Management of Compound Myopic Astigmatism Using Toric Implantable Collamer Lens after Corneal Collagen Cross linking in Keratoconic Eyes

Abstract

Context: Correction of compound myopic astigmatism is a challenge in keratoconic eyes post-CXL using traditional approaches such as spectacles and contact lens. Toric Implantable Collamer Lenses (ICL's) are fast emerging as an efficacious treatment modality in such cases. Aim:To analyze the visual outcomes achieved with implantation of Toric Implantable Collamer Lens (ICL) in patients of keratoconus pretreated with Corneal Collagen Crosslinking with Riboflavin (C3R). Settings and design: Retrospective interventional studyMethods and material: Twelve eyes of seven patients underwent planned toric ICL implantation following 3-6 months post C3R. All surgeries were performed at Lotus Eye Care Institute, Coimbatore, TN, India between October 2009 and August 2011. Follow up examinations were performed at 1 month, 3-6 months and 1 year. Statistical analysis used:The mean and standard deviation were calculated for the age and follow-up of the patients.Results: The mean age was 24 years (range 20-30 years). There were 4 female and 3 male patients. Minimum and maximum follow up was 1 month and 30 months respectively. All patients maintained a UCVA of 6/9 or better. Conclusion:Implantation of a toric ICL in keratoconus patients previously stabilized with C3R is an effective and safe method to provide these patients glass free vision.