Combined 25-gauge microincision vitrectomy and toric intraocular lens implantation with posterior capsulotomy

Purpose: To evaluate the efficacy of combined 25-gauge microincision vitrectomy surgery (MIVS) and toric intraocular lens (IOL) implantation with posterior capsulotomy. Methods: Noncomparative, interventional case series performed at a single center. Twelve patients with vitreoretinal disease and cataracts, with pre-existing regular corneal astigmatism greater than 1 diopter, underwent 25-gauge MIVS and toric IOL implantation with posterior capsulotomy. Results: The toric IOL was successfully implanted in each case. At 6 months postoperatively, mean axis rotation was 5.7° ± 3.1°. At 1 month postoperatively, mean uncorrected and best corrected visual acuity improved; the improvement was maintained after 6 months. The absolute residual refractive cylinder was significantly lower postoperatively than the pre-existing regular corneal cylinder (P = .003). There were no surgical complications except temporary posterior iris synechiae in one case. ConclusionS: Combined 25-gauge MIVS and toric IOL implantation with posterior capsulotomy is a practical and safe method to treat vitreoretinal disease and cataracts with pre-existing corneal astigmatism.