One-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism

doi:10.1016/j.ophtha.2010.03.054

Ophthalmology

Volume 117, Issue 12, December 2010, Pages 2287-2294

https://doi.org/10.1016/j.ophtha.2010.03.054 Get rights and content

Objective

To assess the 1-year clinical outcomes of toric Visian Implantable Collamer Lens (ICL; STAAR Surgical, Nidau, Switzerland) implantation for moderate to high myopic astigmatism.

Design

Prospective, observational case series.

Participants

Fifty-six eyes of 32 consecutive patients, with spherical equivalent errors of −4.00 to −17.25 diopters (D) and cylindrical errors of −0.75 to −4.00 D, who underwent toric ICL implantation.

Methods

Before and 1 week and 1, 3, 6, and 12 months after surgery, the safety, efficacy, predictability, stability, and adverse events of the surgery were assessed in eyes undergoing toric ICL implantation. Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function also were evaluated before and 1 year after surgery.

Main Outcome Measures

Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), safety index, efficacy index, predictability, stability, adverse events, HOAs, and CS function.

Results

The logarithm of the minimum angle of resolution (logMAR) UCVA and logMAR BSCVA were −0.11 (corresponding to Snellen equivalent 20/16)±0.12 and −0.19 (corresponding to 20/12.5)±0.08 1 year after surgery, respectively. The safety and efficacy indices were 1.17±0.21 and 1.00±0.29. At 1 year, 91% and 100% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of −0.07±0.27 D occurred from 1 week to 1 year. For a 4-mm pupil, fourth-order aberrations were changed, not significantly, from 0.05±0.02 μm before surgery to 0.06±0.03 μm after surgery (P = 0.38, Wilcoxon signed-rank test). Similarly, for a 6-mm pupil, fourth-order aberrations were not significantly changed, merely from 0.20±0.08 μm before surgery to 0.23±0.11 μm after surgery (P = 0.15). The area under the log CS function was significantly increased from 1.41±0.15 before surgery to 1.50±0.13 after surgery (P<0.001). No vision-threatening complications occurred during the observation period.

Conclusions

In the authors' experience, the toric ICL performed well in correcting moderate to high myopic astigmatism during a 1-year observation period, suggesting its viability as a surgical option for the treatment of such eyes.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Patients and Methods

Fifty-six eyes (of 15 men and of 41 women) of 32 consecutive patients who underwent implantation of the posterior chamber toric phakic intraocular lens for the correction of moderate to high myopic astigmatism and who regularly returned for postoperative examination were included in this prospective observational study. The inclusion criteria for this surgical technique were as follows: unsatisfactory correction with spectacles or contact lenses, age of 20 to 50 years, stable refraction for at

Patient Population

Preoperative patient demographics are summarized in Table 1. The logMAR UCVA and BSCVA were 1.53±0.18 (range, 1.00–2.00) and −0.13±0.06 (range, −0.18 to 0.00), respectively. Horizontal white-to-white distance was 11.6±0.4 mm (range, 10.9–12.6 mm). Anterior chamber depth was 3.19±0.26 mm (range, 2.82–3.74 mm). The mean keratometric reading was 43.4±1.8 D (range, 39.8–46.6 D). Central corneal thickness was 530.0±33.5 μm (range, 436–600 μm). The IOP was 13.7±2.7 mmHg (range, 9–21 mmHg). The

Discussion

The present study demonstrated that toric ICL implantation was good from the standpoints of safety, efficacy, predictability, and stability for the correction of moderate to high myopic astigmatism throughout the 1-year follow-up period, a finding that was in accordance with previous studies on this surgical technique.19, 20, 21 The United States Food and Drug Administration (FDA) toric ICL clinical study demonstrated that toric ICL implantation was an effective and predictable method for

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: Manuscript no. 2009-1157.

: Financial Disclosure(s): The author(s) have made the following disclosure(s): Kimiya Shimizu - Consultant - STAAR Surgical. No other conflicting relationship exists.

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Original articleOne-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism

Objective

Design

Participants

Methods

Main Outcome Measures

Results

Conclusions

Financial Disclosure(s)

Section snippets

Patients and Methods

Patient Population

Discussion

Ophthalmology

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

Ophthalmology

J Cataract Refract Surg

Ophthalmology

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

Ophthalmology

J Cataract Refract Surg

Original article
One-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism