Article Text

Download PDFPDF

Original article
Comparative analysis of the visual performance after implantation of the toric implantable collamer lens in stable keratoconus: a 4-year follow-up after sequential procedure (CXL+TICL implantation)
  1. Farideh Doroodgar1,
  2. Feazollah Niazi2,
  3. Azad Sanginabadi1,
  4. Sana Niazi3,
  5. Alireza Baradaran-Rafii4,
  6. Cyrus Alinia5,
  7. Eznollah Azargashb6,
  8. Mohammad Ghoreishi7
  1. 1Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
  2. 2Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Thran, Tehran, Iran
  3. 3Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
  4. 4Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
  5. 5Department of Public Health, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran
  6. 6Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
  7. 7Ophthalmology Department, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran
  1. Correspondence to Dr Farideh Doroodgar, No 3. Ketabi St, Shariati Ave, Tehran 1544914599, Iran; farinaz_144{at}yahoo.com

Abstract

Aims To report on 4-year postoperative visual performance with the toric implantable collamer lens (TICL) for stable keratoconus after sequential procedure (corneal collagen crosslinking plus TICL implantation).

Methods Forty eyes of 24 patients with stable keratoconus with myopia between 0.00 and −18.00 dioptres (D) and astigmatism between 1.25 and 8.00 D were evaluated in this prospective interventional study (https://clinicaltrials.gov/ct2/show/NCT02833649). We evaluated refraction, visual outcomes, astigmatic changes analysed by Alpins vector, contrast sensitivity, aberrometry, modulation transfer functions (MTFs), defocus curve, and operative and postoperative complications.

Results At 4-year follow-up, 45% had 20/20 vision or better and 100% had 20/40 or better uncorrected visual acuity (UCVA). Vector analysis of refractive astigmatism shows that the surgically induced astigmatism (SIA) (3.20±1.46 D) was not significantly different from the target induced astigmatism (TIA) (3.14±1.42 D) (p=0.620). At 4 years postoperatively, none of the eyes showed a decrease in UCVA, in contrast to 24 eyes in which UCVA was increased by ≥1 lines, with contrast sensitivity and improvement in total aberrations and MTF value at 5 per degree (*p=0.004) after TICL implantation. The cumulative 4-year corneal endothelial cell loss was ≤5%. No patients reported dissatisfaction. At the end of follow-up, the vault was 658±54.33m (range, 500–711) and the intraocular pressure was 11.7±2.08 mm Hg. Occurrences of glare and night-driving troubles diminished after TICL surgery.

Conclusion The results from this standardised clinical investigation support TICL implantation from clinical and optical viewpoints in patients with stable keratoconus.

Trial registration number NCT02833649, Pre-results

  • keratoconus
  • cross-linking
  • toric implantable collamer lens (TICL)

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

View Full Text

Statistics from Altmetric.com

Footnotes

  • Original reference: None

  • Contributors AS, FD and SN: collected patient data and wrote the manuscript. FD and FN: concept and study design. FD: critical evaluation of the manuscript. FD, ABR and MG: clinical evaluation for severity of addictions. CA: statistical analysis.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Tehran University of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.