Posters

Use of implantable collamer lens (ICL) after phototherapeutic keratectomy (PTK) for corneal haze and high hyperopia regression after photorefractive keratectomy (PRK)

Poster Details

First Author: M.Bellino ITALY

Co Author(s):    M. Bellino   S. Zagari                 

Abstract Details

Purpose:

to report the use of implantable Collamer lens (ICL) (Staar Surgical) in a patient to correct hyperopia regression after PhotoTherapeutic Keratectomy (PTK) for corneal haze and high hyperopia regression after photorefractive keratectomy (PRK)

Setting:

A 30 years old male, who had bilateral PRK to correct high Hyperopia 3 years earlier in another clinic was referred to us with a complaint of blurry vision and corneal haze.

Methods:

we decided first to treat the corneal haze and aberrations with PhotoTherapy Keratectomy with Schwind Amaris Laser; one year later the manifest refraction was +6.25 in the R.E.and +5,75 in the L.E. with an uncorrected visual acuity of 0.4.The anterior chamber depth (ACD) value was 2.80 mm in both eyes and we decided to correct the refraction with implantable Collamer lens (ICL, Staar Surgical , Hyperopic length:12.6 mm (sf +8 diopters in the R.E. and Sf +7 diopters in the L.E.). The Angle was 33°in the R.E. and 36° in the L.E.(mesopic condition)Previous Yag Laser Iridotomy was done in B.E.

Results:

On 1 day the UCVA was 1.0 in R.E. and 0.9 in the left eye; at 1 month, the manifest refraction was +0,75 x 90 in the R.E and +0.50 −1 × 180, with a UCVA of 0.9 in both eyes and a BCVA of 1.0; the keratometry was 40.2/41.6 @ 90 in R.E, 40.06/41.8 @ 90 in L.E, the IOP 12 mmHg both eyes. The anterior chamber depth (ACD) value was 2.2 mm in the R.E. and 2.0 mm In the L.E. The angle (using anterior segment Oct) was 19°in the R.E and 22° in the L.E. (mesopic condition). Central ICL Vaulting (using anterior segment OCT) was 543micron in R.E and 532micron in L.E. At 6 months, the manifest refraction, keratometry , ACD, Angle and Central icl Vaulting were unchanged. No complications was observed during the follow-up.

Conclusions:

The Visian implantable Collamer lens (ICL, Staar Surgical), a posterior chamber pIOL, is reported to be effective not only for the correction of moderate to high myopia as well as high hyperopia, even in complex case like this. In light of the biomechanical instability of a treated cornea like this, hyperopic ICL implantation may be an alternative surgical option for the correction of hyperopia after a hyperopic regression caused by previous prk . In the case we present, hyperopic ICL implantation was beneficial in the correction of refractive hyperopic shift after PRK

Financial Disclosure:

None