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Safety and visual outcome of Visian toric ICL implantation after corneal collagen cross-linking in keratoconus

Session Details

Session Title: Phakic IOLs and keratoconus or high astigmatism

Session Date/Time: Sunday 06/10/2013 | 17:00-18:30

Paper Time: 18:02

Venue: Elicium 1 (First Floor)

First Author: : A.Fadlallah LEBANON

Co Author(s): :    A. Dirani   H. El Rami   G. Cherfan   E. Jarade     

Abstract Details


To evaluate the safety and clinical outcome of phakic Visian Toric V4 Implantable Collamer Lens (ICL) implantation after corneal collagen UVA cross-linking in progressive keratoconus.


University Hospita, Beirut Eye Speciality Hospital


A retrospective study examined the results of a 2-step cross-linking-Visian-Toric- ICL-insertion in 16 eyes of 10 patients with keratoconus. The two procedures were done at an interval of 6 months. Data were collected preoperatively, at the 6-month follow-up visit after cross-linking, and at the 6-month follow-up visit after ICL insertion.


Corneal collagen cross-linking induced a statistically significant decrease in keratometry without any significant change in visual acuity and refraction except for a minor decrease in the mean cylinder from 2.64±1.28 D to 2.45±1.19 D (p=0.047). At six months follow-up after toric ICL implantation, mean K (max) was 50.49±4.07 D vs. 52.29±4.79 D at baseline (p=0.001). Both UDVA and CDVA significantly improved after ICL insertion. Mean UDVA improved from 1.67±0.49 logMAR to 0.17±0.06 logMAR (p=0.001), and mean CDVA improved from 0.15±0.06 logMAR to 0.12±0.04 logMAR (p=0.023). The mean spherical equivalent decreased from -7.24±3.53 D to -0.89±0.76 D (p=0.001), and the mean cylinder from 2.64±1.28 D to 1.16±0.64 D (p=0.001). The safety and efficacy index were 1.08±0.13 and 0.97±0.08 respectively. No intraoperative or postoperative complications occurred.


Implantation of the Visian Toric ICL following corneal collagen crosslinking, is an effective and safe option for improving visual acuity in patients with keratoconus.

Financial Interest:


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