Toric intraocular lenses for astigmatism correction after keratoplasty in phakic and pseudophakic eyes

Residual astigmatism and anisometropia significantly affect patients' vision and quality of life even in clear grafts after corneal transplant. This study reviewed and summarized the role of toric intraocular lenses (IOLs) in phakic and pseudophakic eyes after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty in correcting residual astigmatism. 342 eyes from 20 studies with iris-clipped toric IOL, ciliary sulcus toric implantable collamer lens, piggyback sulcus toric IOL, or posterior chamber toric IOL implantations for phakic, pseudophakic, or eyes undergoing cataract surgery after keratoplasty were included. Visual, refractive, and predictability outcomes were encouraging. Secondary realignment rate and complications were low. Endothelial cell loss secondary to phakic toric IOLs might be a concern over the long-term, particularly in iris-clipped IOLs in PKP eyes. Toric IOLs represent a viable option in the treatment of residual astigmatism in postkeratoplasty eyes, resulting in improved visual acuity and reduced anisometropia.