We present two cases for which intraocular pinhole implants were used to treat irregular corneal astigmatism after planned and unplanned posterior capsule opening during cataract surgery. The first case had a fibrotic posterior capsule that was eliminated with a posterior capsulorhexis. After that, the intraocular lens (IOL) and pinhole were implanted in the capsular bag. In the second case, a posterior capsule tear after phacoemulsification was converted to a posterior capsulorhexis, allowing implantation of an IOL in the capsular bag and the intraocular pinhole in the ciliary sulcus. With this method, irregular astigmatism in both cases could be managed with the intraocular pinhole very effectively. The implants remained stable and well centered in both cases and no complications were noticed.
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