Korean J Ophthalmol.  2013 Jun;27(3):211-214. 10.3341/kjo.2013.27.3.211.

Partial Visual Rehabilitation Using a Toric Implantable Collamer Lens in a Patient with Keratoconus: A Case Report with 20 Months of Follow-up

• Park SW
• Kim MK
• Wee WR
• Lee JH

• KMID: 1798061
• DOI: http://doi.org/10.3341/kjo.2013.27.3.211

Abstract

We report the case of a 37-year-old man with a high myopic keratoconus eye that was treated with a posterior chamber toric implantable collamer lens (ICL) in Korea. The patient had a history of contact lens intolerance and did not want to have a corneal transplantation. His uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity were 0.02 and 0.4 in the left eye, respectively. Preoperatively, the manifest refraction was -12.0 -3.5 x 30A. Postoperatively, the manifest refraction was -1.75 x 180A. UCVA improved markedly after implantation. No intraoperative or postoperative complications were observed during 20 months of follow-up. Toric ICL implantation may be a possible alternative surgical option for the visual rehabilitation of high myopic astigmatism in keratoconus patients with rigid gas permeable contact lens intolerance and in patients who do not want to get a corneal transplant.

Keyword

Astigmatism; High myopia; Keratoconus; Toric implantable collamer lens

MeSH Terms

Adult
Follow-Up Studies
Humans
Keratoconus/*rehabilitation/*surgery
*Lens Implantation, Intraocular
Male
*Phakic Intraocular Lenses
*Visual Acuity

Figure

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  Fig. 1 (A) Anterior segment photography, arrow marking Fleischer's ring, ar rowhead marking corneal scarring. (B) Topography taken 7 years before surgery. (C) Topography before surgery shows stable keratoconus compared with Fig. 1B. The preoperative 3 mm zone irregular astigmatism was ±8.3 diopters and the central corneal thickness was 527 µm. (D) Topography taken 9 months after surgery shows stable keratoconus compared with preoperative topographies. (E) The ultrasound biomicroscopy (UBM) measurement of anterior chamber depth from the endothelium to the anterior surface of implantable collamer lens (ICL) was 2.21 mm one month after surgery. (F) The UBM measurement of anterior chamber depth from the endothelium to the anterior surface of ICL was 2.13 mm 9 months after surgery. (G) The UBM measurement of anterior chamber depth from the endothelium to the anterior surface of ICL was 2.17 mm 20 months after surgery. (H) Contrast sensitivity improved after toric ICL implantation (solid line, postoperative 1 month; dashed line, postoperative 9 months).

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