ESCRS - PP22.07 - ‘Off The Shelf’ Toric Intraocular Lenses (Tiols) For Patients In The National Health Service: Preliminary Data Of A Randomised Control Trial.

‘Off The Shelf’ Toric Intraocular Lenses (Tiols) For Patients In The National Health Service: Preliminary Data Of A Randomised Control Trial.

Published 2022 - 40th Congress of the ESCRS

Reference: PP22.07 | Type: ESCRS 2022 - Posters | DOI: 10.82333/fzxk-7d26

Authors: Khayam Naderi* 1 , Sancy Low 2 , Vijay Wagh 2 , Mani Bhogal 3 , Ailsa Ritchie 3 , Scott Robbie 3 , Chris Hammond 4 , Moin Mohamed 3 , Ashmal Jameel 4 , Nick Stanojcic 3 , Elodie Azan 3 , Lily Lai 3 , Chris Hull 5 , David O'Brart 4

1St.Thomas' Hospital ,London,United Kingdom;King's College London,London,United Kingdom, 2St.Thomas' Hospital ,London,United Kingdom, 3St.Thomas' Hospital,London,United Kingdom, 4St.Thomas' Hospital,London,United Kingdom;King's College London,London,United Kingdom, 53. School of Health Sciences, Optometry and Visual Sciences, City University,London,United Kingdom

Purpose

TIOL implantation is associated with additional chair time and financial expenditure, which is important in a public healthcare setting. We present preliminary data of a randomised controlled trial comparing a ‘fully-tailored’ (FT) TIOLs, and an ‘off the shelf’ (OTS) approach with 2.00 or 4.00 dioptre cylinder (DC) corrections with additional opposite clear corneal incisions. 

Setting

Single-centre, prospective single-masked randomised case-controlled trial in a university hospital. 

Methods

Patients with pre-existing regular corneal astigmatism of 1.50 dioptres or more were recruited. 42 patients have been randomised to the FT group, with 41 patients in the OTS group. Primary outcomes include uncorrected distance visual acuity (UDVA), best corrected visual acuity (BCVA), post-operative refractive cylinder (RC).  Secondary outcomes include validated patient reported outcome measures (PROMs) using CATPROM-5 and EQ-5D-3L questionnaires, and adverse events. Follow up was at four weeks and six months. 



Results

At 4 weeks, mean UDVA(+/-SD) was 0.15 (0.11) in the FT (n=42) and 0.12 (0.11) in the OTS (n=41) group (p=0.41). Mean BCVA was -0.00071 (0.08) in FT and 0.02 (0.10) in OTS (p=0.32). Mean RC was 0.84 (0.50) in FT, and 0.66 (0.36) in OTS (p=0.073). There were no differences in PROMs between groups. In those patients who have thus far reached 6-month follow-up (FT (n=32) and OTS (n=32)), mean UDVA(+/-SD) was 0.11 (0.14) in the FT and 0.13 (0.15) in the OTS group (p=0.55). Mean BCVA was -0.0031 (0.0097) in FT and -0.0013 (0.0096) in OTS (p=0.94). Mean RC was 0.81 (0.51) in FT, and 0.91 (0.54) in OTS (p=0.48)). Patients in the OTS had superior CATPROM-5 scores -7.20 (2.13) compared to the FT group -5.099 (2.88) (p=0.0016). 

Conclusions

The use of ‘off the shelf’ 2.00DC and 4.00DC TIOLs with additional opposite clear corneal incisions may improve UVA and allow patients to achieve spectacle independence for distance vision. Our preliminary data suggests that it is not inferior to using fully tailored TIOLs.