Official ESCRS | European Society of Cataract & Refractive Surgeons
Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Phakic intraocular lens implantation after intracorneal ring segment for keratoconus

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Session Details

Session Title: Keratoconus and Phakic IOLs

Session Date/Time: Monday 12/09/2016 | 16:30-18:30

Paper Time: 16:36

Venue: Hall C4

First Author: : T.Queirós PORTUGAL

Co Author(s): :    N. Franqueira   F. Faria Correia   T. Monteiro   F. Vaz           

Abstract Details


To evaluate the efficacy and safety of sequential phakic intraocular lens (IOL) surgery after implantation of intracorneal ring segments (ICRS) in eyes with keratoconus.


Department of Ophthalmology, Hospital de Braga, Portugal


A retrospective study was conducted in 15 eyes of 12 patients with keratoconus with high spherical ametropia after implantation of Ferrara-ICRS for irregular astigmatism. The phakic IOL implantation was performed at least 6 months after ICRS surgery; two types of IOLs were used: implantable collamer posterior chamber IOL (ICL, V4C STAAR Surgical, Monrovia, CA, USA) and anterior chamber iris-claw IOL Artisan® and Artiflex® (Ophtec, Groningen, Netherlands). Preoperatively and follow-up parameters analyzed: best-corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA); refractive sphere and cylinder; topography (k1, k2, kmax) and corneal endothelial cells count (CECC).


Eighth V4C ICL, six Artiflex and one Artisan IOL were implanted. Mean UCVA was 0.10±0.07 before ICRS implantation; 0.17±0.13 after ICRS implantation; and 0.52±0.25 after phakic IOL, with significant improvement after all procedures (p<0.01). Mean BCVA was 0.35±0.25 before ICRS implantation; 0.52±0.21 after ICRS implantation; and 0.63±0.22 after phakic IOL surgery; with significant improvement after all procedures (p<0.05). Spherical equivalent changed from -7.49D±5.58 to -0.46D±0.99 after phakic IOL surgery (p<0.01). A mean spherical equivalent of ± 0.50D and ±1.00D was achieved in 33% and 47% of eyes, respectively. A mean cell loss of 2,74% at 6 months was found.


The sequencial phakic IOL implant after ICRS implantation in patients with keratoconus with high residual ametropia is a safe procedure, with significant improvement in UCVA and BCVA. Refractive predictability is lower than the one observed if phakic IOL implantation as a primary procedure in non-keratoconus patients.

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