Implanting toric implantable collamer lens displays better astigmatism correction than implantable collamer lens combined with manually limbal relaxing incision

Abstract

Background This retrospective study aimed to compare the outcomes of toric implantable collamer lens (TICL) surgery with those of implantable collamer lens (ICL) implantation combined with limbal relaxing incision (LRI) in patients with low myopia and astigmatism. Methods A total of 40 eyes of 28 patients who underwent TICL implantation and 40 eyes of 27 patients who underwent ICL implantation combined with manually LRI between 2021 and 2022 were included. Primary outcomes were manifest sphere and cylinder, intraocular pressure, visual acuity, and astigmatism parameters at 1 day, 1 week, and 1, 3, and 6 months postoperatively. Results The two surgeries showed comparable effects on manifest sphere and cylinder, intraocular pressure, and visual acuity (all p > 0.1). Surgery-induced astigmatism (SIA) was maintained as stable in the TICL group (1.73 to 1.68, p = 0.420), but was significantly reduced in the ICL/LRI group (1.74 to 1.17, p = 0.001) from preoperative to postoperative 6 months. The TICL group displayed significantly higher SIA and correction index at postoperative 1, 3, and 6 months than the ICL/LRI group (at 6 months: SIA, 1.68 (1.26, 1.96) vs., 1.17 (1.00, 1.64), p = 0.010; CI: 0.98 (0.78, 1.25) vs. 0.80 (0.61, 1.04), p = 0.018). No complications occurred during follow-up. Conclusions The effects of ICL/LRI are comparable to those of TICL in correcting myopia. TICL implantation displays better astigmatism correction than ICL/LRI.

To compare the effect of limbal dissection combined with ICL implantation and toric ICL implantation on astigmatism correction in patients with high myopia

“…In this study, both groups of patients achieved signi cant and stable improvement in UCVA and BCVA postoperatively, similar to previous research results [30,[33][34][35][36]. Meanwhile, the CDVA and UDVA of the LRI group were better than those of the TICL group at 1 month and 3 months postoperatively, which may be related to the accurate correction of AST.…”

“…Yang's retrospective study found that SIA in the LRI group was reduced signi cantly during the 3 months after surgery, indicating a trend of loss of the astigmatic correction effect and undercorrection over time. However, Yang et al also found that SIA in the TICL group was not signi cantly reduced and was slightly higher than that in the LRI group at 3 months postoperatively [30]. In our study, the SIA of the TICL group was lower than that of the LRI group at 3 months postoperatively, and there was no signi cant difference between the two groups.…”

“…During the incision, the surgeon could slightly press the eyeball to x its position. It solved the problems of unstable incision making and poor repeatability [30]. In this study, the mean SI of the LRI group was signi cantly lower than that of the TICL group [(0.39 ± 0.42) vs. (1.73 ± 0.9), P < 0.001], indicating that the manual LRI with a limbal release auxiliary cup was more accurate and reliable in correcting astigmatism than the TICL group.…”

Effect of low-degree astigmatism on the objective visual quality

“…For cataract cases, we discuss the use of Toric IOLs to correct low degrees of corneal astigmatism, however it is not the only resolution. Low-degree corneal astigmatism could be, otherwise, corrected by laser vision correction or limbal relaxing incisions [25][26][27][28] . further research is needed to evaluate the accuracy of each resolution.…”