Comparison between toric and spherical phakic intraocular lenses combined with astigmatic keratotomy for high myopic astigmatism

Lin-Yan Zheng,Shuang-Qian Zhu,Hu-Yong Zou,A-Yong Yu,Yan-Feng Su,Qin-Mei Wang

doi:10.1186/s40662-017-0085-7

Lin-Yan Zheng, Shuang-Qian Zhu + Show 4 more

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https://doi.org/10.1186/s40662-017-0085-7

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Abstract

BackgroundTo compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical PIOL combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism.MethodsThis study enrolled patients with high myopic astigmatism, including 30 eyes (22 patients) that received a toric PIOL implantation (TICL group), and 32 eyes (24 patients) that received combined AK and a spherical PIOL implantation (AK+ ICL group). The outcomes were compared between the two groups before surgery, and at the following time points after surgery: 1 week, 1, 3, 6 months, and 1, 2 years.ResultsPreoperatively, the mean manifest spherical equivalent (SE) was −14.14 ± 2.12 D in the TICL group and −14.83 ± 2.79 D in the AK + ICL group (P = 0.28), and the mean manifest refractive cylinder, −2.87 ± 1.09 D and −2.58 ± 0.85 D, respectively (P = 0.28). Two years postoperatively, the mean safety index was 1.53 ± 0.55 in the TICL group and 1.60 ± 0.70 in the AK + ICL group (P = 1.00), and the mean efficacy index, 1.18 ± 0.45 and 1.38 ± 0.52, respectively (P = 0.86). The mean manifest refractive cylinder correction was 1.94 ± 1.07 D in the TICL group and 1.39 ± 0.71 D in the AK + ICL group (P = 0.02). The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0.50 D in both groups.ConclusionsBoth TICL implantation and AK + ICL implantation are a good alternative for correction of astigmatism in addition to high myopia. TICL implantation has better predictability in correction of high myopic astigmatism.Trial registrationNCT03202485

Highlights

To compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical Phakic intraocular lenses (PIOLs) combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism
Considering that astigmatism is common in highly myopic eyes [1], a toric Implantable Collamer Lens (ICL) (TICL) implantation or combined astigmatic keratotomy (AK) and ICL (AK + ICL) implantation may be a feasible
The inclusion criteria included: 1) age ranged from 18 to 40 years, 2) myopia greater than −8.00 diopters (D), and refractive cylinder in the range of 1.50 D to 5.50 D, 3) for the patients who were planned to undergo AK + ICL implantation, the axial difference between the corneal astigmatism and the manifest refractive astigmatism was less than 10 degrees, 4) a stable refractive error during the previous 2 years, 5) anterior chamber depth more than 2.8 mm, 6) endothelial cell density (ECD) more than 2500 cells/mm2, and 7) scotopic pupillary diameter less than 7 mm

Summary

Introduction

To compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical PIOL combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism. Phakic intraocular lenses (PIOLs) are regarded as an alternative to the current modalities of refractive correction for high myopia. The Implantable Collamer Lens (ICL; STAAR Surgical, Switzerland) is one of the options of regularly used PIOLs, and demonstrates its safety and effectiveness in correcting spherical refractive errors. Considering that astigmatism is common in highly myopic eyes [1], a toric ICL (TICL) implantation or combined astigmatic keratotomy (AK) and ICL (AK + ICL) implantation may be a feasible. Zheng et al Eye and Vision (2017) 4:20

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