Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for the correction of high myopic astigmatism in eyes with keratoconus

Br J Ophthalmol. 2015 Feb;99(2):177-83. doi: 10.1136/bjophthalmol-2014-305612. Epub 2014 Aug 21.


Aim: To assess the clinical outcomes following the use of toric implantable collamer lenses (toric ICL, STAAR Surgical) for the correction of high myopic astigmatism with keratoconus.

Methods: This retrospective study evaluated 21 eyes of 11 patients with spherical equivalents of -9.70±2.33 D (mean±SD) and astigmatism of -3.21±1.56 D who underwent toric ICL implantation for keratoconus. Preoperatively, and at 1, 3 and 6 months and 1, 2 and 3 years postoperatively, we assessed the safety, efficacy, predictability, stability and adverse events of the surgery.

Results: The logarithm of the minimum angle of resolution (logMAR) uncorrected distance visual acuity (UDVA) and the logMAR corrected distance visual acuity (CDVA) were -0.06±0.11 and -0.12±0.09, respectively, at 3 years postoperatively. At 3 years, 67% and 86% of the eyes were within ±0.5 and ±1.0 D, respectively, of the targeted correction. Manifest refraction changes of 0.04±0.33 D occurred from 1 month to 3 years postoperatively. No significant change in manifest refraction (analysis of variance, p=0.989) or keratometry (p=0.951), or vision-threatening complications occurred during the observation period.

Conclusions: Toric ICL implantation is beneficial according to measures of safety, efficacy, predictability and stability for the correction of refractive errors for keratoconus during a 3-year observation period. The disease did not progress even in the late-postoperative period, suggesting the viability of this procedure as a surgical option for the treatment of such eyes.

Keywords: Treatment Surgery.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Astigmatism / complications
  • Astigmatism / physiopathology
  • Astigmatism / surgery*
  • Cell Count
  • Corneal Pachymetry
  • Endothelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / physiology
  • Keratoconus / complications
  • Keratoconus / physiopathology
  • Keratoconus / surgery*
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications
  • Myopia, Degenerative / physiopathology
  • Myopia, Degenerative / surgery*
  • Phakic Intraocular Lenses*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology