Combining corneal crosslinking and phakic toric Implantable Collamer Lenses for the treatment of keratectasia: A case report

Zhang,Xiao; Tao,Xiang‑Chen; Li,Zhi‑Wei; Zhou,Wei‑Yan; Ma,Ping; Zhang,Chun‑Xiao; Wang,Yu‑Meng; Mu,Guo‑Ying

doi:10.3892/etm.2016.3481

Combining corneal crosslinking and phakic toric Implantable Collamer Lenses for the treatment of keratectasia: A case report

Authors:
- Xiao Zhang
- Xiang‑Chen Tao
- Zhi‑Wei Li
- Wei‑Yan Zhou
- Ping Ma
- Chun‑Xiao Zhang
- Yu‑Meng Wang
- Guo‑Ying Mu
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Affiliations: Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
Published online on: June 24, 2016 https://doi.org/10.3892/etm.2016.3481
Pages: 1495-1498

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Abstract

The present study reports the use of a phakic toric Implantable Collamer Lens (ICL) that improved the refraction correction of high myopia and astigmatism in a case of keratectasia following corneal cross‑linking. A 31‑year‑old male was diagnosed with keratectasia 12 years after laser‑assisted in situ keratomileusis (LASIK). Following LASIK, the manifest refraction was ‑3.50‑2.25x90 [0.1 logarithmic expression (LogMAR) best corrected visual acuity (BVCA)] in the right eye and ‑8.00‑3.50x175 (0.3 LogMAR BCVA) in the left eye, with a LogMAR uncorrected distance visual acuity (UDVA) of 0.8 and a ‘counting fingers’ value of 3 ft (CF @3 ft) in the left and right eyes, respectively. Riboflavin/ultraviolet A light (UVA) corneal crosslinking (CXL) was conducted on both eyes. Seven months after cross‑linking, LogMAR UDVA was 0.4, the manifest refraction was ‑2.75‑2.50x85 and LogMAR BCVA was 0.1 in the right eye. In the left eye, LogMAR UDVA was CF @3 ft, the manifest refraction was ‑15.00 and LogMAR BCVA was 0.3. The corneal topography was stable 7 months after CXL. Phakic toric ICL was implanted to correct the refractive error, following which the LogMAR UDVA improved to 0.1 in the right eye and 0.3 in left eye, and visual acuity remained stable for 6 months after ICL implantation. In conclusion, combining riboflavin/UVA corneal cross‑linking and phakic toric ICL implantation may be an alternative in the correction of high refractive error in patients with keratectasia.

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1	Ivarsen A and Hjortdal J: Seven-year changes in corneal power and aberrations after PRK or LASIK. Invest Ophthalmol Vis Sci. 53:6011–6016. 2012. View Article : Google Scholar : PubMed/NCBI
2	Rad AS, Jabbarvand M and Saifi N: Progressive keratectasia after laser in situ keratomileusis. J Refract Surg. 20(Suppl 5): S718–S722. 2004.PubMed/NCBI
3	Ferreira TB, Marques EF and Filipe HP: Combined corneal collagen crosslinking and secondary intraocular lens implantation for keratectasia after radial keratotomy. J Cataract Refract Surg. 40:143–147. 2014. View Article : Google Scholar : PubMed/NCBI
4	Raiskup F and Spoerl E: Corneal crosslinking with riboflavin and ultraviolet A. Part II. Clinical indications and results. Ocul Surf. 11:93–108. 2013. View Article : Google Scholar : PubMed/NCBI
5	Kohlhaas M: Iatrogenic Keratectasia: A Review. Klin Monbl Augenheilkd. 232:765–772. 2015.(In German). PubMed/NCBI
6	Bromley JG and Randleman JB: Treatment strategies for corneal ectasia. Curr Opin Ophthalmol. 21:255–258. 2010.PubMed/NCBI
7	Kamiya K, Shimizu K, Ando W, Asato Y and Fujisawa T: Phakic toric Implantable Collamer Lens implantation for the correction of high myopic astigmatism in eyes with keratoconus. J Refract Surg. 24:840–842. 2008.PubMed/NCBI
8	Kanellopoulos AJ and Binder PS: Management of corneal ectasia after LASIK with combined, same-day, topography-guided partial transepithelial PRK and collagen cross-linking: The Athens protocol. J Refract Surg. 27:323–331. 2011. View Article : Google Scholar : PubMed/NCBI
9	Dang TQ, Molchan RP, Taylor KR, Reilly CD, Panday VA and Caldwell MC: Novel approach for the treatment of corneal ectasia in a graft. Cornea. 33:310–312. 2014. View Article : Google Scholar : PubMed/NCBI
10	Huang D, Schallhorn SC, Sugar A, Farjo AA, Majmudar PA, Trattler WB and Tanzer DJ: Phakic intraocular lens implantation for the correction of myopia: a report by the American Academy of Ophthalmology. Ophthalmology. 116:2244–2258. 2009. View Article : Google Scholar : PubMed/NCBI
11	Sanders DR, Doney K and Poco M: ICL in Treatment of Myopia Study Group: United States food and drug administration clinical trial of the implantable collamer lens (ICL) for moderate to high myopia: Three-year follow-up. Ophthalmology. 111:1683–1692. 2004. View Article : Google Scholar : PubMed/NCBI
12	Sanders DR, Schneider D, Martin R, Brown D, Dulaney D, Vukich J, Slade S and Schallhorn S: Toric Implantable Collamer Lens for moderate to high myopic astigmatism. Ophthalmology. 114:54–61. 2007. View Article : Google Scholar : PubMed/NCBI
13	Gomez-Bastar A, Jaimes M, Graue-Hernández EO, Ramirez-Luquin T, Ramirez-Miranda A and Navas A: Long-term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation. Int Ophthalmol. 34:583–590. 2014. View Article : Google Scholar : PubMed/NCBI
14	Alfonso JF, Palacios A and Montes-Micó R: Myopic phakic STAAR collamer posterior chamber intraocular lenses for keratoconus. J Refract Surg. 24:867–874. 2008.PubMed/NCBI
15	Zhang X, Tao XC, Zhang J, Li ZW, Xu YY, Wang YM, Zhang CX and Mu GY: A review of collagen cross-linking in cornea and sclera. J Ophthalmol. 2015:2894672015. View Article : Google Scholar : PubMed/NCBI
16	Botbol-Baum M: The Declaration of Helsinki in 2015 and the ethics of research in French-speaking Africa. J Int Bioethique. 26:87–101, 167. 2015.(In French). PubMed/NCBI
17	Wollensak G, Spoerl E and Seiler T: Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 135:620–627. 2003. View Article : Google Scholar : PubMed/NCBI
18	Kymionis GD, Mikropoulos DG, Portaliou DM, Voudouragkaki IC, Kozobolis VP and Konstas AG: An overview of corneal collagen cross-linking (CXL). Adv Ther. 30:858–869. 2013. View Article : Google Scholar : PubMed/NCBI
19	Raiskup F and Spoerl E: Corneal crosslinking with riboflavin and ultraviolet A. I. Principles. Ocul Surf. 11:65–74. 2013. View Article : Google Scholar : PubMed/NCBI
20	Antonios R, Dirani A, Fadlallah A, Chelala E, Hamade A, Cherfane C and Jarade E: Safety and visual outcome of visian toric icl implantation after corneal collagen cross-linking in keratoconus: Up to 2 years of follow-up. J Ophthalmol. 2015:5148342015. View Article : Google Scholar : PubMed/NCBI
21	Kamiya K, Shimizu K, Kobashi H, Komatsu M, Nakamura A, Nakamura T and Ichikawa K: Clinical outcomes of posterior chamber toric phakic intraocular lens implantation for the correction of high myopic astigmatism in eyes with keratoconus: 6-month follow-up. Graefes Arch Clin Exp Ophthalmol. 249:1073–1080. 2011. View Article : Google Scholar : PubMed/NCBI