Toric phakic implant successfully treats refraction after CR

[dweezil1968]

OSN SuperSite Breaking News 7/1/2008

Toric phakic implant successfully treats refraction after cross-linking therapy for keratoconus

HONG KONG � Toric ICL implantation 1 year after corneal collagen cross-linking for patients with keratoconus improves uncorrected visual acuity, according to a study presented here.

Alaa El Danasoury, MD, FRCS, chief of refractive surgery at Maghrabi Eye Hospital in Saudi Arabia, presented results from a study on toric ICL (STAAR Surgical) implantation in 32 eyes of 22 keratoconus patients 1 year after cross-linking therapy. Dr. El Danasoury said a stable cornea is not enough to satisfy keratoconus patients.

"At about 1 year after cross-linking therapy, the keratoconus patients come in and say, 'OK, doctor, I came in originally to improve my vision. Now you are telling me my cornea is stable, and for that I thank you very much, but I still cannot see.' So we offer them a toric ICL," he said.

Dr. El Danasoury said he waits 1 year to ensure corneal stability before implanting the ICL.
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"We conducted this study 2 years ago to assess the safety, the efficacy, the stability of toric intraocular lens to correct the compound myopic astigmatism normally associated with keratoconus post corneal cross-linking," he said.

Patients ranged in age from 19 to 36 years with a mean age of 24.1 years. Fifty-eight percent were men. Baseline mean spherical equivalent was �8.56 D � 4.38 D. Mean baseline cylinder measured �3.44 D � 1.68 D. A total of 30 eyes completed 1 year examination.

Dr. El Danasoury performed ICL implantation through a 3-mm clear corneal incision under topical anesthesia and also performed surgical iridectomies.

"In these cases, the technique of implantation of the ICL is not much different than that in a virgin eye," he said.

According to Dr. El Danasoury, at 1 day postop 94% of uncorrected eyes could see 20/40, 81% could see 20/30 or better, and 56% could see 20/20 or better. This compares with preop best corrected visual acuity of 100% at 20/40 or better, 84% at 20/30 and 44% at 20/20 or better.

At 12 month follow-up, 30 eyes had a mean cylinder of �0.26 D at 144.4 inches.

"The toric ICL is highly predictable in correcting compound myopic astigmatism after cross-linking," he said. "Refractive correction is stable after 1 year; the lens is stable inside the eye with no rotation occurring."

[Andrew MacLean]

This makes interesting reading, but I am not sure that the possible need for further surgery to the post CXL eye has ever been part of the 'sales pitch' for this sort of intervention.

This really is why the NHS applies the precautionary principle; if informed consent is necessary, then the best information has to be available.

Thanks for posting this article.

Andrew

[dplees]

Phakic lens implants are offered as a KC treatment at lcrs in london.


http://www.keratoconustreatment.co.uk/2.html