An Abnormal Increase in Corneal Astigmatism after Cataract Surgery in a Post-LASIK Eye: A Case Report
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Background: To investigate the impact of prior corneal refractive surgery on visual quality after phacoemulsification with toric intraocular lens (toric IOL) implantation. Case presentation: We report the case of a 55-year-old male with a history of bilateral LASIK who underwent phacoemulsification with toric IOL implantation for cataracts and astigmatism in the right eye, with a focus on the diagnosis and management of intraocular lens rotation and astigmatism fluctuations postoperatively. Results: The patient exhibited an abnormal increase in preoperative-to-postoperative changes in corneal astigmatic vectors (PCAVs) after cataract surgery and toric IOL implantation due to lens rotation, requiring IOL repositioning. Postoperative corneal astigmatism showed an abnormal increase of 1.75 D but gradually stabilized after an extended recovery period. Conclusions: A history of refractive surgery significantly affects postoperative corneal astigmatism during cataract surgery, increasing prediction errors and prolonging postoperative recovery in toric IOL patients. Cautious patient selection and thorough preoperative consultation are essential.
