Abstract
Purpose: :
To evaluate the safety, efficacy and stability of sequential corneal collagen cross-linking by UVA/riboflavin (X-linking) procedure and Artiflex phakic intraocular lens (pIOL) implantation in selected cases of keratoconus.
Methods: :
This prospective study involved 10 eyes with keratoconus diagnoses between March 2007 to March 2008. The inclusion criteria were keratoconus diagnoses (Amsler-Krumeich grades I,II and III), no corneal opacities, corneas thicker than 450 um, contact lens intolerance, no other treatment for keratoconus except contact lens. Each patient underwent crosslinking procedure in the keratoconus eye. Refraction 6 months after crosslinking procedure showed residual myopia greater than 5.0 D Thus, a Artiflex pIOL was implanted. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, and topographic profiles were taken 1, 3, 6 months after the second surgery.
Results: :
All eyes achieved UCVA of 20/25 or better. The final spherical error ranged from -0.25 to -1.25 D and the cylindrical error, from -0.25 to -1.00 D. No eye lost lines of preoperative BCVA. Statistically significant reductions in the mean maximum (1.39D, p=0.03) and minimum (1.01 D, p=0.03) keratometry values were present at 6 months postoperatively
Conclusions: :
Sequential corneal collagen crosslinking and a Artiflex pIOL implantation was safe, stable, and effective in selected cases of keratoconus.
Keywords: keratoconus • refractive surgery: phakic IOL • cornea: epithelium