Pseudophakic Toric IOL Implantation in Ectatic Corneal Dystrophies
Purpose
To evaluate the safety and efficacy of pseudophakic intraocular lens implantation in patients with nonprogressive keratoconus and pellucid marginal degeneration
Methods
Fifteen eyes of 11 patients (5 eyes of 4 patients with pellucid marginal degeneration, 10 eyes of 7 patients with keratoconus) with non-progressive ectasia and contact lens intolerance were included in this prospective study. Uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, slit lamp findings, corneal topography were evaluated at the preoperative and at all postoperative visits. Biometric measurements were performed using the IOL Master (Zeiss, Germany) and SRK/T formula. Intraocular lens power and axis were calculated according to the manufacturer’s software preoperatively in all patient eyes.
Results
The mean age of patients was 54.0±10.4 years, and the mean follow-up was 8.0±6.6 months. Two patients (4 eyes) underwent clear lens extraction, 9 patients (13 eyes) underwent cataract extraction. All surgeries were performed by one surgeon (OOU) using 2.2 mm corneal incision. The mean UDVA improved from 1.26±0.55 LogMAR (~20/200) to 0.65±0.57 LogMAR (20/60), and the mean CDVA improved from 0.45±0.47 LogMAR (~20/50) to 0.25±0.25 LogMAR (~20/30). The mean IOL axis rotation at the last follow-up examination was 0.7±1.0° (0 to 3°) and all patients evaluated their visual acuity as “very good” to “excellent”.
Conclusion
Pseudophakic toric intraocular lens implantation in selected patients with nonprogressive corneal ectasia and contact lens intolerance seems to be safe and effective for visual correction.