Clear Lensectomy With A Spherical Intar Ocular Lens Implantation Followed By Combined Corneal Cross-Linking With Topo -Guided Photorefractive Keratotomy

To evaluate the visual and topographic outcomes of a two-stage approach treatment for selected cases of keratoconus (KC); Clear lensectomy with a spherical intraocular lens (IOL) implantation followed by combined Corneal Cross-linking (CXL) with Topo -guided Photorefractive Keratotomy (TG-PRK).

The study included 11 eyes of 17 patients diagnosed with stable keratoconus, aged from 39 to 49 years (42.4 ± 6.2)

 All studied eyes underwent a 2-stage approach treatment: first refractive lens exchange and IOL implantation followed after at least 3 months by combined CXL with TG-PRK. A complete ophthalmological examination was performed preoperatively and postoperatively. Topographical and visual outcomes were evaluated during 6 months follow up period.

After the 2 stages procedure, sphere changed from -10.33 ± 4.18 diopter preoperatively to 0.67 ± 0.71 diopter 6 months postoperatively (p<0.001), and cylinder changed from -4.21 ± 0.91D to -1.13 ± 0.69 D (p<0.001). There with significant improvement in the mean uncorrected distance visual acuity (UDVA) from log MAR 1.41 ± 0.49 preoperatively to 0.32 ± 0.08 postoperatively (p<0.001) and the mean corrected distance visual acuity (CDVA) from 0.55 ± 0.14 preoperatively to 0.26 ± 0.11 (p=0.01). All patients were satisfied with their visual improvement.