Isaak Fischinger, Jascha Wendelstein, Kristin Tetz, Matthias Bolz, M Tetz,
"Toric phakic IOLs in keratoconus-evaluation of preoperative parameters on the outcome of phakic anterior chamber lens implantation in patients with keratoconus"
, in A.M. Joussen, SriniVas Sadda, Taiji Sakamoto, in Graefe's Archive for Clinical and Experimental Ophthalmology, Springer, Seite(n) online ahead of print, 1-2021, ISSN: 1435-702X
Toric phakic IOLs in keratoconus-evaluation of preoperative parameters on the outcome of phakic anterior chamber lens implantation in patients with keratoconus
Sprache des Titels:
Purpose: To evaluate the influence of the type of the keratectasia and preoperative keratometry readings on the efficacy of implantation of iris-fixated phakic anterior chamber intraocular lenses (pIOL) in patients with keratoconus.
Methods: In this retrospective study, iris-fixated pIOLs (Artisan/Artiflex (Ophtec®), Verisyse/Veriflex (AMO®)) were implanted in 38 eyes of 22 patients with stable keratoconus. Thirty-six eyes underwent corneal crosslinking (CXL) prior to the lens implantation. The refractive outcome was evaluated 6 weeks postoperatively and the influence of preoperative refraction and topo- and tomographical factors were analyzed.
Results: The mean postoperative uncorrected distance visual acuity (UDVApost) was 0.25 ± 0.15 logMAR and was not statistically different from the mean preoperative corrected distance visual acuity (CDVApre), which was 0.24 ± 0.13 logMAR. Twenty-seven eyes (71%) reached UDVApost/CDVApre ? 1 (efficacy index), whereas patients with PMD-like ectasia (n = 14) showed significantly (p = 0.003) higher efficacy index (100%) than patients diagnosed with keratoconus (n = 24) (54%). Higher eccentricity of the maximum posterior elevation showed a significant beneficial influence on the efficacy index (p = 0.021). Furthermore, a higher Amsler-Krumeich stage and preoperative MAE were correlated with a worse UDVApost. The mean absolute spherical equivalent was significantly decreased from 5.71 ± 4.96 D to 1.25 ± 1.20 D (p < 0.001). No significant difference was found in endothelial cell count.
Conclusion: The results indicate that the implantation of phakic iris-fixated anterior chamber IOLs is a reasonable refractive option for patients with keratoconus. Keratoconus patients with a pellucidal marginal degeneration (PMD)-like appearance ectasia seem to benefit most from such procedures.
Sprache der Kurzfassung:
Graefe's Archive for Clinical and Experimental Ophthalmology