ESCRS - PO234 - Off-Label Use Of Toric Implantable Collamer Lens For Post-Keratoplasty Refractive Correction: A Case Report

Off-Label Use Of Toric Implantable Collamer Lens For Post-Keratoplasty Refractive Correction: A Case Report

Published 2025 - 43rd Congress of the ESCRS

Reference: PO234 | Type: Case Report | DOI: 10.82333/kfe5-7768

Authors: Ēriks Elksnis* 1 , Eva Elksne 2 , Vincenzo Rizzuto 1 , Dita Elīna Sila 1 , Evija Gulbinska 3

1Riga Stradins University,Riga,Latvia;Latvian American eye center,Riga,Latvia, 2Riga Stradins University,Riga,Latvia, 3Latvian American eye center,Riga,Latvia

Purpose

Implantable Collamer Lenses (ICLs) are primarily used to correct refractive errors in high myopia and astigmatism. Their application as a secondary implant following penetrating keratoplasty (PK) remains uncommon. This case highlights the successful implantation of a toric ICL (TICL) to optimize visual function in a patient with high post-penetrating keratoplasty astigmatism. 

Setting

The case report was conducted at the Latvian American Eye Center in Riga, Latvia.

Report of case

A 55-year-old male with stage IV keratoconus in the right eye (RE) underwent PK combined with phacoemulsification and intraocular lens (IOL) implantation. After initial visual improvement, he sustained blunt ocular trauma leading to wound dehiscence and irregular astigmatism. Following stabilization of the refractive error, a TICL was implanted to address refractive error, leading to an improvement in both uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), restoring binocular vision and significantly enhancing the patient’s quality of life. 

Conclusion/Take home message

Toric ICL implantation is a viable option for patients with significant residual astigmatism and anisometropia after PK. Further research is needed to assess its long-term results.