Refractive and anatomic results of ICL collamer phakic lens to correct refractive errors after keratoplasty

Session Details

Session Title: Phakic IOLs

Session Date/Time: Monday 09/10/2017 | 08:30-10:20

Paper Time: 09:43

Venue: Meeting Center Room I

First Author: : J.Alvarez de Toledo SPAIN

Co Author(s): :    R. Barraquer Compte   C. Alvarez de Toledo   P. Sauvageot Beneria              

Abstract Details

Purpose:

Refractive errors after penetrating (PK) or deep lamellar anterior keratoplasty (DALK) are common and, depending on its magnitude, difficult to correct. ICL posterior chamber phakic lens has demonstrated a great predictability and efficacy in correcting astigmatism, myopia and hyperopia in the non-previously operated population. We wanted to analyze the results obtained with this procedure in a series with a previous corneal transplant surgery.

Setting:

Centro de Oftalmología Barraquer of Barcelona. Institut Universitari Barraquer, Universidad Internacional de Catalunya UIC.

Methods:

A series of 63 eyes 61 patients was operated in the period between years 2006-2017. We found 41 eyes that met enough follow up of 1 year. Thirty-three eyes were previously operated with PK and 8 with DALK. After a complete anterior segment examination, standard toric or spherical ICL phakic lenses were implanted following the standard surgical technique that included minimal modifications: 3 mm. incision in the axis with more distance from limbus to graft-host wound, cohesive hyaluronate viscoelastic, and intraoperative alignment of toric ICL with an image software (Goniotrans®) or a digital alignment system (Verion®).

Results:

Series comprised 11 female (26.8%) and 30 male patients (73.2%). Mean age was 30.12 ± 6.79 (19-51) years. Twenty lens were toric ICL and 21 spheric ICL. Graft pachymetry was 569 ± 54 (445/692) μ. Endothelial cell count (ECD) was 1603 ± 814 (451/3077) cel/mm2. Twenty-six lenses were 13.2 or 13.7 mm (63,4%). Sphere decreased from -8.14 ± 9.10 D to +0.29 ± 1.37 D. Refractive cylinder decreased from -3.69 ± 2.03 D to -1.72 ± 1.49 D. The mean postoperative vault was 618 ± 297 (201-1491) μ. No cataract, immune reaction or graft decompensation was observed postoperatively.

Conclusions:

Collamer posterior chamber phakic lens ICL implantation is a safe and effective surgical procedure to correct refractive errors after PK or DALK. Adequate preoperative patient selection, meticulous surgical procedure and strict patient follow up may yield excellent visual rehabilitation in this group of patients.

Financial Disclosure:

NONE