Keratoconus – Cross linking and Visian ICL

Mrs S, a 41 year old nurse wanted freedom from spectacles and contact lenses. She had been diagnosed with keratoconus in 1992 and wore RGP’s for a very high myopic prescription.

Keratoconus case study

The left eye’s prescription was unstable hence requiring collagen cross linking. This was performed without complication by Mr Pillai and the eye recovered well.

The patient was regularly monitored for stability. It was recommended that the best refractive procedure to correct the prescription would be Implantable Contact Lens surgery. Clear Lens Exchange was decided against because there was a risk of retinal detachment due to high myopia, as it would be a permanent treatment and because the patient did not require a near prescription. The Implantable Contact Lens is looked at as a permanent correction but is completely reversible. This is the safest option as the patient is keratoconic.

Bilateral Implantable Contact Lens surgery was carried out 17 months after the collagen cross linking procedure by Professor Filipec. Visian IOL’s were used, therefore iridotomies or peripheral iridectomise were not required. The surgery went without complication and the eyes healed well.

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