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Five Year- Results of Iris-Fixated Toric Phakic IOLs in Japanese Keratoconus Eyes
Yutaro Nishi, Kyoko Sogo, Kayo Nishi, Miki Tachimichi, Okihiro Nishi Contact: [email protected] Nishi Eye Hospital, Osaka, JapanNone of the authors have financial interest
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Purpose
To assess the long term safety, efficacy and complications of the Artisan Toric phakic intraocular lens for the correction of Japanese keratoconus eyes.
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Previous reportsKeratoconus Astigmatism
• Budo C et al. J Refract Surg. 2005 May-Jun;21(3):218-22 “SE was significantly reduced in all six keratoconus eyes. “
• Kamburoğlu G et al. Cataract Refract Surg. 2007 Mar;33(3):528-30 “Corrected refractive error of a keratoconus patient.”
• Venter J. J Refract Surg. 2009 Sep;25(9):759-64 “Good functional in keratoconus eyes during 1 year follow-up.”
Dick HB et al. Ophthalmology. 2003 Jan;110(1):150-62
‣“European multicenter study; correction of astigmatism during 6month follow-up.”
Guell JL et al. Am J Ophthalmol. 2003 Sep;136(3):442-7 ‣“Correction of high astigmatism.”
Alio JL et al. J Refract Surg. 2005 Jul-Aug;21(4):324-31 ‣“Correction of astigmatism.”
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Material and methods‣18 myopic Japanese eyes with
astigmatism ( 21 to 61 y.)
‣10 eyes diagnosed as keratoconus ( 21 to 58 y.)
‣Implantation of Artisan Toric phakic IOLs
‣Implantation period ranged from 3 mo. to 5 y.
‣Examination: UCVA, BCVA, SE (diopters), IOP (mmHg), Endothelial cell count (cells/mm2), ACD (mm), slit-lamp finding
Material PMMA
Overall Ø 8.5 mmOptic Ø 5.0 mm
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Results: Keratoconus eyesPre-Ope
(n=10)3-6Mo (n=9)
1Y (n=7)
3Y(n=4)
5Y(n=3)
BCVA 0.71 ±0.35
0.87 ±0.37
1.0 ±0.18
1.1 ±0.15
0.9 ±0.14
UCVA 0.07 ±0.09
0.63 ±0.52
1.0 ±0.12
0.68 ±0.17
0.7 ±0.21
SE-7.7
±6.3-0.63 ±0.19
-0.1 ±0.35
-0.22 ±0.59
-0.13 ±0.88
Endothelium 3085 ±398.9
2609 ±785.6
2801 ±331.3
2442 ±159.9
2440 ±796.9
IOP11.8
±0.3515.0 ±4.2
11.0 ±0.55
13.5 ±1.3
14.0 ±0.13
IOL extraction in one case
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Case: IOL extraction‣58 years old, male: the oldest in
the keratoconus group
‣Preoperative endothelial cell count = 2531cells/mm2: the lowest in the group Postoperative endothelial cell count = 756 cells/mm2
‣Preoperative ACD= 3.1mm, Postoperative ACD= 3.3mm the smallest values among the
group Distance between endothelium
and IOL (center) was more than 1.5mm by Scheimpflug photography, which met the standard criteria
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Conclusion‣ Long-term results shows the implantation of the Artisan Toric
IOL in Japanese eyes is a reasonable and moderately safe method for the correction of keratoconus.
‣ It showed good functional results.
‣ Longer-term follow ups are important.
‣The criteria regarding distance between corneal endothelium and phakic IOL (center) may better be reconsidered.