TORIC PHAKIC VERSUS BIOPTICS FOR MANAGEMENT OF COMPOUND MYOPIA AND ASTIGMATISM
Published 2022 - 26th ESCRS Winter Meeting
Reference: P100 | Type: Abstracts | DOI: 10.82333/pbww-g225
Authors: Hams Samy* 1 , Ahmed Assaf 1
1Ophthalmology,Watany Eye Hospital,Cairo,Egypt
Purpose
To compare the refractive outcomes after toric phakic IOL implantation with bioptics to manage myopia and astigmatism.
Setting
A prospective non-randomized comparative study.
Methods
Included in this study are patients with compound myopia and astigmatism asking for refractive surgery. Inclusion criteria included myopia of 7D or more and astigmatism of more than 1D. Two groups were established; group A (phakic toric IOL) and B (bioptics).
Eyes with irregular corneal astigmatism and endothelial cell abnormalities based on specular microscopy were excluded.
Group A was assigned to Toric ICL. Group B was subjected to a two-step procedure; the first step included Femto flap creation (100 microns thickness) without lifting, followed by phakic (ICL or VeriFlex) IOL implantation on the same day. The second step was set at least two weeks after phakic lens implantation and included flap lifting and excimer laser ablation to correct residual astigmatism and myopia if present.
Postoperative examinations were scheduled on days 1, 2 wks, 4 wks, and 8 wks.
Results
Group A and B comprised 34 and 52 eyes, respectively. Mean age in both groups showed no statistically significant difference.
At the final postoperative visit, 29% of eyes in group A vs. 96% of eyes in group B achieved a refractive cylinder of 0.5D or less.
The mean refractive astigmatism in group B (0.10D @105±0.29D) was significantly less than group A (0.34D@97±0.68D). Prediction error was significantly higher in group A compared to group B (0.49D@95±0.68D vs. 0.25D@96±0.29D. Ocular coma, trefoil, and spherical aberrations were comparable between both groups. Group A and B comprised 34 and 52 eyes, respectively. Mean age in both groups showed no statistically significant difference. At the final postoperative visit, 29% of eyes in group A vs. 96% of eyes in group B achieved a refractive cylinder of 0.5D or less.The mean refractive astigmatism in group B (0.10D @105±0.29D) was significantly less than group A (0.34D@97±0.68D). Prediction error was significantly higher in group A compared to group B (0.49D@95±0.68D vs. 0.25D@96±0.29D. Ocular coma, trefoil, and spherical aberrations were comparable between both groups.
Conclusion
Bioptics might result in more precise refractive outcomes than phakic toric IOL in treating compound myopia and astigmatism. Flap creation by femtosecond laser allows flap lifting later on, yet if the flap was not lifted during the primary procedure. Added to this, the ease of correction of future ametropia by flap lifting.