Comparison of iris-claw and posterior chamber collagen copolymer phakic intraocular lenses in keratoconus.
OBJECTIVE
To evaluate the visual and refractive outcomes, predictability, and stability of phakic intraocular lens (pIOL) implantation in keratoconic eyes and compare the results of 2 pIOL models.


METHODS
Vissum Instituto Oftalmologico, Alicante, Spain.


METHODS
Retrospective case series.


METHODS
An iris-claw (Artiflex) or collagen copolymer posterior chamber pIOL (PC pIOL) (Implantable Collamer Lens) was implanted in eyes with stable keratoconus. The main outcome measures were postoperative changes from the preoperative manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, corneal topography, and endothelial cell count. Alpins vectorial analysis was performed.


RESULTS
Twenty eyes received an iris-claw pIOL and 28 eyes, a PC pIOL. The mean spherical equivalent was -9.31 diopters (D) ± 4.20 (SD) (range -20.75 to -2.75) preoperatively and -0.46 ± 0.88 D (range -3.25 to 1.00 D) postoperatively (P<.001). No patient lost lines of CDVA. The mean decimal UDVA was 0.08 ± 0.09 preoperatively and 0.71 ± 0.26 postoperatively and the mean decimal CDVA, 0.77 ± 0.24 and 0.87 ± 0.98, respectively (P<.001). The mean efficacy index was 0.90 ± 0.26 and the mean safety index, 1.19 ± 0.29. The mean efficacy index was not statistically different between the PC pIOL (0.88 ± 0.28) and the iris-claw pIOL (0.96 ± 0.22) (P=.058). Refraction was stable during the follow-up.


CONCLUSIONS
Phakic IOL implantation is a suitable refractive surgical option for stable keratoconus. It may be especially indicated for the management of high ametropia and showed good efficacy and safety. Refractive and keratometric stability was confirmed.
From the Keratoconus Unit (Alió), Vissum Instituto Oftalmologico de Alicante (Alió, Abdulla G), and the Division of Ophthalmology (Alió, Peña-García), Universidad Miguel Hernández, Alicante, Spain; the Beverly Hills Medical Centre (Zein) and the Ahmadi Hospital (Abu-Mustafa), Kuwait City, Kuwait. Electronic address: jlalio@vissum.com.
Jorge L
JL
Alió
From the Keratoconus Unit (Alió), Vissum Instituto Oftalmologico de Alicante (Alió, Abdulla G), and the Division of Ophthalmology (Alió, Peña-García), Universidad Miguel Hernández, Alicante, Spain; the Beverly Hills Medical Centre (Zein) and the Ahmadi Hospital (Abu-Mustafa), Kuwait City, Kuwait.
Pablo
P
Peña-García
From the Keratoconus Unit (Alió), Vissum Instituto Oftalmologico de Alicante (Alió, Abdulla G), and the Division of Ophthalmology (Alió, Peña-García), Universidad Miguel Hernández, Alicante, Spain; the Beverly Hills Medical Centre (Zein) and the Ahmadi Hospital (Abu-Mustafa), Kuwait City, Kuwait.
Fidan
F
Abdulla G
From the Keratoconus Unit (Alió), Vissum Instituto Oftalmologico de Alicante (Alió, Abdulla G), and the Division of Ophthalmology (Alió, Peña-García), Universidad Miguel Hernández, Alicante, Spain; the Beverly Hills Medical Centre (Zein) and the Ahmadi Hospital (Abu-Mustafa), Kuwait City, Kuwait.
Ghassan
G
Zein
From the Keratoconus Unit (Alió), Vissum Instituto Oftalmologico de Alicante (Alió, Abdulla G), and the Division of Ophthalmology (Alió, Peña-García), Universidad Miguel Hernández, Alicante, Spain; the Beverly Hills Medical Centre (Zein) and the Ahmadi Hospital (Abu-Mustafa), Kuwait City, Kuwait.
S K
SK
Abu-Mustafa
D000328:Adult; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery; D007640:Keratoconus / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods; D008297:Male; D008875:Middle Aged; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult