Abstract
Purpose. To evaluate the safety, efficacy, and predictability of implantable collamer lens (ICL) implantation combined with a LenSx femtosecond laser-assisted limbal relaxing incision (LRI) for the correction of corneal astigmatism. Methods. This prospective study enrolled 64 eyes (54 patients) with high myopia with low to moderate regular corneal astigmatism. They were divided into an ICL group with ICL implantation (18 patients, 20 eyes), a TICL group with toric ICL implantation (17 patients, 23 eyes), and a LenSx + ICL group with a LenSx femtosecond laser-assisted LRI and an ICL implantation (19 patients, 21 eyes). Visual acuity, astigmatism correction ability, and visual quality were measured before and 1, 3, and 6 months after surgery. Results. The postoperative visual acuity of the 3 groups was higher than the preoperative visual acuity ( P < 0.01 ), and the improvements in the LenSx + ICL group and the TICL group were greater than those in the ICL group ( P < 0.01 ). The LenSx + ICL and TICL groups had less residual astigmatism and a higher astigmatism correction index (CI) than the ICL group ( P < 0.01 ). There was no significant difference among the three groups in total high-order aberrations (HOAs) before and after surgery ( P > 0.05 ). Conclusion. LenSx femtosecond laser-assisted LRI can effectively correct low to moderate corneal astigmatism during ICL implantation surgery. It can achieve similar clinical effects in the short term compared with TICL implantation.
Highlights
In recent years, the implantable collamer lens (ICL, STAAR Surgical Co.) has become one of the mainstream of intraocular refractive surgeries due to its effectiveness, safety, and predictability [1]. ere are two methods for patients who decide to receive treatment with ICL implantation with corneal astigmatism less than −1.50 D
Surgical Complications. e postoperative follow-up found that, in the LenSx + ICL group, there was only a short arc-length relaxing incision left under the cornea after the surgery (Figure 2). ere was no bleeding or infiltration of the incision, the tightness was good, and no complications occurred
Astigmatism greater than −0.75 D can cause diplopia, blurred vision, and photophobia [8]. e STARR company launched TICL implantation for astigmatism correction; the lens can rotate in the ciliary sulcus after implantation, which can lead to a decrease in astigmatism correction or create a new astigmatism
Summary
The implantable collamer lens (ICL, STAAR Surgical Co.) has become one of the mainstream of intraocular refractive surgeries due to its effectiveness, safety, and predictability [1]. ere are two methods for patients who decide to receive treatment with ICL implantation with corneal astigmatism less than −1.50 D. The implantable collamer lens (ICL, STAAR Surgical Co.) has become one of the mainstream of intraocular refractive surgeries due to its effectiveness, safety, and predictability [1]. Ere are two methods for patients who decide to receive treatment with ICL implantation with corneal astigmatism less than −1.50 D. One way is to implant toric ICL, but this procedure can have some disadvantages, such as lens rotation and long waits [2]. E other method is ICL implantation, but residual astigmatism after surgery is often accompanied by a decline in visual acuity, as well as contrast sensitivity and night vision [3]. There have been no relevant reports on the application of femtosecond laser-assisted LRI in ICL implantation. We compared LenSx femtosecond laser-assisted LRI combined with ICL implantation with traditional TICL and ICL implantation to explore the safety, effectiveness, and stability of this new method
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