Toric implantable collamer lens in a patient with corneal scarring and induced astigmatism

A 31-year-old woman presented with unilateral corneal scarring and high astigmatism caused by lipid keratopathy. She was seeking vision correction. The options were limited because of the anisometropia, corneal neovascularization, and high astigmatism. The manifest refraction was −3.00 +4.00 × 115, giving a corrected distance visual acuity of 20/25. The refraction and corneal condition were followed and remained stable for 2 years; therefore, a toric implantable collamer lens (ICL) was selected. The uncorrected distance visual acuity improved from 20/70 to 20/25⁻¹ and continued to remain stable more than 18 months postoperatively. This case shows that a toric ICL might be a viable, stable option in cases of induced astigmatism resulting from corneal scarring and in which visual acuity can be improved with refraction.