Endothelial cell loss following toric implantable collamer lens implantation for correction of myopia and astigmatism after penetrating keratoplasty

Aim The aim of this study was to assess the corneal endothelial cell loss after toric implantable collamer lens (TICL) implantation for correction of myopia and astigmatism after penetrating keratoplasty (PKP). Setting and design This is a prospective noncomparative nonrandomized clinical study that was carried out at Alex Eye Center, Alexandria, Egypt. Patients and methods The study was conducted on 12 eyes of eight patients who underwent PKP for keratoconus. After a full preoperative assessment, VISIAN TICL was implanted after a minimum of 1 year with stable refraction. Cases were followed up for 1 year postoperatively for refraction, visual acuity, endothelial cell density (ECD), adverse events, and postoperative complications. Results The refractive and visual outcome in this study proved to be satisfactory regarding efficacy, predictability, and stability. The ECD loss was reduced from a preoperative mean of 2238.6±113.3 cells/mm2 (range=2033–2367 cells/mm2) to a postoperative mean of 2124.8±107.6 cells/mm2 (range=1930–224 cells/mm2) at 6 months postoperatively, with a percentage of loss of −5.09%, and to a mean of 2023.4±109.2 cells/mm2 (range=1833–2192 cells/mm2) at 1 year postoperatively, with a percentage of loss of −9.61%. Both were statistically significant (P=0.042 and 0.0016, respectively). Conclusion TICLs were effective for correction of high ametropia after PKP, with high efficacy, predictability, stability, and safety. However, ECD loss was reported postoperatively up to 1 year. Further studies are required to assert upon these results.