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

摘要

PURPOSE: To evaluate the safety and clinical outcome of phakic Visian toric implantable collamer lens (ICL) (STAAR Surgical, Monrovia, CA) insertion after corneal collagen cross-linking (CXL) in progressive keratoconus. METHODS: A retrospective study examined the results of the two-step CXL and Visian toric ICL implantation 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 CXL, and at the 6-month follow-up visit after ICL implantation. RESULTS: CXL induced a statistically significant decrease in steep keratometry (50.02 ?? 4.07 at baseline to 48.74 ?? 4.05 at 6 months after CXL, P = .001) without any significant change in visual acuity or refraction. At 6-month follow-up after ICL implantation, mean K (max) was 50.49 ?? 4.07 versus 52.29 ?? 4.79 D at baseline (P = .001). Mean uncorrected distance visual acuity improved from 1.67 ?? 0.49 to 0.17 ?? 0.06 logMAR (P = .001) and mean corrected distance visual acuity improved from 0.15 ?? 0.06 to 0.12 ?? 0.04 logMAR (P = .023). Mean spherical equivalent decreased from -7.24 ?? 3.53 to -0.89 ?? 0.76 D (P = .001) and mean cylinder decreased from 2.64 ?? 1.28 to 1.16 ?? 0.64 D (P = .001). The safety and efficacy indices were 1.08 ?? 0.13 and 0.97 ?? 0.08, respectively. No intraoperative or postoperative complications occurred. CONCLUSIONS: Implantation of the Visian toric ICL following CXL is an effective option for improving visual acuity in patients with keratoconus.