Toric Implantable Collamer Lens for High Myopic Astigmatism in Keratoconic Patients

To evaluate the safety, efficacy, stability and predictability of posterior chamber collagen copolymer phakic intraocular lens (PIOL) implantation to correct myopia and myopic astigmatism in keratoconusaffected patients. Uncorrected (UCVA) and best-corrected (BCVA) distance visual acuity, refraction and complications were evaluated in 22 keratoconic eyes of 14 patients who underwent Implantable Collamer Lens (ICL) (STAAR Surgical Inc.) implantation. The outcomes were evaluated during a 6 month follow up. Mean preoperative spherical equivalent (SE) and cylinder decreased from 4.98±2.63 and -2.77±0.99 diopters (D) preoperatively to -0.33±0.51 and −1.23±0.65 D at the end of 6-month follow up, respectively. Preoperatively, the mean Snellen decimal BCVA was 0.63±0.20. The mean UCVA was 0.76±0.23 and BCVA was 0.85±0.21 at the final follow up. The mean safety and efficacy indices were 1.40±0.32 and 1.24±0.34, respectively. No line of BCVA was lost; 17 eyes (77.3%) gained 1 or more lines. Fifteen 68.2%) of the eyes were within±0.50 D and 20 (90.9%) were within±1.00 D of the desired spherical equivalent refraction. There was a change in manifest refraction of 0.09±0.21 (range, -0.25 to +0.75) from week 1 to month 6 postoperatively. Toric ICL was safe, effective, and predictable to correct myopia and myopic astigmatism associated with keratoconus. The achieved refraction remained stable during the course of the study.