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

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

Abstract

Background: 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.

Methods: This 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.

Results: Preoperatively, 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.

Conclusions: Both 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 registration: NCT03202485.

Keywords: Astigmatic keratotomy; Astigmatism; High myopia; Phakic intraocular lenses.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of best corrected visual acuity (BCVA) in the TICL and AK + ICL groups 2 years after surgery
Fig. 2
Fig. 2
Proportion of eyes with uncorrected visual acuity (UCVA) in LogMAR in the TICL and AK + ICL groups 2 years after surgery
Fig. 3
Fig. 3
Scattergrams illustrating the spherical equivalent attempted versus achieved 2 years after surgery. a TICL group; b AK + ICL group
Fig. 4
Fig. 4
Percentage of eyes within ±0.50 D and ±1.00 D of the attempted correction of spherical equivalent (SE) in the TICL and AK + ICL groups
Fig. 5
Fig. 5
Double-angled polar plot of astigmatism before and 2 years after surgery. a TICL group; b AK + ICL group. The dots closer to the origin indicates less astigmatism
Fig. 6
Fig. 6
Time course of manifest spherical equivalent (a) and manifest cylinder (b) in the TICL and AK + ICL groups

References

    1. Heidary G, Ying GS, Maguire MG, Young TL. The association of astigmatism and spherical refractive error in a high myopia cohort. Optom Vis Sci. 2005;82:244–247. doi: 10.1097/01.OPX.0000159361.17876.96.
    1. Kamiya K, Shimizu K, Igarashi A, Komatsu M. Comparison of Collamer toric implantable [corrected] contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism. J Cataract Refract Surg. 2008;34:1687–1693. doi: 10.1016/j.jcrs.2008.06.030.
    1. Sanders DR, Sanders ML. Comparison of the toric implantable collamer lens and custom ablation LASIK for myopic astigmatism. J Refract Surg. 2008;24:773–778.
    1. Schallhorn S, Tanzer D, Sanders DR, Sanders ML. Randomized prospective comparison of visian toric implantable collamer lens and conventional photorefractive keratectomy for moderate to high myopic astigmatism. J Refract Surg. 2007;23:853–867.
    1. Thibos LN, Horner D. Power vector analysis of the optical outcome of refractive surgery. J Cataract Refract Surg. 2001;27:80–85. doi: 10.1016/S0886-3350(00)00797-5.
    1. Akura J, Matsuura K, Hatta S, Otsuka K, Kaneda S. A new concept for the correction of astigmatism: full-arc, depth-dependent astigmatic keratotomy. Ophthalmology. 2000;107:95–104.
    1. Haq FE, Speaker MG, Nilforoushan MR, Tullo W, Morschauser D. Transverse keratotomy followed by LASIK for the treatment of naturally occurring astigmatism. J Refract Surg. 2007;23:209–212.
    1. Alfonso JF, Fernández-Vega L, Fernandes P, González-Méijome JM, Montés-Micó R. Collagen copolymer toric posterior chamber phakic intraocular lens for myopic astigmatism: one-year follow-up. J Cataract Refract Surg. 2010;36:568–576. doi: 10.1016/j.jcrs.2009.10.052.
    1. Dick HB, Buchner SE. Toric phakic intraocular lenses. Ophthalmologe. 2007;104:1032–40.
    1. Kamiya K, Shimizu K, Aizawa D, Igarashi A, Komatsu M, Nakamura A. One-year follow-up of posterior chamber toric phakic intraocular lens implantation for moderate to high myopic astigmatism. Ophthalmology. 2010;117:2287–2294. doi: 10.1016/j.ophtha.2010.03.054.
    1. Sanders DR, Schneider D, Martin R, Brown D, Dulaney D, Vukich J, et al. Toric Implantable Collamer Lens for moderate to high myopic astigmatism. Ophthalmology. 2007;114:54–61.
    1. Akura J, Matsuura K, Hatta S, Kaneda S, Ikeda T. Experimental study using pig eyes for realizing ideal astigmatic keratotomy. Cornea. 2001;20:325–328. doi: 10.1097/00003226-200104000-00017.
    1. Akura J, Matsuura K, Hatta S, Kaneda S, Kadonosono K. Clinical application of full-arc, depth-dependent, astigmatic keratotomy. Cornea. 2001;20:839–843. doi: 10.1097/00003226-200111000-00012.
    1. Chang J, Lau S. Toric Implantable Collamer Lens for high myopic astigmatic Asian eyes. Ophthalmology. 2009;116:2340–7.
    1. Budak K, Yilmaz G, Aslan BS, Duman S. Limbal relaxing incisions in congenital astigmatism: 6 month follow-up. J Cataract Refract Surg. 2001;27:715–719. doi: 10.1016/S0886-3350(00)00687-8.
    1. Sanders DR, Doney K, Poco M; ICL in Treatment of Myopia Study Group. United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up. Ophthalmology. 2004;111:1683–92.
    1. Sanders DR. Anterior subcapsular opacities and cataracts 5 years after surgery in the visian implantable collamer lens FDA trial. J Refract Surg. 2008;24:566–570.
    1. Lindland A, Heger H, Kugelberg M, Zetterström C. Vaulting of myopic and toric Implantable Collamer Lenses during accommodation measured with Visante optical coherence tomography. Ophthalmology. 2010;117:1245–50.

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