A new approach to keratoconus: refractive lens exchange with piggyback intraocular pinhole
Session Details
Session Title: Keratoconus & Secondary Ectasia
Session Date/Time: Sunday 15/09/2019 | 08:00-10:00
Paper Time: 08:06
Venue: Free Paper Forum: Podium 2
First Author: : C.Trindade BRAZIL
Co Author(s): : B. Trindade F. Trindade
Abstract Details
Purpose:
To evaluate the effect on visual acuity of refractive lens exchange with IOL implantation, followed by primary piggyback implantation of an intraocular pinhole device, in patients with keratoconus with significant visual impairment.
Setting:
Cançado Trindade Eye Institute
Methods:
In this prospective case series, 92 eyes with keratoconus were included. Exclusion criteria were presence of any other ocular comorbidity, good rigid gas-permeable contact lens fitting. Mean keratometric reading were 53.6D and mean corneal paquimetry values (thinnest point) was 397 micron. Mean age was 40 years. After in-the-bag IOL implantation, a pinhole supplementary device was implanted in the sulcus, to minimize the impact of high order corneal aberrations. Primary outcome variables were manifest refraction, uncorrected and best-corrected visual acuity (distance and near), subjective patient satisfaction, and intraoperative and postoperative adverse events and complications.
Results:
At three months post-operative, the mean UCDVA improved from 20/532±4.27 lines in Snellen units to 20/60±2.79 lines in Snellen units (p<0.001). The BCDVA improved from 20/81±2.53 lines in Snellen units to 20/37±2.26 lines in Snellen units (p<0.001). No postoperative complications were noted and all patients reported a great subjective improvement in vision.
Conclusions:
Refractive lens exchange associated with supplementary intraocular pinhole implantation can be successfully used to treat eyes with keratoconus as a primary procedure.
Financial Disclosure:
receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
