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Two year results of quadruple procedure for the treatment of keratoconus: topo-guided transepithelial PRK followed by toric phakic IOL implantation after intracorneal ring implantation and corneal collagen cross-linking

Poster Details

First Author: E.Coskunseven TURKEY

Co Author(s):                  

Abstract Details


To determine the efficacy of Topo-Guided Transepithelial PRK followed by Toric Phakic IOL implantation after intracorneal ring (ICR) implantation and corneal collagen crosslinking (CXL) to improve vision and stop progression.


Dunya Eye Hospital Istanbul Turkey


In this prospective case series, 7 patients (11 eyes) with progressive keratoconus were included. All patients underwent topography-guided transepithelial PRK Followed by Toric Phacic IOL Implantation after intracorneal ring segments implantation, followed by CXL treatment. The follow-up period was 24 months after the last procedure for all patients. Time interval between both CXL and Toric Phacic IOL and between Toric Phacic IOL and topography-guided transepithelial PRK was 6 months


LogMAR mean uncorrected distance visual acuity and mean corrected distance visual acuity were signifi cantly improved (P_.05) from 0,02±0,01 and 0.15±0.2 preoperatively, to 0.68±0.07 and 0.72±0.04 after the completion of the 4-step procedure, respectively. Mean spherical equivalent refraction was signifi cantly reduced (P_.05) from _-14,19±3,68 diopters (D) preoperatively to -0,25±0,81 D after the 4-step procedure. Mean steep and fl at keratometry values were signifi cantly reduced (P_.05) from 55,25±3,87 D and 49,75±5,46 D preoperatively, to 48,28±3,29 D and 46,45±3,76 D after the 4-step procedure, respectively.


Combined Topo-Guided Transepithelial PRK followed by Toric Phakic IOL Implantation after ICR implantation followed by CXL is an effective treatment sequence that can stop progression and improve vision and refraction in select keratoconus patients. FINANCIAL INTEREST: One of more of the authors... travel has been funded, fully or partially, by a competing company

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