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Astigmatism and the toric intraocular lens and other vertex distance effects.

An intraocular lens with a given cylindrical power will correct a variable amount of cylinder at the spectacle plane. This variability depends not only on the vertex distance but also on the degree of ametropia. The amount of spectacle cylinder corrected will be more for myopes and less for hyperopes. Anterior corneal cylinder (as determined by the keratometer) is a more reliable way of estimating the cylinder needed at the intraocular lens plane.

Astigmatism↗
PubMed1984

The value of the Terry keratometer in predicting postoperative astigmatism.

The Terry keratometer was used immediately before and immediately after cataract surgery. The results were compared with keratometry readings taken before surgery and readings taken on the morning of the first postoperative day. The mean preoperative cylinder in 27 eyes was 1/2 diopter less than that measured prior to the start of surgery. Preoperative readings and readings obtained prior to the start of surgery differed by more than 1 diopter in 37% of eyes. The keratometer readings obtained at the end of the surgery in 63 eyes were flatter than those obtained on the first postoperative day. Forty-four percent of the intraoperative cylinder readings differed from postoperative readings by more than 2 diopters. The factors which can produce errors with the use of this instrument include changes in intraocular pressure, the effect of the lid speculum, rectus suture tension, the alignment of the eye with respect to the keratometer , and user experience.

Aged↗
PubMed1985

Visual acuity, refractive error, and astigmatism following corneal transplantation for pseudophakic bullous keratopathy.

Seventy-six corneal transplants performed by one surgeon for pseudophakic bullous keratopathy (PBK) were studied. The mean follow-up was 23 months (range 2-76). Of 41 eyes with lenses left in situ, the mean acuity was 20/45; 60.9% of the eyes saw 20/40 or better. In contrast, the mean acuity for 18 eyes with lens removal and 17 eyes with intraocular lens exchange was 20/52 and 20/62, respectively; 42.8% saw 20/40 or better. Eighty-three percent of all grafts remained clear. Vitreous loss, glaucoma, and cystoid macular edema were more common with eyes with lens removals and exchanges. The type of lens present at transplant for PBK did not affect visual outcome. Although the results were not statistically significant, this study suggests that lenses left in situ are associated with a better visual prognosis, and that there is no difference in the clinical results between aphakic and pseudophakic bullous keratopathy.

Aged↗