The toric implantable collamer lens for the correction of high compound myopic astigmatism

Abstract

Objective To study the safety and efficacy of toric implantable collamer lens (TICL) for the correction of high compound myopic astigmatism. Methods Thirty eyes of 15 patients with high myopic astigmatism were retrospectively analyzed.They were treated with TICL implantation via corneal incision under surface anesthesia.The range of preoperative myopia diopters was -8.00~-21.00D with average (-12.42±3.86) D. Astigmatism ranged from -1.50 to -6.50D with average (-2.56±1.32) D. and the equivalent spherical diopters was (-14.56±0.32)D; All patients were followed up for 12 months. Results The range of myopia diopters 12 months after operation was-0.25D to+ 0.25D with average (-0.16±0.17) D and the range of postoperative astigmatism was 0~0.50D with average (-0.15±0.16) D UCVA in 20 eyes (66.67%) was improved by one line after operation compared with BCVA before operation. UCVA in 6 eyes (20.00%) was improved by two lines.Preoperative intraocular pressure of patients was (15.49±1.07) mmHg, and the intraocular pressure 1 day after operation was(15.75±1.32)mmHg.The difference of intraocular pressure was not statistically significant between preoperation and one day after operation(t=0.42, p=0.67); The intraocular pressure 12 months after surgery was (15.40±1.04) mmHg (1 mmHg=0.133 kPa), and compared with the preoperative intraocular pressure, the difference was not statiatically significant(t=0.33, P=0.74). The mean preoperative endothelial cell counting was (2840.75±83.04)/mm2, and 12 months after operation, the average endothelial cell counting was (2837.75±82.95) /mm2. The difference was not statistically significant between preoperation and postoperation(t=0.518, P=0.776); The vision decreased in one eye 12 months after operation, and the imbalance of TICL arch height in right eye was found under mydriasis. The astigmatism was corrected by adjusting the TICL position, and the visual acuity was recovered. Conclusion The keys of TICL implantation for the correction of high myopic astigmatism are accurate preoperative parameters measurement, appropriate TICL selection, complete aspiration of sodium hyaluronate and stable postoperative intraocular pressure. Key words: Myopia, very high; Astigmatism; Lens, intraocular, toric, implantable, collamer