• Should I use a toric lens if I have had corneal transplants?


    Question:

    I have two corneal grafts (transplants) and need cataract surgery. My surgeon would implant toric intraocular lenses (IOLs) for astigmatism (irregularly shaped cornea) as part of the procedure. In discussing the risks involved he says that I eventually may need new corneal transplants because of the continual changing nature of my corneas. If so, the implanted lenses would be a total mismatch for the new corneas. Is it possible to remove IOLs after a prolonged period such as 10 years? Is this ever done?


    Answer:

    This is an extremely complicated and nuanced decision. If your grafts are clear and stable and the astigmatism is regular then I would consider a toric intraocular lens. If the grafts are unstable, meaning changing or beginning to fail and repeat transplants are imminent then I would not consider a toric IOL. And, yes, implants can be exchanged but the longer they have been in the more difficult that may be.


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