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Outcomes of toric iris-claw phakic intraocular lens implantation after deep anterior lamellar keratoplasty for keratoconus

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Session Details

Session Title: Presented Poster Session: Intraocular Refractive Results

Venue: Poster Village: Pod 2

First Author: : M.Tiveron Jr SPAIN

Co Author(s): :    J. Alio del Barrio   A. Plaza-Puche   N. Kara-Junior   J. Alio     

Abstract Details


To assess visual and refractive outcomes of toric iris-claw phakic intraocular lens (PIOL) implantation in patients that had previously undergone deep anterior lamellar keratoplasty (DALK).


Cornea and Refractive Surgery Unit, Vissum Corporation, Alicante, Spain.


Retrospective noncomparative interventional case series including 24 eyes of 24 patients implanted with toric Artiflex or Artisan (Ophtec BV, Groningen, Holland) PIOL following DALK for keratoconus. Over a 12-month follow-up, the main outcome measures were uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), spherical equivalent (SE) refraction, keratometry parameters and endothelial cell count (ECC). The astigmatism outcomes were evaluated according to the Alpins vectorial analysis. The safety index (ratio of mean postoperative CDVA to mean preoperative CDVA) and the efficacy index (ratio of mean postoperative UDVA to mean preoperative CDVA) were also calculated.


At the last follow-up, 71% of eyes reached a SE within ±0.50D and 92% within ±1.00D. Mean refractive astigmatism was reduced from −4.92 ± 1.55 D to -0.66 ± 0.61 after treatment, and 76.5% of cases were within ±1.00 D. No significant differences (P = .123) were detected in SE values between 3 and 12-month follow-up visits. No eyes lost line in CDVA, and 54% of eyes gained one or more lines. Postoperative UDVA was ≥ 20/40 in 88% of eyes. Efficacy and safety indexes at 12 months were 0.93 and 1.00, respectively. Mean ECC was 6.10% one year postoperatively.


The implantation of a toric iris-claw PIOL has shown high efficacy and safety in this series and may be considered a reasonable option in the management of residual ametropia after DALK.

Financial Disclosure:


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