Comparison Of Collamer Toric Contact Lens Implantation And Femtosecond Laser In Situ Keratomileusis In The Correction Of Myopic Astigmatism

To compare the postoperative visual outcomes after implantation of a Collamer toric implantable contact lens (ICL) and Femtosecond laser in situ keratomileusis (FS – LASIK) in high myopic astigmatism. 

Oftalmosalud Institute of Eyes, Lima, Peru. 

This prospective cohort study comprised 74 eyes having toric ICL implantation and 75 eyes having FS – LASIK to correct high myopic astigmatism between January and April of 2022 in patients older than 18 years old with no history of prior ocular surgery, with corrected distance visual acuity (CDVA) of 0.18 LogMAR or better, minimum myopia of -2.00 Diopters (D) and minimum refractive astigmatism of -0.75 D. The safety, efficacy, predictability, stability, and adverse events were assessed preoperatively and 3 months postoperatively. For statistical analysis, the Wilcoxon comparison test was used and the Astigmatism Double Angle Plot Tool v1.3.0 was used to determine the centroid and mean of astigmatism

The preoperative refractive astigmatism was -2.9 D ± 0.4 in ICL group and -2.9 D ± 0.2 in FS – LASIK group (p=0.728). The calculated efficacy index at 3 months was 1 in ICL group and 1 in FS – LASIK group. The calculated safety index was 0.98 in ICL group and 1 in FS – LASIK group. 86% in the ICL group and 99% of eyes in the FS - LASIK group were within ±1.00 D of the targeted spherical equivalent correction and 81% in the ICL group and 100% of eyes in the FS - LASIK group were within ±1.00 D of the targeted refractive cylinder. 41% of eyes in the ICL group achieved a BCVA of 20/20, compared to 72% in the FS-LASIK group. 

FS-LASIK and toric ICL are both safe and efficacy to correct myopic astigmatism, however FS-LASIK showed lower residual refractive error than toric ICL.