Posters

Two-stage procedure in the management of selected cases of keratoconus: clear lens extraction with aspherical IOL implantation followed by WFG-PRK

Poster Details

First Author: W.Ali Abousamra EGYPT

Co Author(s):    T. Mokbel   M. Elwan   S. Saleh   A. Wehidy   M. Ikbal   A. Ellayeh     

Abstract Details

Purpose:

To assess the objective and subjective results of a two-stage procedure for management of keratoconus: clear lensectomy with aspherical intraocular lens (IOL) implantation followed by wave front-guided photorefractive keratotomy (WFG-PRK).

Setting:

Mansoura Ophthalmic center, mansoura university

Methods:

The study included patients aged 35 years or older with stable keratoconus, a clear visual axis, minimal corneal thickness (MCT) 420 μm or more and average k. Refraction of all selected eyes should be -8.00 D sphere or more with less than -6.00 D cylinder and could be corrected two lines or more with spectacles or contact lenses. two-stage approach was done: first refractive lens exchange and aspherical IOL implantation followed, after at least 3mo, by WFG- PRK. Pre and postoperative topographical, visual and aberrometric results were recorded. Moreover, patient satisfaction and other subjective outcomes were also analyzed.

Results:

The manifest sphere of studied eyes was -10.3±4.2 D and the manifest cylinder was -4.2±1.2 D. After the two-stage procedure, sphere and cylinder reduced significantly to -0.43±0.22 D and -1.3±0.72 D respectively.There was also a highly significant improvement in the mean uncorrected distance visual acuity from logMAR 1.41±0.49 preoperatively to 0.51±0.16 postoperatively and the mean corrected distance visual acuity from 0.76±0.24 preoperatively to 0.49±0.13 after the operation. All aberrometric and mesopic vision parameters and most of the topographical indices demonstrated highly significant improvement that remains stable until the end of follow up.

Conclusions:

Two-stage approach (clear lens exchange with monofocal IOL followed by WFG-PRK) in selected cases of keratoconus is a safe, effective and highly predictable procedure with satisfactory visual and refractive results

Financial Disclosure:

None