Implantation of toric intraocular lens (IOL) during cataract surgery in eyes with irregular astigmatism such as keratoconus and pellucid marginal degeneration (PMD) is controversial with uncertainty over possible deterioration in higher order aberrations (HOAs) following surgery. We report a case of success in bilateral implantation of toric intraocular lenses, the Alcon Acrysof�® model SN60T9, in which the HOAs of one of the PMD eyes were documented pre- and post-operatively with the use of a new aberrometer, the Topcon KR-1W. Overall, uncorrected visual acuity, best-corrected visual acuity, total ocular and internal HOAs of the eye were improved after surgery, and the patient gained spectacle-independence and was happy with the outcome.
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