3%) and 2 (10%) eyes had anterior corneal regular astigmatism <= 0.5 D and <= 1.0 D, respectively; and the centroid value was 1.14 D @ 179 degrees +/- 2.05 D. Postoperatively, the mean magnitude of refractive regular astigmatism was 0.46 +/- 0.44 D; 29 (73%) and 35 (88%) of eyes had refractive regular astigmatism <= 0.5 D and <= 1.0 D, respectively (P < .05); and the centroid value was 0.12 D @ 173 degrees +/- 0.63 D (P < .05). Conclusions: Toric IOLs can be used successfully to treat corneal regular astigmatism in eyes with previous RK. Copyright (C) 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.