ESCRS - PO557 - Clear Lensectomy With Toric Iol Implantation After Corneal Collagen Cross-Linking In Selected Cases Of Progressive Keratoconus

Clear Lensectomy With Toric Iol Implantation After Corneal Collagen Cross-Linking In Selected Cases Of Progressive Keratoconus

Published 2025 - 43rd Congress of the ESCRS

Reference: PO557 | Type: Free paper | DOI: 10.82333/2sry-qk39

Authors: Valentino De Ruvo* 1 , Andrea Taloni 1 , Raphael Kilian 1 , Andrea Sollazzo 1 , Angeli Christy Yu 1 , Niccolò Salgari 1 , Rossella Spena 1 , Cristina Bovone 1 , Massimo Busin 1

1Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy;Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO),Forlì,Italy;Department of Translational Medicine,University of Ferrara,Ferrara,Italy

Purpose

To evaluate the visual and topographic outcomes of a two-stage approach treatment for selected cases of

progressive keratoconus (KC); Corneal Collagen Cross-Linking (CXL) followed by phacoemulsification with toric IOL

implantation

Setting

The study included 9 eyes of 6 patients diagnosed with progressive keratoconus, aged from 35 to 47 years (41.6

± 11.2).

Methods

All studied eyes underwent a 2-stage approach treatment: first corneal collagen cross-linking (CXL) followed

after at least 6 months by phacoemulsification with foldable toric intraocular lens (IOL) implantation in both eyes of 3

patients and only one eye of the other 3 patients. A complete ophthalmological examination was performed

preoperatively and postoperatively. Topographical and visual outcome were evaluated during one-year follow up

period.

Results

At baseline, sphere ranged from -3.00 to -8.00 diopter and cylinder from -3.50 to -5.50 diopter. All eyes could

be corrected to 6/18 or more. At 6 months after CXL, steep K and K max decreased significantly from baseline, with

no change in visual acuity or refraction. After phacoemulsification with toric IOL implantation, sphere changed from -

5.74 ± 1.88D preoperatively to 0.33 ± 0.72D postoperatively (p<0.001), and cylinder changed from -4.53 ± 0.98 D to -

1.10 ± 0.76 D (p<0.01). There was significant improvement in mean uncorrected and corrected distance visual

acuity. All patients were satisfied with the visual improvement.

Conclusions

This 2-stage approach in selected cases of progressive keratoconus is safe and effective procedure