Outcome of phakic anterior chamber lens implantation in patients with corneal ectasia

Session Details

Session Title: Refractive
Session Date/Time: Friday 21/02/2020 | 08:15-10:10
Paper Time: 08:51
Venue: Fes 1.

First Author: I.Fischinger GERMANY
Co Author(s): K. Tetz  M. Bolz  M. Tetz           

Abstract Details

Purpose:

To evaluate the efficacy of implantation of iris-fixated phakic anterior chamber intraocular lenses (pIOL) in patients with keratectasia

Setting:

Berlin Eye Research Institute, Berlin, Germany

Methods:

In this retrospective study, iris-fixated pIOLs (Artisan/Artiflex(Ophtec®), Verisyse/Veriflex(AMO®)) were implanted in 38 eyes of 22 patients with stable keratectasia. Thirty-six eyes underwent corneal crosslinking (CXL) prior to the lens implantation. The refractive outcome was checked 6 weeks postoperatively and the influence of preoperative factors such as type and stage of keratectasia, keratometric parameters and refraction were evaluated.

Results:

The mean postoperative UCVA (UCVApost) was 0.25±0.15 and was not statistically different from the mean preoperative CDVA (CDVApre), which was 0.24±0.13. 71% reached a UCVApost/CDVApre ≥ 1, whereas patients with PMD-like ectasia (n=14) showed significantly (p= 0.003) higher success rates (100%) than patients diagnosed with keratoconus (n=24) (54%). Higher eccentricity of the maximum posterior elevation showed a significant beneficial influence on refractive success (p=0.021). No other preoperative parameters, such as stage of the keratectasia or keratometric readings, had significant influence on the refractive outcome. The mean absolute spherical equivalent was significantly decreased from 5.71±4.96 D to 1.25±1.20D.

Conclusions:

The results indicate that CXL followed by implantation of phakic iris-fixated anterior chamber IOLs is an effective therapeutic option for keratectasia. Pellucidal marginal degeneration (PMD)-like ectasias seem to benefit most from such procedures.

Financial Disclosure: