Eyeworld

18 | EYEWORLD | WINTER 2025 ASCRS NEWS by Dany Hage, MD,* Johnson Huang, MD,* Jonathan Le, MD,* Karolina Leziak, MD,* Emma Stenz, MD,* Marcus Turner, MD,* Ophthalmology Residents; Parisa Taravati, MD, Residency Program Director, University of Washington *These authors contributed equally to this work. authors compared the results between post-PK and post-DALK eyes. 3 Design and methods The article described a retrospective analysis of patients who had received iris-claw pIOL for high ametropia and astigmatism after PKP or DALK at the Santo Antonio Local Health Unit, in Porto, Portugal, between January 2013 and December 2023. Eligible patients were 21 years or older, with 12 or more months of refractive stability, best-corrected visual acuity of 20/40 or better, and glasses or contact lens intolerance. Inclusion criteria were anterior chamber depth of 3 mm or greater and ECD of at least 2,000 cells/mm 2 for DALK and 1,000 cells/mm 2 for PK. Exclusion criteria were corneal scarring, less than 12 months of follow-up data, past uveitis or ocular hypertension history, and any previous refractive procedures. Surgeries were conducted by three experienced surgeons at a single center. Patient data were examined at four vis- its, immediately prior to implantation, 12–18 months after implantation, and 5- and 10-year subsequent visits. Each visit consisted of correct- ed and uncorrected visual acuity measurement, intraocular pressure measurement, and com- plete ophthalmic examination including fundos- copy. Additionally, ECD measurements, corneal tomography, and corneal wavefront analysis were conducted at these visits. Refraction was done 3 months after removal of corneal sutures. Implantation of the IOL was performed by three corneal specialists and involved paracen- teses, instillation of viscoelastic in the anterior chamber, insertion of the lens using lens spatula or forceps, fixation on the horizontal axis, and surgical iridectomy. Wounds were closed with a single polyamide suture. Patients were given a regimen of postop antibiotic, steroid, and nonsteroidal anti-inflammatory drops. Oral prednisolone was given to those without contra- indications. Statistical analysis included data normality assessment with the Kolmogorov-Smirnov test, comparisons between continuous variables em- ployed the Student's t-test and the Mann-Whit- ney U test, Fisher's exact test for nominal scaled EyeWorld Journal Club continued on page 20 Review of "Long term efficacy and safety of iris-claw phakic intraocular lens in the management of post keratoplasty astigmatism" K eratoplasty, whether through pen- etrating keratoplasty (PK) or deep anterior lamellar keratoplasty (DALK), is a cornerstone surgical technique for managing several corneal diseases. Despite its success in restoring corneal clarity, visual acuity is often limited by high degrees of post-keratoplasty astigmatism. 1 Advances in suture management, corneal refraction, contact lenses, and toric lenses have improved outcomes to some extent. 2 However, further advances are needed to improve vision. Iris-claw phakic intra- ocular lenses (pIOL) have demonstrated efficacy in correcting astigmatism in both unoperated and post-keratoplasty eyes. In this single-center, retrospective study of patients implanted with iris-claw pIOL, Ribeiro et al. evaluated long- term refractive outcomes, safety profile, and endothelial cell density (ECD) changes in post-keratoplasty eyes. Furthermore, the University of Washington ophthalmology residents Source: University of Washington Parisa Taravati, MD Residency Program Director Department of Ophthalmology University of Washington Seattle, Washington

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