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Add-on toric lens as an effective treatment of high residual astigmatism after keratoplasty in a pseudophakic patient

Poster Details

First Author: P. Cid-Bertomeu SPAIN

Co Author(s):    V. Huerva Escanilla   M. Vilatella Ortiz   M. Sancho Romero   M. Dominguez Bernaus           

Abstract Details


To report a challenging refractive case of one pseudophakic patient with high residual astigmatism post-keratoplasty who was treated with a toric AddOnᆴ toric intraocular lens (IOL) placed in sulcus.


Department of Ophthalmology. Arnau de Vilanova University Hospital. University of Lleida. Lleida, Spain.


Case Report. Data was collected preoperatively and postoperatively between January of 2015 and December of 2020, and included under corrected and best corrected visual acuity, axial length, anterior chamber depth, keratometry and corneal topography. The correction cylinder for the AddOnᆴ IOL was calculated using subjective refraction. Informed consent was obtained from the patient.


A 79-year-old man with ophthalmologic history of pseudoexfoliative glaucoma and Fuchs endothelial dystrophy had a graft failure after DSAEK procedure on his right eye. Consequently, a penetrating keratoplasty was performed and a high residual corneal astigmatism of -10.2D resulted in that eye after selective suture removal. As a treatment, an AddOnᆴ toric IOL customized for the patient with a power of +11D was implanted to 50ᄎ in sulcus of the right eye. Final refraction was +1.0D of sphere and -2.0D of cylinder to 105ᄎ, which spherical equivalent result in 0.0D. Best corrected visual acuity was logMAR 0.1 (20/25, 0.8 decimal).


High astigmatism is a common complication after penetrating keratoplasty and its treatment can be challenging in those patients who are already pseudophakic. With our case, we can state that the toric AddOn secondary IOL, when placed in sulcus, can be effective and safe in correcting refractive error of high astigmatism after keratoplasty in pseudophakic eyes.

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