Phakic IOLs in Keratoconus: Long-Term Results
Narrative Responses:
Purpose
Describe the long-term refractive outcomes of patients with keratoconus treated with posterior chamber phakic intraocular lenses in a referral center in Mexico City.
Methods
28 patients (41 eyes) treated with posterior chamber phakic toric or spheric intraocular lens. 25 patients were treated with toric model and 16 patients with spheric lens.
Preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical error and spherical equivalent were recorded each visit. Preoperative and postoperative intraocular pressure, keratometric data, topography and specular microscopy were also recorded.
Results
Mean age was 30±7.4 years. The preoperative mean spherical equivalent was -12.25±3.92 D (-6 to -22) and postoperative spherical equivalent was -0.72±1.07 (+1 to -4) p <0.001). Mean preoperative UDVA was 1.77±0.49 (1 to 3 logMar) and postoperative UDVA was 0.22±0.15 (0 to 1 logMar), p <0.001. The mean preoperative CDVA was 0.22±0.15 (0 to 1 log Mar); postoperative CDVA was 0.1±0.09 (0 logMar) p <0.001. The mean corneal power was 47±2.6 D (45-63 D). The mean follow-up time was 45±33 months (3-122 months) with no evidence of progression of the keratoconus during the follow-up time.
Conclusion
The use of posterior chamber phakic intraocular lenses is a long term safe, predictable and efficacious strategy to manage large refractive errors and astigmatism in patients with stable keratoconus that are not good candidates for corneal transplantation with a very low complication rate and excellent visual results and patient satisfaction.