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BACKGROUND: The pathophysiological mechanisms of macular edema secondary to branch retinal vein occlusion (BRVO) remain unclear. OBJECTIVES: To analyze the protein profile of human vitreous of patients with BRVO and to identify specific dysregulated proteins. MATERIALS AND METHODS: Undiluted vitreous humor samples from patients with treatment naïve BRVO and 15 controls with idiopathic floaters were analyzed in this clinical-experimental study using capillary electrophoresis coupled to a mass spectrometer (CE-MS) and tandem mass spectrometry (MS/MS). Quantitative analysis of the dysregulated proteins was performed with enzyme-linked immunosorbent assay (ELISA). Protein-protein interactions were depicted with the STRING database. RESULTS: A total of 84 proteins were found in the human vitreous samples of 15 patients with BRVO and 15 controls. In all, 14 proteins were significant when comparing the signal intensities of BRVO and control samples. Six significant dysregulated proteins with p < 0.001 were further verified with ELISA. Clusterin, complement factor C3, prostaglandin-H2 Disomerase and vitronectin were significantly upregulated in the BRVO group and opticin was downregulated. The protein interactions analysis showed associations with inflammatory cascades, matrix changes, mechanisms of cell survival und death. CONCLUSIONS: The results of the study reveal that the proteomic composition of vitreous humor differed significantly between the patients with BRVO and the controls. Whether the identified proteins may serve as potential biomarkers for pathophysiology, diagnostics or therapy should be examine in further studies.
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Edema Macular , Oclusión de la Vena Retiniana , Humanos , Proteoma , Proteómica , Espectrometría de Masas en Tándem , Factor A de Crecimiento Endotelial Vascular , Cuerpo VítreoRESUMEN
Purpose To evaluate and compare the visual performance of a trifocal and a trifocal-toric intraocular lens (IOL) based on the same diffractive platform. Methods Prospective non-randomized comparative study enrolling 142 eyes of 77 patients (age 40-73 years) undergoing uneventful phacoemulsification lens surgery. Two groups were differentiated according to the implanted IOL: trifocal group, 98 eyes (50 patients) implanted with the trifocal diffractive IOL AT LISA tri 839MP (Carl Zeiss Meditec), and trifocal-toric group, 44 eyes (27 patients) implanted with the trifocal-toric diffractive IOL AT LISA trifocal-toric 939MP (Carl Zeiss Meditec). Visual and refractive changes were evaluated 3 months postoperatively. Results No significant differences between groups were found in postoperative refraction (p ≥ 0.144), monocular and binocular uncorrected intermediate visual acuity (UIVA; p = 0.519 and 0.398, respectively) and binocular uncorrected near visual acuity (UNVA; p = 0.073). In contrast, significantly better monocular and binocular uncorrected distance visual acuity (UDVA; p ≤ 0.002), as well as monocular UNVA (p = 0.005), were found in the trifocal group. A postoperative spherical equivalent within ± 1.00 D was found in 98â% and 100â% of eyes in the trifocal and trifocal-toric groups, respectively. Postoperative binocular UDVA, UIVA and UNVA of 20/30 or better were found in 100, 95 and 100â% of eyes, and in 96.3, 95.8 and 90.9â% of eyes in the trifocal and trifocal-toric groups, respectively. Conclusions The evaluated trifocal and trifocal-toric IOLs both provide a successful restoration of the visual function after cataract surgery, with good levels of refractive precision, as well as UIVA and UNVA.
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Lentes Intraoculares , Facoemulsificación , Humanos , Satisfacción del Paciente , Estudios Prospectivos , Diseño de Prótesis , Seudofaquia , Refracción OcularRESUMEN
Purpose To compare the visual outcomes after ReLEx SMILE treatment of eyes with low and high PTA values (PTA: percent tissue altered) within a follow-up period of up to 3 years and to assess whether a high PTA value might contribute to the development of keratectasia, as is the case for LASIK. Methods This retrospective analysis comprises results from 313 eyes (189 patients) with a PTA value of less than 40â% and of 373 eyes (213 patients) with a PTA value of at least 40â%. Preoperatively and up to 3 years after SMILE surgery, refraction values, monocular corrected (CDVA) and uncorrected distant visual acuity (UDVA) and wavefront data were evaluated. Results One to 3 years after surgery, the group with PTA < 40â% (PTA ≥ 40â%) had a loss of two Snellen lines in 1.1â% (0.0â%) of the cases. Loss of one line occurred in 1.1â% (3.6â%) of the eyes, whereas 97.7â% (96.4â%) remained unchanged or gained lines. With respect to predictability of the spherical equivalent, 92.0â% (78.6â%) of the eyes were within ± 0.5D and 97.7â% (92.9â%) were within ± 1.0D. The group with high PTA values displayed a slightly but significantly greater undercorrection of about 0,25D. 74.4â% (71.8â%) achieved UDVA of at least 20/20 and 96.5â% (87.1â%) achieved at least 20/25. The mean UDVA was - 0.03 ± 0.10logMAR (0.01 ± 0.12logMAR) and its mean difference to the preoperative CDVA was 0.00 ± 0.09logMAR (0.03 ± 0.12logMAR). Conclusion ReLEx SMILE is a safe and effective corneal refractive treatment, even for PTA values of 40â% and more. Eyes with high PTA values did not display any evidence of keratectasia development within the 3-year follow-up of this study.
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Córnea/patología , Enfermedades de la Córnea/epidemiología , Cirugía Laser de Córnea/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Errores de Refracción/epidemiología , Agudeza Visual , Adulto , Anciano , Causalidad , Comorbilidad , Enfermedades de la Córnea/patología , Enfermedades de la Córnea/prevención & control , Dilatación Patológica , Medicina Basada en la Evidencia , Femenino , Alemania/epidemiología , Humanos , Incidencia , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/estadística & datos numéricos , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/prevención & control , Prevalencia , Errores de Refracción/terapia , Estudios Retrospectivos , Factores de Riesgo , Resultado del TratamientoRESUMEN
PURPOSE: Evaluation of the visual and refractive results 3 months after implantation of a diffractive extended range of vision (ERV) intraocular lens (IOL) during cataract surgery. METHODS: In a prospective multicentre study, patients with a calculated postoperative corneal astigmatism of ≤ 1.5 D received a diffractive ERV IOL (TECNIS Symfony, model ZXR00, Abbott Medical Optics, USA) during cataract surgery. After 3 months, the monocular and binocular corrected and uncorrected far, intermediate and near visual acuity, as well as refraction, were evaluated. RESULTS: 18 patients (36 eyes) with a mean age of 63.34 ± 4.6 years underwent bilateral cataract surgery. After 3 months, the binocular uncorrected distance visual acuity (UDVA) of logMAR was - 0.05 ± 0.11 and the corrected distance visual acuity (CDVA) of logMAR - 0.14 ± 0.05. Binocular uncorrected intermediate (UIVA) and near visual acuity (UNVA) were logMAR - 0.09 ± 0.02 and 0.19 ± 0.09, respectively. A target refraction of ± 0.75 D was reached by 89â% of the patients. CONCLUSION: Implantation of an extended range of vision intraocular lens offers an effective way for visual rehabilitation at far and intermediate distances. Near vision is still in a functional range.
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Extracción de Catarata/rehabilitación , Implantación de Lentes Intraoculares , Lentes Intraoculares , Recuperación de la Función , Errores de Refracción/diagnóstico , Errores de Refracción/rehabilitación , Adulto , Extracción de Catarata/efectos adversos , Análisis de Falla de Equipo , Femenino , Estudios de Seguimiento , Alemania , Humanos , Estudios Longitudinales , Masculino , Diseño de Prótesis , Errores de Refracción/etiología , Resultado del Tratamiento , Agudeza VisualRESUMEN
PURPOSE: Evaluation of the clinical data 3 months after implantation of a new diffractive multifocal intraocular lens (MIOL) with a reduced near add power of + 2.75 D. METHODS: In a prospective study, patients who underwent cataract surgery or refractive lens exchange with implantation of an MIOL (Tecnis ZKB00, Abbott Medical Optics, Santa Ana, California, USA) were included. Three months postoperative corrected and uncorrected visual acuities at different distances were measured and evaluated. Those patients that underwent bilateral MIOL implantation additionally filled out a questionnaire 3 months postoperatively. RESULTS: Between October 2013 and August 2014, 115 eyes of 62 patients were implanted with the ZKB00 IOL. Mean postoperative refractions were - 0.27 ± 0.44 D for the spherical equivalent, respectively. Mean binocular CDVA was - 0.01 ± 0.3 logMAR with a mean binocular UDVA of 0.06 ± 0.08 logMAR. For near distance in 40 cm, an UNVA of 0.07 ± 0.10 logMAR three months postoperatively was measured. CONCLUSION: The ZKB00 IOL belongs to a group of novel MIOL with an increased intermediate visual performance. Our study shows good visual acuity at all distances, as well as a high rate of satisfaction and subjectively good image quality.
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Extracción de Catarata/efectos adversos , Extracción de Catarata/rehabilitación , Implantación de Lentes Intraoculares , Lentes Intraoculares/clasificación , Errores de Refracción/etiología , Errores de Refracción/terapia , Anciano , Anciano de 80 o más Años , Análisis de Falla de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Diseño de Prótesis , Errores de Refracción/diagnóstico , Resultado del Tratamiento , Agudeza VisualRESUMEN
PURPOSE: To correlate key inflammatory and pro-angiogenic cytokines from undiluted vitreous fluid of treatment-naïve patients with central retinal vein occlusion (CRVO) with SD-OCT parameters. METHODS: Thirty-five patients (age 71.1 years, 24 phakic, 30 non-ischaemic) underwent intravitreal combination therapy, including single-site 23-gauge core vitrectomy. Twenty-eight samples from patients with idiopathic, non-uveitis floaterectomy served as controls. Levels of interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF-A) were correlated with visual acuity (logMar), category of CRVO (ischaemic or non-ischaemic) and morphological parameters, such as central macular thickness (CMT), thickness of neurosensory retina (Tneuro), extent of serous retinal detachment (SRT) and disintegrity of the IS/OS and others. RESULTS: Mean IL-6 was 64.7 pg/ml (SD ± 115.8), mean MCP-1 1015.7 pg/ml (± 970.1), and mean VEGF-A 278.4 pg/ml (± 512.8), which was significantly higher than the control values of IL-6 6.2 ± 3.4 pg/ml (p = 0.06), MCP-1 253.2 ± 73.5 pg/ml (p < 0.0â000â001) and VEGF-A 7.0 ± 4.9 pg/ml (p < 0.0006), respectively. All cytokines correlated highly with one another (correlation coefficient r = 0.82 for IL-6 and MCP-1; r = 0.68 for Il-6 and VEGF-A; r = 0.64 for MCP-1 and VEGF-A). IL-6 correlated significantly with CMT, TRT, SRT, dIS/OS, and dELM. MCP-1 correlated significantly with SRT, dIS/OS, and dELM. VEGF-A did not correlate with changes in SD-OCT, while it had a trend to be higher in the ischaemic versus the non-ischaemic CRVO groups (p = 0.09). CONCLUSIONS: The inflammatory cytokines were more often correlated with morphological changes assessed by SD-OCT, whereas VEGF-A did not correlate with CRVO-associated changes in SD-OCT. VEGF inhibition alone may not be sufficient to decrease the inflammatory response in CRVO therapy.
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Citocinas/inmunología , Mediadores de Inflamación/inmunología , Oclusión de la Vena Retiniana/inmunología , Oclusión de la Vena Retiniana/patología , Tomografía de Coherencia Óptica/métodos , Cuerpo Vítreo/inmunología , Anciano , Femenino , Humanos , Aumento de la Imagen/métodos , Masculino , Reproducibilidad de los Resultados , Oclusión de la Vena Retiniana/diagnóstico por imagen , Sensibilidad y Especificidad , Estadística como AsuntoRESUMEN
BACKGROUND: To estimate the efficacy and safety profile of half-dose photodynamic therapy (hdPDT) for treating central serous chorioretinopathy (CSC). PATIENTS AND METHODS: An interventional, retrospective case series of patients with CSC (symptoms ⧠3 months) receiving half-dose PDT (3 mg/m2 verteporfin). The ophthalmic examination at baseline and at 8 and 16 weeks after treatment included slit-lamp biomicroscopy, indirect ophthalmoscopy, measurement of intraocular pressure (IOP), ETDRS best-corrected visual acuity (BCVA), Amsler grid screening and contrast visual acuity (CVA). Fluorescein angiography (FA), autofluorescence (FAF) and optical coherence tomography (OCT) were measured at each visit. Central macular thickness (CMT) was measured automatically. RESULTS: 12 eyes of 12 patients (10 male and 2 female patients; mean age 46.6 ± 7.91 years) were included in this study. Anatomical resolution was obtained in 10 eyes (83.4â%) at week 16, but 2 eyes (16.6â%) exhibited persistent SRD throughout the follow-up period. Baseline CMT decreased from initially 330.1 µm ± 131.3 to 205.6 µm ± 97.6 (p = 0.034) at week 8 and to 220.3 µm ± 120.1 (p = 0.05) at week 16. Visual acuity (number of total letters read) significantly improved from initially 82.8 ± 11.5 to 86.8 ± 13.9 at week 8 and 91.3 ± 13.8 at week 16 (p = 0.012). Contrast visual acuity (calculated decimal visual acuity) significantly improved from initially 0.14 ± 0.09 to 0.38 ± 0.28 (p = 0.002) at week 16. After therapy, no significant changes in RPE could be detected with FAF and no ocular adverse events were observed. CONCLUSION: PDT with half-dose verteporfin resulted in reduced leakage in FA, enhanced visual acuity and resolution of subretinal fluid in OCT in patients with CSC, with no detected side effects of treatment.
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Coriorretinopatía Serosa Central/tratamiento farmacológico , Coriorretinopatía Serosa Central/patología , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/administración & dosificación , Porfirinas/administración & dosificación , Trastornos de la Visión/prevención & control , Coriorretinopatía Serosa Central/diagnóstico , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fotoquimioterapia/efectos adversos , Porfirinas/efectos adversos , Estudios Retrospectivos , Resultado del Tratamiento , Verteporfina , Trastornos de la Visión/diagnóstico , Agudeza Visual/efectos de los fármacosRESUMEN
BACKGROUND: A clinical evaluation of the functional results and its impact on daily activities of an aspherical, aberration correcting intraocular lens (IOL) was undertaken. PATIENTS/METHODS: Twenty-one patients aged from 50 to 83 years underwent cataract surgery with implantation of the aspheric IOL (Tecnis ZCB00, Abbott Medical Optics). They were evaluated 2 to 4 months after surgery for their subjective satisfaction of vision quality and its impact on performance of daily activities as well as functional results and refractive outcome. Patients were asked to fill out a questionnaire - the Heidelberg DATE (DAily Tasks Evaluation) questionnaire. RESULTS: Significant changes from pre- to postoperative results were found in refraction (p ≤ 0.03), with a mean prediction error of + 0.21 ± 0.43 D. UDVA and CDVA improved significantly (p < 0.01), with a postoperative CDVA of 0.0 logMAR or better in 97.1â% of eyes. All patients would recommend the procedure to a relative or a friend and 93.8â% of patients reported to be satisfied with the outcome. CONCLUSION: The implantation of the aspheric IOL Tecnis ZCB00 after cataract surgery allows the restoration of visual function, providing an optimised optical quality and a high level of patient satisfaction.
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Actividades Cotidianas/psicología , Extracción de Catarata/psicología , Extracción de Catarata/rehabilitación , Lentes Intraoculares , Satisfacción del Paciente , Errores de Refracción/rehabilitación , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Implantación de Lentes Intraoculares , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Errores de Refracción/diagnóstico , Errores de Refracción/psicología , Encuestas y Cuestionarios , Resultado del Tratamiento , Agudeza VisualRESUMEN
PURPOSE: An evaluation of the visual and refractive results was undertaken one year after implantation of a trifocal diffractive toric intraocular lens (IOL) during cataract surgery. METHODS: In a prospective study patients with a calculated postoperative corneal astigmatism of ≥ 0.75 D received a diffractive trifocal toric IOL (AT LISA tri toric 939MP, Carl Zeiss Meditech, Jena, Germany) during cataract surgery. One year postoperatively the near, intermediate and distance visual acuity, corrected and uncorrected vision as well as refraction were evaluated. RESULTS: 20 patients (40 eyes) with a median age of 59 ± 11 years of which 15 were female underwent bilateral cataract surgery. One year postoperatively a binocular uncorrected distance visual acuity (UDVA) of 0.10 logMAR ± 0.11 and a corrected distance visual acuity (CDVA) of 0.00 logMAR ± 0.08 could be found. Binocular intermediate visual acuity (UIVA) and near visual acuity (UNVA) were 0.00 logMAR ± 0.05 and 0.09 logMAR ± 0.07, respectively. 100â% of patients were between ± 1.0 D from target refraction. Even 1 year after surgery no patient had an IOL rotation greater than 5°. CONCLUSION: The implantation of a trifocal toric intraocular lens offers an effective way for visual rehabilitation in near, intermediate and far distances with a good rotational stability of the IOL platform.
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Extracción de Catarata/rehabilitación , Lentes Intraoculares , Recuperación de la Función , Errores de Refracción/diagnóstico , Errores de Refracción/prevención & control , Agudeza Visual , Extracción de Catarata/efectos adversos , Femenino , Humanos , Implantación de Lentes Intraoculares , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Errores de Refracción/etiología , Resultado del TratamientoRESUMEN
PURPOSE: The aim of this study was to make an evaluation of the pseudoaccommodation span and clinical results after implantation of a diffractive, apodised and trifocal multifocal intraocular lens (MIOL). METHODS: In a prospective, single-centre study 28 eyes of 14 patients were evaluated after in the bag implantation of the Micro-F MIOL (PhysIOL, Belgium) during routine microsurgical cataract surgery. Two to four months postoperatively the final examinations were performed. Refraction, visual acuity monocular and binocular (near in 40 cm, intermediate in 80 cm and distance) as well as binocular defocus curves were evaluated. RESULTS: Mean monocular UDVA (uncorrected distance visual acuity) increased significantly (p < 0.0001) from 0.471 ± 0.22 logMAR to 0.144 ± 0.14 logMAR. For the monocular UNVA (uncorrected near visual acuity) and UIVA (uncorrected intermediate visual acuity) postoperative values of 0.127 ± 0.117 and 0.158 ± 0.20 logMAR compared to binocular results of 0.057 ± 0.137 and 0.094 ± 0.181 logMAR were found. In the analysis of the binocular defocus curve two peaks could be found between 0.0 and - 0.5 D with a visual acuity of 0.0 logMAR and at - 3.0 D with a visual acuity of 0.068 logMAR. In the intermediate range a constant pseudoaccommodation of 0.2 logMAR could be found. CONCLUSIONS: The trifocal, diffractive MIOL shows good functional results in all distances with a span of pseudoaccommodation of 3D and a mean visual acuity of 0.2 logMAR and better. Indeed it is offering a high level of spectacle independency without the typical intermediate gap of bifocal diffractive MIOLs.
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Acomodación Ocular , Extracción de Catarata/rehabilitación , Lentes Intraoculares/clasificación , Errores de Refracción/rehabilitación , Visión Binocular , Agudeza Visual , Análisis de Falla de Equipo , Humanos , Implantación de Lentes Intraoculares , Diseño de Prótesis , Errores de Refracción/diagnóstico , Resultado del TratamientoRESUMEN
Nowadays, further developments in the field of intraocular lenses offer a higher level of spectacle independence for our patients. As light gets scattered on different focal points a wider range of defocus is created. This greater defocus area makes it more difficult for us to determine the objective or subjective refraction. This contribution is concerned with the difficulties of measuring visual acuity in different intraocular lens designs and different measurement distances. Measuring refraction after implantation of a multifocal intraocular lens is a complex procedure and the experience of the examiner plays a crucial role. Retinoscopy, keratometry and the defocus curve are reliable methods for testing, while the auto refractometer, bichromatic testing and the cross-cylinder have limitations.
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Paquimetría Corneal/métodos , Lentes Intraoculares , Presbiopía/diagnóstico , Presbiopía/rehabilitación , Refracción Ocular , Retinoscopía/métodos , Humanos , Implantación de Lentes Intraoculares , Evaluación de Resultado en la Atención de Salud/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Resultado del TratamientoAsunto(s)
Antiinflamatorios/administración & dosificación , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/terapia , Implantes de Medicamentos/administración & dosificación , Fluocinolona Acetonida/administración & dosificación , Trastornos de la Visión/prevención & control , Anciano de 80 o más Años , Enfermedad Crónica , Retinopatía Diabética/complicaciones , Femenino , Humanos , Inyecciones Intravítreas , Insuficiencia del Tratamiento , Resultado del Tratamiento , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiología , Agudeza VisualRESUMEN
OBJECTIVE OF SURGERY: The aim of the surgical treatment of retinal detachment is retinal reattachment especially of the central portion for the best possible regeneration of functional visual outcome. INDICATIONS: Total and subtotal retinal detachments in combination with macular involvement were investigated. SURGICAL TECHNIQUE: After complete 20 or 23-gauge pars plana vitrectomy (ppV) the internal limiting membrane (ILM) was stained with Brilliant Blue for 30 s. The detached and more mobile central retina was weighted and stabilized with decaline so that the raised ILM could be carefully peeled away under the decaline level. Removal of residual decaline was followed by drainage of subretinal fluids through the retinal foramen and fluid-air exchange. To prevent renewed detachment circular laser coagulation was performed under air and followed by tamponade with silicone oil or SF6 gas depending on the status of the retina. RESULTS: The surgical intervention could be successfully performed in all selected patients with a primary reattachment rate of 100 %. In the 12-month follow-up period no renewed detachment or formation of a secondary epiretinal membrane was observed. The postoperative visual acuity (VA) showed a statistically significant increase (p < 0.0001) in the Wilcoxon test for paired samples. CONCLUSION: Primary vitrectomy with ILM peeling under decaline is a promising but ambitious surgical intervention for the treatment of incomplete and complete retinal detachment with and without proliferative vitreoretinopathy.
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Membrana Epirretinal/cirugía , Naftalenos/uso terapéutico , Desprendimiento de Retina/patología , Desprendimiento de Retina/cirugía , Vitrectomía/métodos , Anciano , Terapia Combinada , Femenino , Humanos , Masculino , Resultado del TratamientoAsunto(s)
Antihipertensivos/efectos adversos , Hipersensibilidad a las Drogas/etiología , Glaucoma/complicaciones , Glaucoma/tratamiento farmacológico , Presión Intraocular/efectos de los fármacos , Sensibilidad Química Múltiple/complicaciones , Antihipertensivos/administración & dosificación , Hipersensibilidad a las Drogas/diagnóstico , Femenino , Glaucoma/diagnóstico , Glaucoma/cirugía , Humanos , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Sensibilidad Química Múltiple/diagnóstico , Soluciones Oftálmicas , StentsRESUMEN
BACKGROUND: Residual refractive errors, especially high-grade astigmatism after penetrating keratoplasty, often lead to a significant loss of vision. If high anismetropia could not be corrected with glasses or contact lenses, different kinds of surgical procedures are available for visual rehabilitation (intraocular lens exchange, astigmatic keratotomy, Excimer laser treatment, intrastromal corneal ring segment implantation and additive intraocular lens implantation). Toric add-on IOLs are especially designed for sulcus implantation and correcting high astigmatism in pseudophakic eyes. All toric IOLs are individually manufactured according to subjective refraction and biometry. Depending on the underlying manufacturer high-grade astigmatism can be corrected with a cylindrical power up to + 30.0 D. CASE REPORT: A 74-year-old patient presented with endothelial decompensation and an uncorrected distance visual acuity (UDVA) of 1.0 logMAR for penetrating keratoplasty on the right eye due to a Fuchs endothelial dystrophy. Postoperatively, the uncorrected distance visual acuity improved to 0.8 logMAR, with pinhole correction to 0.5 logMAR. After removing the sutures a high and irregular corneal astigmatism of 21.0 D was found. The corrected distance visual acuity (CDVA) with a refraction of + 5.5 D sph, - 21.0 D cyl 90° was 0.24 logMAR. Therefore an individually manufactured toric additive intraocular lens of + 25.0 D cylindrical and - 18.0 D spherical power for sulcus implantation was chosen and implanted uneventfully. Eight months after surgery refractive astigmatism was reduced significantly to - 0.75 D with an UDVA of 0.08 logMAR and a CDVA of 0.02 logMAR. During the 8-months follow-up period the additive IOL remained centered and no IOL rotation could be observed. CONCLUSION: Toric add-on IOLs are a safe and successful method for reducing high astigmatism and anisometropia after penetrating keratoplasty. One of the main advantages is the reversibility of the procedure by an explantation of the IOL.