Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism

Abstract

PurposeTo compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism.Patients and methodsThis study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated.ResultsThis study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B.ConclusionBoth procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients.

Toric and Phakic IOLs for the Treatment of Astigmatism and/or High Myopia: Our Experience at Prince Hashem Hospital Zarqa

“…All patients had satisfactory improvements in their visual acuities. Three of the patients who underwent toric intra-ocular lens implantation had lens rotation few days after surgery that resulted in decrease in their visual acuity and that was overcome by realignment of their IOL intraoperatively [6,7]. They were followed for up to three months with no change in their BCVA or their lens status.…”

“…Three of the patients who received Visian ICLs had lens rotation after surgery and this was due to under sizing of the lens [4,6]. They underwent lens exchange and replaced with a larger ICL with more stable alignment.…”

“…We also excluded patients with zonular dehiscence, poor pupillary dilatation as this will affect lens alignment by obscuring the axis. Keratoconus patients with corneal thickness less than 400um were and patients with amblyopia were excluded as well and patients with unrealistic expectations [2,4,5,6].…”