Purpose: To evaluate the efficacy, predictability, and safety of myopic phakic posterior chamber Implantable Collamer Lens (ICL) to correct myopia associated with keratoconus.
Methods: In a prospective, noncomparative, interventional case series, outcomes in 25 consecutive keratoconus eyes of 16 patients, myopia from -3.00 to -18.00 diopters (D) and astigmatism from -0.50 to -3.00 D, were analyzed 12 months after implantation of myopic ICLs (STAAR Surgical). All eyes showed best spectacle-corrected visual acuity (BSCVA) > or =20/50, central keratometric values < or =52.00 D, and refractive cylinder < or =3.00 D. Myopic ICL implantation was performed through a corneal incision in the steepest meridian.
Results: The mean uncorrected visual acuity and BSCVA after ICL implantation were 0.17+/-0.19 and 0.12+/-0.12 logMAR, respectively. The efficacy index was 0.98. No eyes lost 2 or more lines of visual acuity, 2 eyes lost 1 line, 18 eyes did not change after surgery, and 5 eyes gained 1 or more lines. The safety index was 1.05. Best spectacle-corrected visual acuity after ICL implantation was statistically significantly better than preoperative BSCVA (P=.0021). Spherical equivalent refraction was within +/-1.00 D of the desired refraction in all cases and 84% of cases were within +/-0.50 D. Mean postoperative spherical equivalent refraction was 0.32+/-0.55 D at 12 months.
Conclusions: Myopic ICL implantation was a safe, effective, and predictable procedure for the correction of myopia associated with keratoconus.