Intraindividual Comparison of ICL and Toric ICL Implantation in the Correction of High Myopia With Astigmatism

PURPOSE: We compared intra-individual visual outcomes and patient satisfaction after implantable contact lens (ICL) and Toric ICL implantation. METHODS: Twenty-eight eyes of 14 patients were enrolled in this retrospective study. One eye of each patient was assigned to ICL (ICL Group), and the contralateral eye was allocated to Toric ICL (Toric ICL Group). All patients were examined for visual acuity, refraction, intraocular pressure, slit lamp measurements, and satisfaction one week, one month, two months, and six months postoperatively. RESULTS: Mean spherical equivalents of the two groups were corrected from -7.83D (ICL Group) and -5.55D (Toric ICL Group) to 0.13D and 0.20D, respectively, and the mean refractive cylinders were corrected from 0.92D and 2.60D to 0.42D and 0.27D, respectively, at six months postoperatively. The myopias of these two groups and the astigmatism of the Toric ICL group were effectively corrected. The uncorrected visual acuity (UCVA) of the two groups were 1.02 and 1.05, respectively, at six months postoperatively. The safety index, efficacy index, predictability, and stability were favorable. There were no significant differences between the two groups in terms of postoperative UCVA, intraocular pressure(IOP), vaulting, noticeable complications, or patient satisfaction. CONCLUSIONS: The results show ICL implantation is effective treatment for high myopia, and Toric ICL implantation is a viable surgical option for the treatment of compound myopia astigmatism. Selection of proper phakic intraocular lens(IOL) is recommended for correcting astigmatism.

Clinical Outcomes of Toric Implantable Collamer Lens implantation

PURPOSE: To assess the efficacy of the Toric Implantable Collamer Lens (Toric ICL) to treat moderate to high myopic astigmatism. METHODS: Toric ICL was implanted in 77 eyes of 40 patients with myopia (spherical equivalent [SE] between 3.5 and 18.5 diopters [D]) and astigmatism between 1 and 6 D. The patients were followed up for at least 3 months. Uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), adverse events, and postoperative complications were evaluated. RESULTS: At 3months postoperatively, the proportion of eyes with 1.0 or better UCVA (56 eyes out of 77 eyes, 72.7%) was significantly greater than the proportion of eyes with preoperative 1.0 or better BSCVA (38 eyes out of 77 eyes, 49.4%). The mean manifest refractive cylinder dropped from 2.78D (+/-1.05) at baseline to 0.35D (+/-0.34) postoperatively, an 87.4% decrease in astigmatism. Mean manifest refraction SE (MRSE) improved from -9.93D (+/-2.66) preoperatively to 0.15D (+/-0.33) postoperatively. A total of 96.1% of eyes were predicted accurately to within +/-0.75D of predicted MRSE. Mean improvement in BSCVA was 0.79lines; there were no eyes that lost two lines of BSCVA after 3 months postoperatively. CONCLUSIONS: The results support the efficacy and predictability of Toric ICL implantation to treat moderate to high myopic astigmatism.