Combined Intracorneal Ring Segments and Iris-Fixated Phakic IOL for Keratoconus Refractive and Visual Improvement

Ferreira, Tiago

Combined Intracorneal Ring Segments and Iris-Fixated Phakic IOL for Keratoconus Refractive and Visual Improvement

Sunday, April 27, 2014: 4:21 PM

Room 151B (Boston Convention and Exhibition Center)

Tiago B. Ferreira, MD, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal

José L. Güell, MD, Instituto de Microcirugia Ocular, Barcelona, Spain

Felicidad Manero, MD Barcelona, Spain

Narrative Responses:

Purpose
To evaluate the efficacy and safety of keratoconus refractive and visual improvement by combined intracorneal ring segments (ICRS; Intacs/Intacs SK) and phakic IOL (pIOL; Artiflex Toric) implantation.

Methods
This study comprised patients who had Intacs ICRS and Artiflex Toric for the correction of keratoconus. Over a 12-month follow-up after pIOL implantation, the main outcome measures were uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), spherical equivalent (SE) refraction and central endothelial cell density. Efficacy and safety indexes were calculated.

Results
The study included 33 eyes (21 patients). The mean UDVA 12 months after ICRS and pIOL implantation increased from 2.0 ± 0 (SD) logMAR to 0.25 ± 0.22 (p<.001). The mean CDVA increased from 0.32 ± 0.14 logMAR to 0.13 ± 0.13 (p=.039). Predictability of refractive results was very good, with an SE refraction within ±0.50 D of the attempted spherical correction in 25 eyes (80.6%). The mean central endothelial cell density decreased from 2533 ± 281 cells/mm² to 2392 ± 263 cells/mm²post-operatively (p=.402). The efficacy index was 0.87 and the safety index was 0.61.

Conclusion
Keratoconus visual and refractive improvement by sequential Intacs and Artiflex Toric IOLs is a safe and predictable procedure.