Outcomes And Complications Of Implantable Collamer Lens For Mild To Advanced Keratoconus.

To evaluate the refractive and visual outcomes and safety of implantable collamer lens (ICL; (Visian, STAAR Surgical, Monrovia, CA, USA) in mild to advance keratoconus patients with myopia and myopic astigmatism.  

Tertiary Care Eye Hospital

This retrospective study evaluated all patients who underwent ICL implantation for the management of keratoconus at a tertiary care eye hospital from January 2012 to January 2018. The mean duration of follow up was 15.3 months (range, 3.13 to 38.97 months). Data were collected on preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction were compared, and adverse effects were evaluated.

Thirty-two eyes were evaluated. The median CDVA was 20/30 preoperatively and 20/20 at last follow up. The median UDVA was 20/25 at last follow up. Thirteen patients (40.6%) had 20/20 UDVA in comparison to none at baseline. The median spherical equivalent was -7.875 D preoperatively and decreased statistically significantly to -0.3125 D at last follow up. The median manifest refractive cylinder was 3.00 D preoperatively and decreased to 1.125 D postoperatively.

Cylinder axis rotation of 10° or greater, occurred in 3 eyes (9.37%) and required repositioning of the ICL. One patient (3%) developed non-visually significant anterior subcapsular cataract. One ICL (3.12%) had to be explanted due to residual refractive error and unsatisfactory vision.

ICLs are a suitable refractive option for the correction of refractive error associated with stable, non-progressive keratoconus even in advance cases. However, the risk of ICL rotation and subsequent repositioning remain. Careful patient selection is necessary for achieving good outcomes and mitigating intraoperative and postoperative complications.