The Implantable Phakic Contact Lens, or IPCL, might be an additional good option to correct refraction in combination with intracorneal ring segments for patients with keratoconus, according to one surgeon.
Luis Salvà Ladaria, MD, an ophthalmologist in Palma de Mallorca, Spain, performed the first implantation of this lens in a 29-year-old patient with grade 4 keratoconus who was previously implanted with an intracorneal ring segment in the left eye.
“In his left eye, the patient had visual acuity of counting fingers at 25 cm. We implanted an intracorneal ring segment, 250 µm thick and 210° of arc, for an optical zone size of 6 mm. The ring stabilized the keratoconus, and 6 months later, having the cone more central and stable, we corrected the residual spherical and cylindrical defect with a Phakic Toric Implantable Contact Lens (IPCL-T),” he said.
Results were excellent, and the patient was happy. Visual acuity improved from counting finger to 20/60, and refraction improved from –9.25 D –6.25 × 135° to –0.75 –1.00 × 115°.
According to Salvà, the IPCL (Care Group) is “a new twist” to the well-established intraocular contact lens (ICL) concept. It is designed to have six points of contact with the ciliary sulcus for improved stability instead of four points. It has two positioning holes in the haptics to facilitate implantation and four holes in the optic periphery to allow aqueous flow without causing disturbance to vision. In addition, it has a wider dioptric range and a multifocal and a toric option.
“With the very irregular cornea of keratoconus patients, peripheral holes are better than the central hole of an ICL, which might disturb vision and produce aberrations,” Salvà said.
A second advantage is that the IPCL is easier to insert through a smaller incision. With an ICL, the incision is at least 2 mm, while the IPCL can be inserted through a 1.8-mm incision with a Medicel injector, providing better control of postoperative astigmatism.
“In addition, the range of correction is wider. With an ICL it is from 0 D to –16 D, while the IPCL goes up to –26 D, a big range that might be required in keratoconus cases,” Salvà said.
Finally, the cost is lower with the IPCL, he said. The IPCL is now commercially available in Europe, gaining popularity in Spain and raising the interest of ophthalmologists in other countries, Salvà said. – by Michela Cimberle
Click to see, VIDEO: New phakic lens improves vision in keratoconus patient implanted with intracorneal ring segment.
- For more information:
- Luis Salvà Ladaria, MD, is the head of Oftalmedic-Clínica Salvà in Palma de Mallorca, Spain. He can be reached at email: firstname.lastname@example.org.
Disclosure: Salvà reports no relevant financial disclosures.