{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:57:05Z","timestamp":1788587825449,"version":"build-2803163510"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To analyze the outcomes of phacoemulsification with high power customized toric intraocular lens implantation (IOL) in patients with high corneal astigmatism (6-10 D Cyl) post keratoplasty and keratoconus eyes with cataract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Five eyes post keratoplasty with clear graft, four eyes with stable keratoconus, one eye with pterygium excision scar with visually significant cataract were included in this retrospective study. Phacoemulsification was done followed by implantation of custom made high power toric IOL in all patients. Outcomes included uncorrected and best-corrected distance visual acuity (UDVA, BCVA), pre-operative astigmatism at the corneal plane and IOL plane, post-operative residual astigmatism, mean torus of all IOLs used were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The minimum follow-up time was 12 months. At the last follow-up visit, there was a significant improvement (pre-operative vs post-operative) of UDVA (1.5 \u00b1 0.47 vs 0.28 \u00b1 0.14 logMAR;\n                      <jats:italic toggle=\"yes\">P &lt;<\/jats:italic>\n                      0.05), cylindrical refraction (-9.0 \u00b1 1.80 D vs - 1.1 \u00b1 0.45 vs ;\n                      <jats:italic toggle=\"yes\">P &lt;<\/jats:italic>\n                      0.05). Range of IOL powers used was 1.0-26.50 DSph and 9.0-15.5 DCyl. Post-operative mean residual spherical equivalent was 0.75 \u00b1 0.5.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This novel study describes the effectiveness of custom toric IOLs in high astigmatism in the range of 9.0-15.5 DCyl. Phacoemulsification with implantation of a customized high power toric IOL was effective in correcting high astigmatism in complex cases in our study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2640_20","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T14:43:02Z","timestamp":1624632182000},"page":"1766-1768","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["High power custom toric intraocular lens for correcting high corneal astigmatism in post-keratoplasty and keratoconus patients with cataract"],"prefix":"10.4103","volume":"69","author":[{"given":"J K","family":"Reddy","sequence":"first","affiliation":[{"name":"Department of Cornea, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja C","family":"M","sequence":"additional","affiliation":[{"name":"Department of Cornea, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhakar","family":"G V","sequence":"additional","affiliation":[{"name":"Department of Cornea, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,6,18]]},"reference":[{"key":"R1-20260523","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/S0161-6420(00)00112-3","article-title":"Penetrating keratoplasty for keratoconus:Visual outcome and success","volume":"107","author":"Lim","year":"2000","journal-title":"Ophthalmology"},{"key":"R2-20260523","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1016\/j.ophtha.2010.07.033","article-title":"The AcrySof Toric intraocular lens in subjects with cataracts and corneal astigmatism:A randomized, subject-masked, parallel-group, 1-year study","volume":"117","author":"Holland","year":"2010","journal-title":"Ophthalmology"},{"key":"R3-20260523","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1001\/archophthalmol.2010.127","article-title":"Economic evaluation of toric intraocular lens:A short- and longterm decision analytic model","volume":"128","author":"Pineda","year":"2010","journal-title":"Arch Ophthalmol"},{"key":"R4-20260523","doi-asserted-by":"crossref","first-page":"230","DOI":"10.3111\/13696990903257439","article-title":"Modelling lifetime cost consequences of toric compared with standard IOLs in cataract surgery of astigmatic patients in four European countries","volume":"12","author":"Laurendeau","year":"2009","journal-title":"J Med Econ"},{"key":"R5-20260523","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.jcrs.2011.01.015","article-title":"Phacoemulsification and customized toric intraocular lens implantation in eyes with cataract and high astigmatism after penetrating keratoplasty","volume":"37","author":"de Sanctis","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"R6-20260523","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/ICO.0b013e31802be5cc","article-title":"Cataract surgery with toric intraocular lenses can optimize uncorrected postoperative visual acuity in patients with marked corneal astigmatism","volume":"26","author":"Kersey","year":"2007","journal-title":"Cornea"},{"key":"R7-20260523","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1444-0938.2009.00436.x","article-title":"Correction of astigmatism after penetrating keratoplasty using the Acri. Comfort toric intraocular lens","volume":"93","author":"Statham","year":"2010","journal-title":"Clin Exp Optom"},{"key":"R8-20260523","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/j.1442-9071.2010.02336.x","article-title":"Comparison of grafted and non-grafted patients with corneal astigmatism undergoing cataract extraction with a toric intraocular lens implant","volume":"38","author":"Stewart","year":"2010","journal-title":"Clin Experiment Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_2640_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:26:52Z","timestamp":1786735612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_2640_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,18]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2640_20","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,18]]},"assertion":[{"value":"2020-08-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}