EFFICACY AND SAFETY OF TORIC POSTERIOR CHAMBER IMPLANTABLE COLLAMER LENS AND TORIC IRIS-FIXATED FOLDABLE PHAKIC INTRAOCULAR LENS IMPLANTATION FOR MYOPIC ASTIGMATISM

To compare visual, refractive, and safety outcomes of toric posterior chamber implantable collamer lens (T-ICL) and toric iris-fixated foldable phakic intraocular lens (T-Artiflex) implantation for the correction of myopic astigmatism.

Ophthalmology Department; Hospital de Braga

Escola de Ciências da Saúde da Universidade do Minho

Retrospective cohort study included 312 eyes of 312 subjects submitted to phakic intraocular lens implantation for myopic astigmatism. Two groups were defined: group 1 comprised 205 eyes that underwent T-ICL implantation; group 2 comprised 107 eyes that underwent T-Artiflex implantation. Safety, efficacy and predictability outcomes were evaluated preoperatively and at 12 months postoperatively. Refractive and corneal astigmatic vector analysis were performed using Alpins method.

One-year postoperatively, uncorrected visual acuity was 0.05±0.18 (T-ICL) and 0.10±0.16 logMAR (T-Artiflex), with efficacy indexes of 1.16±0.27 and 1.05±0.31 (p<0.001). Safety indexes were 1.28±0.30 and 1.21±0.31, respectively (p=0.04). Spherical equivalent was within ±0.5D of emmetropia in 165 (80.5%) and 88 (82.2%) eyes, respectively. Refractive astigmatic analysis showed an index of success of 0.28±0.33 (T-ICL) and 0.31±0.26 (T-Artiflex) (p=0.07). Surgically induced corneal astigmatism was 0.48±0.74D and 0.81±0.61D, respectively (p<0.001). Mean endothelial loss was 1.11% and 2.05%, respectively (p=0.42). Six (2.9%) eyes of T-ICL and one (0.9%) eye of T-Artiflex were submitted to IOL repositioning due to significant lens misalignment. No vision-threatening complications occurred.

Both T-ICL and T-Artiflex showed high visual and refractive efficacy with good safety profile for the correction of myopic astigmatism. T-ICL demonstrated significantly better efficacy and safety indexes at 1-year evaluation. Vector analysis showed similar refractive astigmatic correction in both groups; however, T-Artiflex implantation revealed significantly higher surgically induced corneal astigmatism.