Outcomes of Toric Iris-Claw Phakic Intraocular Lens Implantation After Deep Anterior Lamellar Keratoplasty for Keratoconus
- 1 August 2017
- journal article
- Published by SLACK, Inc. in Journal of Refractive Surgery
- Vol. 33 (8), 538-544
- https://doi.org/10.3928/1081597x-20170616-02
Abstract
PURPOSE: To assess visual and refractive outcomes of toric iris-claw phakic intraocular lens (IOL) implantation in patients who had previously undergone deep anterior lamellar keratoplasty (DALK). METHODS: Retrospective case series including 24 eyes of 24 patients implanted with toric Artiflex or Artisan (Ophtec BV, Groningen, Holland) phakic IOL following DALK for keratoconus. During a 12-month follow-up, the main outcome measures were uncorrected and corrected distance visual acuities (UDVA and CDVA), refractive error components, topographic parameters, and endothelial cell count. Alpins vectorial analysis was performed. RESULTS: At the last follow-up, the spherical equivalent (SE) was within ±0.50 diopters (D) in 71% of eyes and within ±1.00 D in 92% of eyes. Mean refractive astigmatism was reduced from −4.92 ± 1.55 D (range: −2.50 to −8.00 D) preoperatively to −0.66 ± 0.61 D (range: −2.00 to 0.00 D) after treatment, and 76.5% of cases were within ±1.00 D. No significant differences ( P = .123) were detected in spherical equivalent values between 3- and 12-month follow-up visits. No eyes lost lines in CDVA, and 54% of eyes gained one or more lines. Postoperative UDVA was 20/40 or better in 88% of eyes. Efficacy and safety indexes at 12 months were 0.93 and 1.00, respectively. Mean endothelial cell loss was 6.10% at 12 months postoperatively. No intraoperative or postoperative complications were noted over the follow-up period. CONCLUSIONS: The implantation of a toric iris-claw phakic IOL has shown high efficacy and safety in this series and may be considered as a reasonable option for the management of refractive errors after DALK. [ J Refract Surg. 2017;33(8):538–544.]Keywords
This publication has 42 references indexed in Scilit:
- Laser in situ keratomileusis to manage refractive errors after deep anterior lamellar keratoplastyJournal of Cataract & Refractive Surgery, 2012
- The Effect of Iris-Fixated Foldable Phakic Intraocular Lenses on Retinal StraylightAmerican Journal of Ophthalmology, 2011
- Phakic Intraocular Lens Implantation for Treatment of Anisometropia and Amblyopia in Children: 5-year Follow-upJournal of Refractive Surgery, 2011
- Artiflex Phakic Intraocular Lens Implantation After Corneal Collagen Cross-linking in Keratoconic EyesJournal of Refractive Surgery, 2011
- The Intrastromal Corneal Ring in Penetrating Keratoplasty—Long-term Results of a Prospective Randomized StudyCornea, 2011
- Long-Term Results of Deep Anterior Lamellar Keratoplasty for the Treatment of KeratoconusAmerican Journal of Ophthalmology, 2011
- Comparison of refractive changes after deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconusJapanese Journal of Ophthalmology, 2011
- Deep Anterior Lamellar Keratoplasty as an Alternative to Penetrating Keratoplasty: A Report by the American Academy of OphthalmologyOphthalmology, 2011
- Artisan Phakic IOL for the Correction of Ametropia After Deep Anterior Lamellar KeratoplastyJournal of Refractive Surgery, 2010
- Photorefractive Keratectomy With Mitomycin C After Deep Anterior Lamellar Keratoplasty for KeratoconusCornea, 2008