The Clinical Outcome Of Implantable Collamer Lens In Corneal Ectasia Post Astigmatic Keratotomy

to report the outcome of implantable collamer lens for unusual indication. Corneal ectasia with high refractive error post astigmatic keratotomy.

39 years old male with a past ocular history of keratoconus underwent astigmatic keratectomy followed by crosslinking in both eyes a couple of years later due to signs of corneal ectasia progression. Upon presentation, he had uncorrected distance visual acuity (UCVA) of 0.9 and 1.2 LogMAR to the right and left eye, respectively. His refraction shows high compound myopic astigmatism with the best spectacle-corrected visual acuity (BSCVA) of 0.1 LogMAR in both eyes. After confirming the stability of refraction and corneal topographic reading for the past couple of years. We insert EVO visian V4c ICL 13.2 manufactured by STAAR surgical company under topical anesthesia sequentially to both eyes. Both surgeries went uneventfully without complications. Routine post-operative medications were given. We followed up with the patient on day 1 postoperatively, 2 weeks, 8 weeks, and 6 months later. On day 1, UCVA was 0 LogMAR for the right eye and 0.2 LogMAR for the left eye. The patient maintained this vision for more than 6 months post-operatively with no residual refraction. Intraocular pressure (IOP) was within normal range for both eyes. He did not experience a spike of high IOP or angle closure glaucoma during the follow-ups. ICL vault was measured using anterior segment optical coherence tomography (AS-OCT) and was 301 microns for the right eye and 498 microns for the left eye. Upon the last visit, the patient was satisfied and maintained his UCVA.