High astigmatism correction in cataract surgery by astigmatic keratotomy

Abstract

The authors present a case report of a 74-year- old female patient with a unilateral corticonuclear cataract and high corneal astigmatism in her right eye. Patient’s medical history evidenced anisometropic amblyopia with CDVA 0,63 twenty years ago. A cataract surgery of the right eye was indicated. The implantation of a toric IOL was recommended due to the regular corneal astigmatism (4,2 Dcyl) in Pentacam. However, the patient re fused this IOL because of low expectation, so we decided to perform phacoemulsification and implantation of a spheric IOL, with 3 incisional astigmatic keratotomies at the steep corneal meridian. 15 months later, the patient was satisfied as her vision got better to UDVA 0,9 and CDVA 1,0 with 0,5D cyl.
This case study demonstrates the effectiveness of astigmatic keratotomy. Moreover, it points out the possibility of apparent amblyopia, which can be caused by the combination of high refractive error and anis ometropia