A Case Of Ticl V4c Implantation After Corneal Cross-Linking

If ICL V4C implantation can effectively improve vision after cross-linking in patients with keratoconus?

Corneal cross-linking is currently a effective treatment for patients with keratoconus.Patients with keratoconus often have relatively large irregular astigmatism, and corneal cross-linking cannot correct astigmatism. Therefore, even if corneal cross-linking is performed, the patient's visual quality is often very poor.If ICL V4C implantation can be a good way to improve vision after cross-linking surgery for patients with keratoconus?

A Female, 32 years old，She came to our hospital for treatment because of decreased vision in both eyes for 12 years in July 2021. Examination revealed abnormal corneal topography in both eyes. The curvature of the anterior surface of the right cornea was K1:44.8, K2:47.9, Km:46.3, KMax:51.7, and the thinnest corneal thickness was 500µm. And the left cornea data was K1:46.7, K2:49.9, Km:48.3, KMax:54.7, and the thinnest corneal thickness was 474µm. She was diagnosed with keratoconus in both eyes. In August 2021, both eyes underwent corneal cross-linking surgery. In August 2022, the corneal topography was stable. The patient wanted to improve her vision and visual quality, and She wanted to have an ICL implantion. Preoperative examination in February 2023 was as follows: OD: Optometry: -3.75/-3.25✖45=0.6，ACD:3.56mm，WTW:12.0mm，IOP：8.5mmHg, Corneal endothelial cell count:2797cell/mm².OS: Optometry: -5.00/-3.25✖110=0.6, ACD:3.66mm, WTW:12.1mm, IOP：9.0mmHg, Corneal endothelial cell count:2784cell/mm². The operation went smoothly. The patients underwent regular follow-up. The results of the 2-year follow-up in February 2025 were as follows:OD:UCVA:1.0, Optometry: -0.75/-0.25✖109,IOP:8mmHg,vault:350µm, Corneal endothelial cell count:2665cell/mm²; OS:UCVA:1.0, Optometry: -0.50/-1.00✖132,IOP:8.7mmHg,vault:410µm, Corneal endothelial cell count:2591cell/mm²; The UCVA exceeded the expected BCVA, and the patient said that the visual quality after surgery was very good

ICL V4C implantation is an effective way to improve vision in patients with keratoconus after corneal cross-linking