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Refractive and anatomical results after collamer phakic posterior chamber lens implantation (ICL) after penetrating keratoplasty

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Session Details

Session Title: Phakic IOLs I

Session Date/Time: Monday 07/09/2015 | 14:30-16:30

Paper Time: 15:33

Venue: Room 10

First Author: : J.Alvarez de Toledo SPAIN

Co Author(s): :                        

Abstract Details


To analyze and present the refractive and anatomical results with the use of the ICL phakic posterior chamber lens after penetrating keratoplasty( PK). To analyze and present the preoperative biometric factors and its influence in lens size selection and final vaulting results.


Centro de Oftalmología Barraquer Barcelona. Universidad Autónoma de Barcelona UAB.


A group of 20 eyes previously operated of PK in which ICL collamer pahkic lens was implanted to correct the refractive residual error is studied. In 18 eyes the PK indication was keratoconus, 1 eye was lattice dystrophy and 1 eye was herpetic keratitis. In 2 eyes previous arcuate incisions had been performed. All eyes had an stable refraction minimum one year before surgery. Anterior segment biometry was performed using picture calibrated measurement, Orbscan-IIz and optical coherence tomography ( Visante-OCT). Spheric and toric ICLs were used when indicated, aligning the axis with the Goniotrans system. Vaulting was measured with OCT.


In 10 eyes a toric ICL was implanted and spheric ICL in 10 eyes. Mean age was 26 ± 4 (19/37) years, being 25% women. Preoperative astigmatism was 3.28 ± 1.91 (0/-7) and preoperative sphere -7.66 ± 5.18 (+2.50/-17). Preoperative UCVA was 0.05 ± 0.05 (0.01/0.25) and BCVA 0.63 ± 0.21 (0.2/1.0). One year after surgery astigmatism was 1.16 ± 1.09 (0/5), sphere was 0.23 ± 0.99 (+2.75/-1.25), UCVA was 0.56 ± 0.24 ( 0.15/1.0) and BCVA was 0.89 ± 0.17 ( 0.55/1.2). Safety index was 1.55 and efficacy index 0.91. Vaulting observed postoperatively was 601 ± 231 (201/904) microns. No significant difference (p: 0.6117) in white-to-white measurements between ORBSCAN and photographic scale method was observed.


The use of an intraocular phakic lens (ICL) is a very effective and safe procedure to correct residual errors after penetrating keratoplasty. When refractive stability after PK is achieved, and high astigmatic results are previously treated when needed by arcuate incisions or intracorneal segment implantation, the implant of a phakic lens is a very predictable and safe procedure to be considered in the refractive rehabilitation of these patients.

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