Офтальмохирургия (Nov 2018)
Toric intraocular lens implantation outcomes in patients with stable keratoconus
Abstract
Purpose. To evaluate the clinical and functional results of phacoemulsification with toric IOL implantation in eyes with stable keratoconus.Material and methods. This study comprised 49 patients (49 eyes) with stable keratoconus and cataract post ICRS implantation and UVcrosslinking in anamnesis. Mean age was 46±1.2 years.Depending on different corneal astigmatism constant, all patients were subdivided in clinical groups. The first one was 27 patients with corneal astigmatism from 1.25 to 4.0D (2.52±1.63D) where the phaco AcrySof IQ Toric were implanted (Alcon, USA). The second group included 22 patients with corneal astigmatism from 4.0 to 10.50D (7.43±1.81D). In that group the IOL AT Torbi 709M (Carl Zeiss Meditec, Germany) was implanted, with the possibility of astigmatism corr ection up to 12.0 D.Results. Postoperative results were evaluated after 1, 3, 6 and 12 months. By the end of the first month all patients registered a significant visual acuity improvement. The UCVA and BCVA were 0.6±0.19 (from 0.4 to 0.7) and 0.8±0.1 (from 0.7 to 0.9) in the group 1. In the group 2: 0.5±0.18 (from 0.3 to 0.6) and 0.6±0.14 (from 0.5 to 0.7). The final refractive criteria stabilization was achieved 3 months after the surgery. The objective spherical and cylindrical refraction in the group 1 was –1.5±1.58 and – 0.75±0.56D; in the group 2: –1.25±2.22 and –1.25±0.56D, respectively. In refractive results estimation a hyperopic shift was found, +0.67±0.19D (from +0.53 to +0.98D) in the group 1 and +0.98±0.21D (from +0.75 to +1.21D) i n the group 2.Conclusion. Phaco with toric IOL implantation is a safe and effective option of ametropia correction in eyes with stable keratoconus, which leads to a visual function improvement in overwhelming majority of patients, however, this method needs to capture all corneal parameters. The obtained results require a deeper further i nvestigation.
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