Toric intraocular lens implantation in eyes with forme fruste keratoconus

We describe 2 cases of hydrophobic aspheric toric IOL implantation following phacoemulsification in eyes with topographic evidence of keratoconus. Several modalities of keratometric measurement were used preoperatively. Postoperatively, visual acuity, manifest refraction, and toric IOL axis were examined. At 6 months, the corrected distance visual acuity in Case 1 was 20/25 (1.75 diopters refractive cylinder) and the uncorrected distance visual acuity in Case 2 was 20/20 (no refractive cylinder). These 2 cases demonstrate that toric IOL implantation at the time of cataract surgery can be a safe and effective method for correcting astigmatism in eyes with forme fruste keratoconus when the preoperative steep meridian can be identified. Neither author has a financial or proprietary interest in any material or method mentioned.