title: Toric implantable collamer lens for high myopic astigmatism in keratoconic patients after six months.
abstract: BACKGROUND
  The aim was to evaluate the safety, efficacy, stability and predictability of posterior chamber collagen copolymer phakic intraocular lens (pIOL) implantation to correct myopia and myopic astigmatism associated with keratoconus.
  
  
  METHODS
  The unaided vision and visual acuity, refraction and adverse events were measured in 22 keratoconic eyes of 14 patients after using an implantable collamer lens (ICL) (STAAR Surgical Inc.) to correct refractive error. The outcome was evaluated over six months.
  
  
  RESULTS
  The mean pre-operative spherical equivalent (SE) and cylinder changed from -4.98 ± 2.63 DS and -2.77 ± 0.99 DC to -0.33 ± 0.51 DS and -1.23 ± 0.65 DC, respectively at the end of six months. Before the surgery the mean Snellen decimal visual acuity was 0.63 ± 0.20. The mean unaided vision and visual acuity changed to 0.76 ± 0.23 and 0.85 ± 0.21, respectively at the end of six months. The mean safety and efficacy indices were 1.40 ± 0.32 and 1.24 ± 0.34, respectively. No eye lost a line of visual acuity and 17 eyes (77.3 per cent) gained one or more lines. Fifteen eyes (68.2 per cent) were within 0.50 D and 20 (90.9 per cent) were within 1.00 D of the desired spherical equivalent refraction. There was a change in manifest refraction of 0.09 ± 0.21 (ranging from -0.25 to +0.75) from one week to six months after the surgery.
  
  
  CONCLUSIONS
  The clinical outcomes of the current study demonstrate the safety, efficacy and predictability of toric implantable collamer lens in the correction of myopia and myopic astigmatism associated with keratoconus. The patients' refractions achieved early stability and remained stable during the course of the study.
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Javad
authors.initials: SJ
authors.lastname: Hashemian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Soleimani
authors.forename: Alireza
authors.initials: A
authors.lastname: Foroutan
authors.forename: Mahmood
authors.initials: M
authors.lastname: Joshaghani
authors.forename: Jafar
authors.initials: J
authors.lastname: Ghaempanah
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Jafari
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D009216:Myopia / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011446:Prospective Studies; D013997:Time Factors; D014792:Visual Acuity