Outcomes after implantable collamer lens surgery in a Canadian cohort.

OBJECTIVE: To describe refractive outcomes and complications after implantable collamer lens (ICL) implantation. DESIGN: Retrospective, interventional case series. METHODS: A database search of ICL surgeries over a 5-year period (2009-2013) was conducted, and 83 eyes of 44 patients were included. The Visian ICL (STAAR Surgical, Monrovia, Calif.) was used in all eyes. The primary outcome measure was postoperative uncorrected distance acuity (UCDA). Secondary outcomes include predictability, safety, and adverse events. RESULTS: Mean age was 31 years, and 59% of patients were female. Mean observation time was 14.9 months. Mean manifest refractive spherical equivalent (MRSE) was -11.1 ± 3.24 D preoperatively and -0.18 D ± 0.57 D postoperatively. Mean astigmatism was -1.90 ± 1.34 D, and 82% of eyes received toric ICLs, 93.4% of eyes achieved 20/40 UCDA, and 50.8% achieved 20/20 at last observation; 67.1% and 89.5% of eyes had MRSE within 0.5 and 1.00 D of target refraction, respectively. Safety index was 1.16 and overall improvement of 0.060 logMAR was observed. Eight (10.5%) eyes had residual astigmatism with 5 (6.5%) requiring laser enhancement. Glare and haloes were reported in 6 eyes (7.9%). Three eyes developed cataract. One eye had a retinal detachment. CONCLUSIONS: Toric and nontoric ICL implantations show promising refractive outcomes and acceptable safety in moderate to high myopes and can be considered for patients who are noncandidates for refractive laser surgery.

Accelerated (9-mW/cm2) corneal collagen crosslinking for keratoconus-A 1-year follow-up.

PURPOSE: The aim of this study was to assess the efficacy of accelerated crosslinking (irradiance of 9 mW/cm; 10 minutes) in keratoconus-affected eyes through topographical, visual, and refractive end points. METHODS: Mild-moderate keratoconus-affected eyes that underwent accelerated corneal collagen crosslinking (CXL) treatment and had 6 and 12 months of follow-up were reviewed retrospectively. Data regarding uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity (CDVA), and computerized corneal topography data before surgery and post-CXL treatment were extracted and analyzed. RESULTS: Sixteen eyes of 14 patients were included in the study. The mean patient age was 24.9 ± 5.8 years (range: 17.1-38.3 years). No statistically significant changes were found in the mean CDVA, mean refractive cylinder, or mean manifest refraction spherical equivalent at either time point. There was a gain of 0.13 logarithm of the minimum angle of resolution lines in the mean UDVA (P = 0.012) at 12 months. All corneal parameters including Ksteep, Kflat, average K (Km), corneal astigmatism (Kcyl), and maximal curvature reading at the corneal apex (Kmax) were stable at 6 and 12 months in all patients. No complications were observed during the follow-up period. CONCLUSIONS: Accelerated corneal CXL is effective in stabilizing topographic parameters after 12 months of follow-up in mild-moderate keratoconus-affected corneas. Improvement in the UDVA and stabilization of all tested corneal parameters were noted after the treatment. However, a longer follow-up with larger cohorts is necessary to validate these findings.