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Safety and visual outcome of visian toric ICL implantation after corneal collagen cross-linking in keratoconus

Poster Details

First Author: AliDirani LEBANON

Co Author(s):    Ali Fadlallah   Elias Chelala   Hala El Rami   George Cherfan   Elias Jarade  

Abstract Details


To evaluate the safety and clinical outcome of phakic Visian toric implantable collamer lens (ICL) (STAAR Surgical, Monrovia, CA) insertion after corneal collagen cross-linking (CXL) in progressive keratoconus.


: Beirut Eye Specialist Hospital, Beirut, Lebanon


A retrospective study examined the results of the two-step CXL and Visian toric ICL implantation in 16 eyes of 10 patients with keratoconus. The two procedures were done at an interval of 6 months. Data were collected preoperatively, at the 6-month follow-up visit after CXL, and at the 6-month follow-up visit after ICL implantation.


CXL induced a statistically signifi cant decrease in steep keratometry (50.02 ± 4.07 at baseline to 48.74 ± 4.05 at 6 months after CXL, P = .001) without any signifi cant change in visual acuity or refraction. At 6-month follow-up after ICL implantation, mean K (max) was 50.49 ± 4.07 versus 52.29 ± 4.79 D at baseline (P = .001). Mean uncorrected distance visual acuity improved from 1.67 ± 0.49 to 0.17 ± 0.06 logMAR (P = .001) and mean corrected distance visual acuity improved from 0.15 ± 0.06 to 0.12 ± 0.04 logMAR (P = .023). Mean spherical equivalent decreased from -7.24 ± 3.53 to -0.89 ± 0.76 D (P = .001) and mean cylinder decreased from 2.64 ± 1.28 to 1.16 ± 0.64 D (P = .001). The safety and effi cacy indices were 1.08 ± 0.13 and 0.97 ± 0.08, respectively. No intraoperative or postoperative complications occurred.


Implantation of the Visian toric ICL following CXL is an effective option for improving visual acuity in patients with keratoconus. FINANCIAL INTEREST: NONE

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