Результаты имплантации торических ИОЛ у пациентов с катарактой и стабилизированным кератоконусом

[摘要] Purpose . To evaluate the clinical and functional results of phacoemulsification with toric IOL implantation in eyes with stable keratoconus.Material and methods . This study comprised 49 patients (49 eyes) with stable keratoconus and cataract post ICRS implantation and UVcrosslinking in anamnesis. Mean age was 46±1.2 years. Depending on different corneal astigmatism constant, all patients were subdivided in clinical groups. The first one was 27 patients with corneal astigmatism from 1.25 to 4.0D (2.52±1.63D) where the phaco AcrySof IQ Toric were implanted (Alcon, USA). The second group included 22 patients with corneal astigmatism from 4.0 to 10.50D (7.43±1.81D). In that group the IOL AT Torbi 709M (Carl Zeiss Meditec, Germany) was implanted, with the possibility of astigmatism corr ection up to 12.0 D.Results . Postoperative results were evaluated after 1, 3, 6 and 12 months. By the end of the first month all patients registered a significant visual acuity improvement. The UCVA and BCVA were 0.6±0.19 (from 0.4 to 0.7) and 0.8±0.1 (from 0.7 to 0.9) in the group 1. In the group 2: 0.5±0.18 (from 0.3 to 0.6) and 0.6±0.14 (from 0.5 to 0.7). The final refractive criteria stabilization was achieved 3 months after the surgery. The objective spherical and cylindrical refraction in the group 1 was –1.5±1.58 and – 0.75±0.56D; in the group 2: –1.25±2.22 and –1.25±0.56D, respectively. In refractive results estimation a hyperopic shift was found, +0.67±0.19D (from +0.53 to +0.98D) in the group 1 and +0.98±0.21D (from +0.75 to +1.21D) i n the group 2. Conclusion . Phaco with toric IOL implantation is a safe and effective option of ametropia correction in eyes with stable keratoconus, which leads to a visual function improvement in overwhelming majority of patients, however, this method needs to capture all corneal parameters. The obtained results require a deeper further i nvestigation.

[学科分类] 眼科学

[关键词] keratoconus;cataract phacoemulsification;toric IOL;кератоконус;факоэмульсификация катаракты;торические ИОЛ