One of the patients was, at time of the refractive surgery, 36 years old. The refraction was: OD -18.0 - 3.5 cyl / 14° and OS -18.0 -3.5 cyl 174°. After Implantation of an Artisan IOL, the postoperative best corrected visual acuity (BCVA) was: OD -1.0 -2.75 16° =20/25 and OS -0.75 -2.25 167°=20/25.
Four months after stabile refraction, an uneventful excimer treatment of the residual astigmatism with photorefractive keratectomy was undertaken. The postoperative refraction was: BCVA OD -0.75 -0.5 / 10° = 20/25 and BCVA OS +0.25 - 0.5 / 175° = 20/25. The uncorrected visual acuity was also 20/25.
Ten years later, the patient developed a cataract in both eyes. The four surgical options outlined above, as well as possible late complications, were discussed.
“Since the corneal endothelium showed almost no loss of cells (and so was normal), we decided on the forth option,” explained Dr Klass.
“The correct power of the IOL was calculated with the help of the formulas of Gullstrand's theoretical analyses and individual corrections based on our complete IOL-master-values before and after pIOL-implantation as well as immediately before cataract surgery,” he added.