Safety and Visual Outcome of Visian Toric ICL Implantation After Corneal Collagen Cross-linking in Keratoconus

Abstract

Implantation of the Visian toric ICL following CXL is an effective option for improving visual acuity in patients with keratoconus.

Implantable Collamer Lens (ICL) Sizing in Advanced Keratoconus

“…Recent studies have established the safety and efficacy of posterior chamber phakic intraocular lens for the correction of moderate to high myopic astigmatism in keratoconus. [2][3][4][5] Accurate ICL sizing is important in reducing the complication rate because most ICL related complications are the result of improper vault. The most popular method for determining ICL size is the use of WTW to indirectly predict the sulcus diameter.…”

“…1 Favorable outcomes with ICL implantation alone or in combination with CXL and intracorneal rings have been reported to treat the myopic astigmatism in keratoconus. 2,3,4,5 Thereby phakic IOLs are fast becoming an acceptable alternative for visual rehabilitation in keratoconus patients who are contact lens intolerant. White-to-White (WTW) measurement (horizontal corneal diameter measurement) is an important step in sizing the ICL.…”

Keratoconus: How Best to Treat it?

“…Improvements maybe bett er than possible with glasses but less than those with contact lenses. 21,22 Charu Khurana: How oft en do you perform DALK/ PK in your keratoconus patients?…”

Visian Toric ICL Implantation for Residual Refractive Errors After ICRS Implantation and Corneal Collagen Cross-linking in Keratoconus

“…According to our treatment protocol, 1 the best approach for these cases is intracorneal ring segments (ICRS) implantation (usually one segment) to improve CDVA followed by corneal collagen cross-linking (CXL) treatment 4 weeks later to stabilize the cornea and phakic toric implantable collamer lens (TICL) (Visian Toric V4b ICL; STAAR Surgical, Monrovia, CA) implantation 4 to 6 months after CXL to correct the residual refractive errors. We conducted a retrospective analysis of 11 eyes of 7 patients with moderate to severe keratoconus (according to the Amsler-Krumeich classifi cation 2 , 4 eyes had stage II keratoconus and 7 eyes had stage III) and poor CDVA who underwent three-step ICRS implantation-CXL-TICL implantation procedures at our eye hospital.…”