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First Author: AliFadlallah LEBANON
Co Author(s): Ali Dirani Elias Chelala Ziad Khoueir Joelle Antoun George Cherfan Elias Jarade
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To evaluate the safety and clinical outcome of Visian Toric ICL Implantation for the treatment of residual refractive errors 6 months after sequential Intracorneal Ring segments (ICRS) and corneal collagen UVA cross-linking (CXL) in stable keratoconus.
: Beirut Eye Specialist Hospital, Beirut, Lebanon
A retrospective study examined the results of a 3-step ICRS-CXL-TICL in 11 eyes of 7 patients with moderate to severe keratoconus. The two procedures (ICRS-CXL) were performed sequentially at an interval of 4 weeks and TICL implantation was performed at least 6 months after CXL. Data were collected preoperatively, at the 6-month follow-up visit after sequential ICRS-CXL, and at the 6-month follow-up visit after TICL implantation.
ICRS-CXL induced a significant decrease in keratometry, increase in visual acuity and decrease in refraction. At 6-month follow-up after ICRS-CXL, mean Kflat was 45.19± 3.98 D vs. 48.51±4.26 D preoperatively (p=0.022) and mean Ksteep was 50.41± 4.32 D vs. 54.24±4.96 D preoperatively (p=0.032). Uncorrected distance visual acuity (UCVA) significantly improved from 1.47±0.38 logMAR before ICRS-CXL to 0.27±0.20 logMAR 6 months after (p = 0.002). Corrected distance visual acuity (CDVA) significantly improved from 0.50±0.22 logMAR to 0.29±0.23 logMAR (p=0.001). At 6-month post TICL implantation, UCVA improved significantly to 0.27±0.20 logMAR and the CDVA was 0.19±0.11 logMAR. No intraoperative or postoperative complications occurred.
TICL implantation after sequential ICRS implantation and CXL is an effective and safe option for correcting high residual refractive error and improving visual acuity in patients with moderate to severe keratoconus. FINANCIAL INTEREST: NONE