March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Phakic Foldable Intraocular Lens Implantation For The Visual Rehabilitation Of Residual Significant Anisometropia Following The Stabilization Of Keratoconus With The Athens Protocol
Author Affiliations & Notes
  • Carolyn P. Graeber
    Ophthalmology, NYU/MEETH, New York, New York
  • A. J. Kanellopoulos
    Ophthalmology, NYU/MEETH, New York, New York
  • Footnotes
    Commercial Relationships  Carolyn P. Graeber, None; A. J. Kanellopoulos, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 4047. doi:
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      Carolyn P. Graeber, A. J. Kanellopoulos; Phakic Foldable Intraocular Lens Implantation For The Visual Rehabilitation Of Residual Significant Anisometropia Following The Stabilization Of Keratoconus With The Athens Protocol. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4047.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the safety and efficacy of phakic intraocular lens implantation for the visual rehabilitation of residual significant anisometropia following the stabilization of keratoconus with the Athens Protocol.

Methods: : Consecutive eyes with keratoconus treated with the Athens Ptotocol (photorefractive keratectomy with collagen cross-linking) with residual significant anisometropia (greater than 6 diopters) and with contact lens intolerance were implanted with phakic intraocular lenses (AcrySof® Cachet® Phakic Lens) for visual rehabilitation over a period of 2 years. The preoperative versus postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive error, keratometry (K), corneal topography (T), pachymetry (P), and endothelial cell count (ECC) were compared. Signs of progression of corneal ectasia were assessed using sequential corneal topography and tomography. Any change in keratometry greater than one diopter was considered to be progression of ectasia.

Results: : 12 cases of keratoconus that were previously treated with the Athens Protocol were included. The mean follow-up was 0.9 years (range 3 months to-1.5 years). UCVA changed from 0.2 to 0.7. BSCVA improved from 0.6 to 0.8. Mean refractive spherical equivalent decreased from -8.25D to +0.5D. ECC stayed relatively stable (2750 versus 2800) as did corneal P, T and K. None of the eyes developed signs of ectasia progression.

Conclusions: : Phakic intraocular lens implantation for the improvement of residual significant anisometropia following the stabilization of keratoconus with the Athens Protocol is a safe and effective adjunctive treatment. This form of refractive surgery does not appear to cause progression of corneal ectasia in this high-risk group of individuals.

Keywords: keratoconus • refractive surgery • intraocular lens 
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