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Outcomes and complications of implantable collamer lens for mild to advance keratoconus

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Abstract

Purpose

To evaluate the outcome and safety of implantable collamer lens (ICL; (Visian, STAAR Surgical, Monrovia, CA, USA) in mild to advance keratoconus patients with myopia and myopic astigmatism.

Methods

This retrospective study evaluated all patients who underwent ICL implantation for the management of keratoconus at a tertiary care eye hospital from January 2012 to January 2018. The mean duration of follow-up was 15.3 months (range, 3.13 to 38.97 months). Data were collected on preoperative and postoperative uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction was compared, and adverse effects were evaluated.

Results

Thirty-two eyes (32 patients) were evaluated. The median CDVA was 20/30 preoperatively and 20/20 at last follow-up. The median UDVA was 20/25 at last follow-up. Thirteen patients (40.6%) had 20/20 UDVA in comparison to none at baseline. The median spherical equivalent in diopters (D) was −7.875 D (−4.125 to −10.0 D) preoperatively and decreased to −0.3125 D at last follow-up. The median manifest refractive cylinder was 3.00 D (2.25 to 5.25 D) preoperatively and decreased to 1.125 D postoperatively.

Cylinder axis rotation of 10° or greater occurred in 3 eyes (9.375%) and required repositioning of the ICL. One patient (3%) developed nonvisually significant anterior subcapsular cataract. One ICL (3.125%) had to be explanted due to residual refractive error and unsatisfactory vision.

Conclusion

ICLs are a suitable refractive option for the correction of refractive error associated with stable, nonprogressive keratoconus even in advance cases. However, the risk of ICL rotation and subsequent repositioning remain. Careful patient selection is necessary for achieving good outcomes and mitigating intraoperative and postoperative complications.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Ophthalmology Department, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia

    Rafah Fairaq

  2. Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia

    Rafah Fairaq, Mohammed Almutlak, Enmar Almazyad, Abdulrahman H. Badawi & Muhammad Ali Ahad

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  1. Rafah Fairaq
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  2. Mohammed Almutlak
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  3. Enmar Almazyad
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  4. Abdulrahman H. Badawi
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  5. Muhammad Ali Ahad
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Rafah Fairaq, Enmar Mazyad Almazyad and Abdulrahman H. Badawi. The first draft of the manuscript was written by Rafah Fairaq and Muhammad Ahad, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Muhammad Ali Ahad.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board (IRB) and Ethics Committee of King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, approved this study. Project number: (RP-1848).

Consent to participate

Not applicable. This is a retrospective chart review with no identifying information used. Informed consent was not obtained from individual participants included in the study.

Informed consent

Informed consent was not obtained from individual participants included in the study.

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Fairaq, R., Almutlak, M., Almazyad, E. et al. Outcomes and complications of implantable collamer lens for mild to advance keratoconus. Int Ophthalmol 41, 2609–2618 (2021). https://doi.org/10.1007/s10792-021-01820-2

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  • DOI: https://doi.org/10.1007/s10792-021-01820-2

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