Toric phakic implant shows good refractive, visual acuity results in eyes with keratoconus

J Cataract Refract Surg. 2010;36(6):906-916.

Implantation of a collagen copolymer toric phakic lens was shown to be predictable and effective in correcting myopia and astigmatism in eyes with keratoconus, a study showed.

Minimally invasive surgical procedures should be considered for young keratoconus patients. In addition, PRK and LASIK may result in further corneal thinning. Implantation of intrastromal ring segments may yield spherical refractive errors and residual astigmatism, and the long-term safety of collagen cross-linking has not been established, the study authors said.

"There are recent reports of the effective use of anterior chamber phakic intraocular lenses alone or combined with other surgical procedures to correct refractive errors associated with keratoconus," they said. "To date, there are few reports of the use of posterior chamber toric [phakic] IOLs to correct refractive error in these patients, and the studies often have small patient cohorts."

The prospective study included 30 eyes of 21 patients with a mean age of 35.2 years. All patients underwent implantation of the Visian toric posterior chamber implantable Collamer lens (STAAR Surgical). Follow-up examinations were conducted at 1, 3, 6 and 12 months after surgery. Investigators assessed uncorrected and corrected distance visual acuity, refraction and postoperative complications.

Study data showed that 86.7% of all eyes were within 0.5 D of attempted refraction and all eyes were within 1 D. Mean corrected distance visual acuity was 20/40 or better in 29 eyes and 20/25 or better in 22 eyes. No eyes lost more than two lines of corrected distance visual acuity.

Data showed no intraoperative or postoperative complications; no implants required repositioning or explantation, the authors said.

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