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Phakic intraocular lens implantation after intracorneal ring segment: combined treatment for keratoconus

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Session Details

Session Title: Presented Poster Session: Intraocular Refractive Results

Venue: Poster Village: Pod 2

First Author: : T.Fernandes PORTUGAL

Co Author(s): :    T. Monteiro   F. Faria Correia   N. Franqueira   F. Vaz     

Abstract Details

Purpose:

To evaluate the efficacy and safety of sequential phakic intraocular lens (IOL) surgery after implantation of intracorneal ring segments (ICRS) in eyes with keratoconus.

Setting:

Department of Ophthalmology, Hospital de Braga, Portugal

Methods:

A retrospective study was conducted in 25 eyes of 25 patients with keratoconus with spherical ametropia after implantation of Ferrara-ICRS for irregular astigmatism. The phakic IOL implantation was performed at least 6 months after ICRS surgery; two types of IOLs were used: implantable collamer posterior chamber IOL (ICL, V4C STAAR Surgical, Monrovia, CA, USA) and anterior chamber iris-claw IOL Artisan® and Artiflex® (Ophtec, Groningen, Netherlands). Preoperatively and follow-up parameters analyzed: best-corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA); refractive sphere and cylinder; topography (k1, k2, kmax) and corneal endothelial cells count (CECC).

Results:

18 V4C ICL, 6 Artiflex and 1 Artisan IOL were implanted. Mean UCVA was 0.09±0.06 before ICRS implantation; 0.16±0.12 after ICRS implantation; and 0.56±0.25 after phakic IOL, with significant improvement after all procedures (p<0.01). Mean BCVA was 0.39±0.28 before ICRS implantation; 0.56±0.24 after ICRS implantation; and 0.69±0.25 after phakic IOL surgery; with significant improvement after all procedures (p<0.05). Spherical equivalent changed from -8,87D±4.82 to -0.49D±1.17 after phakic IOL surgery (p<0.01). No eye lost 2 or more lines of BCVA; 44% of eyes gained 2 or more lines of BCVA.

Conclusions:

The sequential phakic IOL implant after ICRS implantation in patients with keratoconus with residual ametropia is a safe and effective procedure, with significant improvement in UCVA and BCVA. Refractive predictability is lower than the one observed if phakic IOL implantation as a primary procedure in non-keratoconus patients.

Financial Disclosure:

NONE

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