Multifocal toric intraocular lens implantation for forme fruste and stable keratoconus

To describe the results of multifocal toric intraocular lens implantation in two patients (one with forme fruste keratoconus and the other with frank but stable keratoconus).

A 50-year-old woman with forme fruste keratoconus and positive family history of keratoconus and a 42-year-old man with frank keratoconus underwent corneal collagen cross-linking. Uncorrected distance visual acuity was 20/800 in the right eye and 20/400 in the left eye and 20/400 in the right eye and 20/100 in the left eye, respectively. Refractive lens exchange was performed using multifocal toric intraocular lenses in both cases.

After phacoemulsification, uncorrected distance visual acuity, corrected distance visual acuity, binocular uncorrected distance visual acuity was 20/25 and 20/30 in cases 1 and 2, respectively, and residual refraction was within 0.5 diopters of emmetropia in both cases. Patients were subjectively satisfied.

Presbyopic treatment options are scarce for patients with keratoconus and multifocal toric intraocular lenses may be useful in selected cases.