Visian Toric Implantable Collamer Lens for Correction of Compound Myopic Astigmatism

Abstract

To assess the safety, efficacy, predictability, and stability of a toric posterior chamber phakic intraocular lens for the correction of myopia with astigmatism. A non-randomized, retrospective analysis of 63 eyes of 36 patients with a minimum follow-up of 6 months was performed. The STAAR Toric Implantable Collamer Lens (TICL) was implanted under topical anesthesia through a 3-mm temporal clear corneal incision. Mean preoperative spherical equivalent refraction was -10.71+/-3.55 diopters (D). Median preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25, with a mean sphere of -8.78 D (range: -2.50 to -16.50 D) and mean cylinder of 3.60 D (range: 1.25 to 7.00 D). Postoperative parameters were analyzed at different time points, and vector analysis was performed to calculate surgically induced astigmatism. Fifty-nine (93.6%) eyes had a spherical equivalent refraction within +/-1.00 D and 52 (82.5%) eyes were within +/-0.50 D of emmetropia. Median postoperative uncorrected visual acuity was 20/25 and BSCVA was 20/20. Preoperative keratometric astigmatism was 1.99@178.2 vs 1.82@178.6 postoperative keratometric astigmatism, most likely due to the surgical incision. Preoperative refractive astigmatism was 2.17@93 whereas postoperatively it reduced to 0.38@99.6. No eye lost 2 or more lines of Snellen BSCVA. Twenty-two (34.9%) eyes gained 2 or more Snellen lines of vision. Preoperatively, 45 (71.4%) eyes had a BSCVA of 20/30 or better, whereas 60 (95.2%) eyes were within this range of BSCVA after surgery. The TICL demonstrated good rotational stability in this study. Implantation of the STAAR TICL was an effective, predictable, and safe method for correction of high myopia and myopic astigmatism as shown in this retrospective observational series.