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Refractive and anatomical results after collamer phakic posterior chamber lens implantation (ICL) in keratoconus

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Session Details

Session Title: Phakic IOLs II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 14:00

Venue: Room 17

First Author: : M.Marmol SPAIN

Co Author(s): :    J. Alvarez de Toledo   R. Barraquer Compte                 

Abstract Details


To analyze the refractive and anatomical results with the phakic ICL lens in keratoconus patients. To describe the influence of the preoperative biometric factors in the selection of the lens size and to describe the postoperative vaulting results obtained.


Centro de Oftalmología Barraquer. Barcelona. Institut Universitari Barraquer. Universitat Autonoma de Barcelona UAB


A series of 31 eyes of 23 patients with keratoconus in which an ICL phakic lens was implanted to correct the refractive error was studied. In 12 eyes previous intracorneal segment implantation had been performed to treat corneal astigmatism/aberrations and in 3 eyes a previous crosslinking to stabilize the progression of the disease had been also performed. All eyes had a one-year stable refraction preoperatively. Anterior segment biometry to choose ICL size was performed with Visante-OCT, Orbscan IIz and calibrated anterior segment photography.When a toric ICL was implanted, intraoperative alignment was assisted with the Goniotrans system.


In 15 eyes a toric ICL was implanted and in 16 eyes an spheric ICL. Mean age was 31 ± 6 (23/48) being 32% women. Preoperative astigmatism was 2.74 ± 1.71 (0/-7) diopters and mean sphere was -7.39 ± 4.2 (-1/-16). Preop UCVA was 0.01 ± 0.1 (0.005/0.55) and BCVA was 0.7 ± 0.25 (0.2/1.2). One year after surgery mean astigmatism was 1.44 ± 1.27 (0/4.5) and mean sphere was 0.32 ± 1.1 (+3.25/-2.00). UCVA was 0.61 ± 0.28 ( 0.15/1.0) and BCVA was 0.78 ± 0.25 ( 0.15/1.2). Safety index was 1.12 and efficacy index was 0.82. Mean postoperative vaulting was 601 ± 314 (103/1410) microns.A significant difference ( p:0.0002) in biometric calculations methods was observed.


The implantation of a phakic posterior chamber lens ( ICL) is a very effective and safe method to correct the regular refractive errors in keratoconus patients. Once the disease is stable or a crosslinking has been performed to stop its progression, a complete refractive analysis should be preformed. If there are important corneal aberrations such as astigmatism or coma, they should be managed with intracorneal segments. When the residual refractive error is regular, the phakic lenses can achieve optimal results in these patients.

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