Results Of Toric Phakic Intraocular Lens Implantation In Patients With Keratoconus

Analysis and clinical evaluation of toric PIOL implantation

Preoperatively, biometric, topographic, and tomographic studies were performed. We used a WaveLight Allegro Topolayzer TM Vario™ (Alcon, USA), an IOLMaster700 (Carl Zeiss Meditec), and an AS OCT Casia 2 (Tomey, Japan). Endothelial cell counts were measured using an EM-4000 endothelial microscope (Tomey, Japan).

50 eyes (43 patients), 7 patients in both eyes, 30 patients in one eye, 6 patients in combined surgeries Follow-up period from 2020 to 2026.

The length of the FIOL is calculated based on the diameter of the ciliary sulcus, which ensures ideal stability and promotes proper fornix. The exact WTW size is important, as it can give different readings on different devices, which can lead to errors.

Visual acuity: uncorrected visual acuity / corrected visual acuit 

Before surgery. Mean ±   0,08±0,02 / 0,49±0,34    

After surgery. Mean ± 0,48±0,12 / 0,64±0,24

Astigmatism (D)  before -4,8±2,31, after -1,50±1,15

SE (D) before-9,24±5,32 after -0,15±0,64

ACD Endo (mkm) before 3,59±0,24 after 3,09±0,45 after 1 year, 2,95±0,32 after 2-4 years

Endothelial cells before 2759±164 after 2649±259 after 1 year, 2588±301 after 2-4 years

Vault 565±289 after 1 year, 544±251 after 2 years, 499±130 after 4 years

An analysis and clinical evaluation of toric PIOL implantation showed positive results in terms of efficacy and safety in stable keratoconus. Combinations with intrastromal segment implantation are possible. Standard PIOL selection methods are insufficient. To achieve the required safety profile, AS-OCT (ATA and CLR) should be used. This allows for the correct PIOL size selection and reduces the risk of developing cataracts, glaucoma, or endothelial dystrophy.