Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty

Background To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up. Methods This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed. Results The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery ( P < 0.0001) and remained unchanged throughout the whole follow-up ( P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up ( P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%. Conclusions The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.