title: Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for the correction of high myopic astigmatism in eyes with keratoconus.
abstract: OBJECTIVE
  To assess the clinical outcomes following the use of toric implantable collamer lenses (toric ICL, STAAR Surgical) for the correction of high myopic astigmatism with keratoconus.
  
  
  METHODS
  This retrospective study evaluated 21 eyes of 11 patients with spherical equivalents of -9.70±2.33 D (mean±SD) and astigmatism of -3.21±1.56 D who underwent toric ICL implantation for keratoconus. Preoperatively, and at 1, 3 and 6 months and 1, 2 and 3 years postoperatively, we assessed the safety, efficacy, predictability, stability and adverse events of the surgery.
  
  
  RESULTS
  The logarithm of the minimum angle of resolution (logMAR) uncorrected distance visual acuity (UDVA) and the logMAR corrected distance visual acuity (CDVA) were -0.06±0.11 and -0.12±0.09, respectively, at 3 years postoperatively. At 3 years, 67% and 86% of the eyes were within ±0.5 and ±1.0 D, respectively, of the targeted correction. Manifest refraction changes of 0.04±0.33 D occurred from 1 month to 3 years postoperatively. No significant change in manifest refraction (analysis of variance, p=0.989) or keratometry (p=0.951), or vision-threatening complications occurred during the observation period.
  
  
  CONCLUSIONS
  Toric ICL implantation is beneficial according to measures of safety, efficacy, predictability and stability for the correction of refractive errors for keratoconus during a 3-year observation period. The disease did not progress even in the late-postoperative period, suggesting the viability of this procedure as a surgical option for the treatment of such eyes.
authors.affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors.forename: Kimiya
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors.forename: Hidenaga
authors.initials: H
authors.lastname: Kobashi
authors.affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Igarashi
authors.affiliation: Sanno Hospital, Tokyo, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Komatsu
authors.affiliation: Nakamura Eye Clinic, Ibaraki, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Nakamura
authors.affiliation: Nagoya Eye Clinic, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kojima
authors.affiliation: Nagoya Eye Clinic, Aichi, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002452:Cell Count; D063171:Corneal Pachymetry; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007640:Keratoconus / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
keywords: Treatment Surgery