Multifocal Toric IOL Implantation in Forme Fruste and Stable Keratoconus
Narrative Responses:
Purpose
To describe the visual and refractive outcomes of multifocal toric intraocular lens implantation in two patients, one with forme fruste keratoconus and another with forme frank but stable keratoconus.
Methods
A 50-year-old female with forme fruste keratoconus previously treated with corneal collagen crossliking and positive family history of keratoconus. UDVA 20/800 and 20/400 with a refraction of -5.50 -2.25 x 45 and -3.25 -1.75 x 165 respectively. The second case was a 42-year-old male with topographic diagnosis of keratoconus. UDVA 20/400 and 20/100 with a refraction of -10.25 -5.00 x 25 and - 3.50 -6.00 x 140 respectively. Refractive lens exchange was performed using multifocal toric intraocular lenses in both patients.
Results
After phacoemulsification UDVA, CDVA, Binocular UDVA and UNVA were excellent in both cases with a very mild residual refraction. The patients were subjectively very satisfied.
Our findings suggest that the option of a multifocal toric intraocular lens could provide optimum outcomes, as these two cases of form frustre keratoconus and stable moderate keratoconus;; obtaining spectacle independence and correction to a satisfactory level (20/40 or better).
Conclusion
Presbyopic treatment options are scarce in keratoconus patients, multifocal toric IOLs could be useful in well selected cases.