Abstract
Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber.
 Objective: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. in Eye Specialty Private Hospital, Baghdad, Iraq.
 Type of the Study: a prospective non randomize intervention study.
 Methods: 60 eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design).Mean spherical refraction was ₋11.32 diopter (D) ±3.17 (SD) with range from ₋6.00 to ₋18.00D and the mean cylinder was -2.61(D) ±1.16 with range from ₋1.00 to ₋5.50D .The outcome measures that evaluated during a 12 months follow-up period include UDVA, refractive outcomes, CDVA, vault and adverse events.
 Results: At 12 months postoperatively the mean Snellen decimal UDVA was 0.77±0.23 and mean CDVA was 0.80±0.21, with an efficacy index 1.16. Twenty nine eyes (48.33%) showed gain in CDVA with safety index
 
 
 1.21.The treatment was highly predictable for spherical equivalent and astigmatic component .The mean SE dropped from (₋12.63D ±3.11) to ( ₋0.11 D±0.20) with 58 eyes within ±0.50 D and 60 eyes with ± 1.00D of target correction . For achieved cylinder 60 eyes (100%) had ≤0.50D and 51 eyes (85%) had ≤0.25D with strong positive linear correlation between achieved and expected cylinder(r=0.94)
 Conclusions: The results of the present study support safety, efficacy, predictability of toric implantable collamer lens implantation to treat moderate to high myopic astigmatism.
Highlights
There are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber
Preoperative evaluation: Before surgery, patients had a full ophthalmologic examination including : UDVA, corrected distance visual acuity (CDVA),manifest and cycloplegic refractions,slit lamp evaluation,Goldman applanation tonometry, gonioscopy, ultrasonic corneal pachymetry (Tomey SP100),and corneal topography(Sirius),central endothelial cell count (ECC),binocular indirect ophthalmoscopy through dilated pupil and white to white distance measured by caliper
The aim of the current study was to determine whether implantation of the toric Implantable Collamer Lens PIOL is safe, predictable, and effective for moderate to high myopic astigmatism correction and to analyze the benefits or disadvantage related to the new design
Summary
There are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber. Objective: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. Methods: 60 eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design).Mean spherical refraction was −11.32 diopter (D) ±3.17 (SD) with range from −6.00 to −18.00D and the mean cylinder was -2.61(D) ±1.16 with range from −1.00 to −5.50D .The outcome measures that evaluated during a 12 months follow-up period include UDVA, refractive outcomes, CDVA, vault and adverse events. Results: At 12 months postoperatively the mean Snellen decimal UDVA was 0.77±0.23 and mean CDVA was 0.80±0.21, with an efficacy index 1.16. Twenty nine eyes (48.33%) showed gain in CDVA with safety index
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