Posters

New lens-based treatment for keratoconus: refractive lens exchange with pinhole implant piggyback

Poster Details

First Author: C.Trindade BRAZIL

Co Author(s):    B. Trindade   F. Trindade                 

Abstract Details

Purpose:

To evaluate the impact of refractive lens exchange with IOL implantation plus primary piggyback implantation of a intraocular pinhole implant, in cases of advanced keratoconus. The primary outcome variables analysed were UCDVA, UCNVA, BCDVA, subjective refraction and intraoperative and postoperative adverse events and complications.

Setting:

Private Practice

Methods:

This is a non-randomised, unmasked clinical trial with 68 eyes of 62 patients. The study followed the tenets of the Declaration of Helsinki, and approval of the Board/Ethics Committee was obtained. Mean age was 39.2 y.o. Key inclusion criteria were the presence of keratoconus with the BCDVA of less than 20/40, documented topographic stability over a period of at least 12 months, based on criteria from the 2015 Global Consensus on Keratoconus and Ectatic Diseases, improvement of BCDVA to at least 20/40 during pinhole acuity test over the best correction, clear lens or clinically insignificant cataract, and clear central cornea.

Results:

A statistically significant difference between preoperative and postoperative results was found in the 3 visual acuity measurements. Mean uncorrected distance vision improved from logMAR 1.478 (20/602) ± 0.388 preoperatively to logMAR 0.355 (20/45) ± 0.138 (p<0.001) 1 year postoperatively. Mean spherical equivalent refraction reduced from -10.85 ± 3.18D preoperatively to -0.99 ± 1.27D 1 year postoperatively (p=0.001).

Conclusions:

Refractive lens exchange with IOL implantation and piggyback of an intraocular pinhole implant has been shown to be an effective way to treat irregular corneal astigmatism caused by keratoconus. A significant improvement of both uncorrected and best-corrected visual acuity was achieved with no reported complications.

Financial Disclosure:

gains financially from product or procedure presented