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Phakic intraocular lens for selected cases of keratoconus

Poster Details

First Author: Y.Fern SPAIN

Co Author(s):    J. Ramos Navarro              

Abstract Details


To report a case of early-stage stable keratoconus in which toric intraocular collamer lenses (ICLs) effectively corrected the myopic astigmatism.


: Yolanda Fernández Barrientos. Clínica Baviera, Spain. Authors has no financial interest in the subject matter of the presentations


A toric ICL was implanted in an early-stable keratoconus, observation during one year follow up: slit-lamp evaluation, corneal topography, endothelial cell count, manifest refraction, and uncorrected and best-corrected visual acuity, were determined.


A 40-year-old woman with visual complains caused by high myopia, astigmatism and contact lens intolerance, preoperatively, in the patient´s right eye, the manifest refraction was -5.5 -3.5 x 40 degrees, the uncorrected distance visual acuity (UDVA) was 20/2000, and the corrected distance visual acuity (CDVA) was 20/30; in the left eye, the manifest refraction was -4 -5 x 135 degrees, and the UDVA was 20/2000 and CDVA was 20/30, respectively. After bilateral implantation of toric ICL, in the right eye no manifest refraction was left, the UDVA was 20/20; in the left eye, the manifest refraction was -0.5 -0.75 x 160 degrees, the UDVA and CDVA were 20/25 and 20/16, respectively. Preoperative topographic astigmatism for the right and the left eye was 2.8 and 3.8 D, respectively, one year later no changes were observed. No sign of progressive disease and no vision-threatening complication were observed during the one year follow up.


Several studies have demonstrated that toric ICL implantation is a predictable, effective procedure to correct ametropia in eyes with keratoconus. The astigmatism reduction after intraestromal cornel ring segments or no toric intraocular lens combined with clear corneal incisions in the steepest meridian seems to be modest versus toric ICL. Contact lenses offer better visual results than spectacles in patients with keratoconus, but some patiens cannot tolerate them. Spectacles often result in inferior optical image quality, and significant inconvenience. Although there are well described advantages that favor the use of ICL, potencial risks must be evaluated before using these lenses. Toric ICL implantation may be a viable surgical option for the correction of myopic astigmatism in keratoconus with stable refraction and clear central cornea.

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