Phakic intraocular lens implantation after intracorneal ring segment for keratoconus

Session Details

Session Title: Keratoconus and Phakic IOLs

Session Date/Time: Monday 12/09/2016 | 16:30-18:30

Paper Time: 16:36

Venue: Hall C4

First Author: : T.Queirós PORTUGAL

Co Author(s): :    N. Franqueira   F. Faria Correia   T. Monteiro   F. Vaz           

Abstract Details

Purpose:

To evaluate the efficacy and safety of sequential phakic intraocular lens (IOL) surgery after implantation of intracorneal ring segments (ICRS) in eyes with keratoconus.

Setting:

Department of Ophthalmology, Hospital de Braga, Portugal

Methods:

A retrospective study was conducted in 15 eyes of 12 patients with keratoconus with high spherical ametropia after implantation of Ferrara-ICRS for irregular astigmatism. The phakic IOL implantation was performed at least 6 months after ICRS surgery; two types of IOLs were used: implantable collamer posterior chamber IOL (ICL, V4C STAAR Surgical, Monrovia, CA, USA) and anterior chamber iris-claw IOL Artisan® and Artiflex® (Ophtec, Groningen, Netherlands). Preoperatively and follow-up parameters analyzed: best-corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA); refractive sphere and cylinder; topography (k1, k2, kmax) and corneal endothelial cells count (CECC).

Results:

Eighth V4C ICL, six Artiflex and one Artisan IOL were implanted. Mean UCVA was 0.10±0.07 before ICRS implantation; 0.17±0.13 after ICRS implantation; and 0.52±0.25 after phakic IOL, with significant improvement after all procedures (p<0.01). Mean BCVA was 0.35±0.25 before ICRS implantation; 0.52±0.21 after ICRS implantation; and 0.63±0.22 after phakic IOL surgery; with significant improvement after all procedures (p<0.05). Spherical equivalent changed from -7.49D±5.58 to -0.46D±0.99 after phakic IOL surgery (p<0.01). A mean spherical equivalent of ± 0.50D and ±1.00D was achieved in 33% and 47% of eyes, respectively. A mean cell loss of 2,74% at 6 months was found.

Conclusions:

The sequencial phakic IOL implant after ICRS implantation in patients with keratoconus with high residual ametropia is a safe procedure, with significant improvement in UCVA and BCVA. Refractive predictability is lower than the one observed if phakic IOL implantation as a primary procedure in non-keratoconus patients.

Financial Disclosure:

NONE