Myopic phakic STAAR collamer posterior chamber intraocular lenses for keratoconus

To evaluate the efficacy, predictability, and safety of myopic phakic posterior chamber Implantable Collamer Lens (ICL) to correct myopia associated with keratoconus.

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.

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.

Myopic ICL implantation was a safe, effective, and predictable procedure for the correction of myopia associated with keratoconus.