Management Of Low Astigmatism In Implantable Collamer Lens Surgery: Opposite Clear Corneal Incisions Versus Toric Implantable Collamer Lens

Published 2023 - 41st Congress of the ESCRS

Reference: PO0971 | Type: Free paper | DOI: 10.82333/dx2s-zb75

Authors: Antonio Cano Ortiz* ¹ , Alberto Villarrubia ¹ , Álvaro Sánchez Ventosa ¹ , Timoteo González Cruces ² , Maria Dolores López-Pérez ¹ , Elisa Palacín ¹

¹cornea, refractive and external disease,Arruzafa hospital,Cordoba,Spain, ²Arruzafa hospital,Cordoba,Spain

Purpose

To compare two techniques to correct low astigmatism during implantable collamer

lens (ICL) surgery: astigmatic opposite clear corneal incisions (OCCIs) and toric ICL

(T-ICL).

Setting

Arruzafa Ophthalmological Hospital, Cordoba, Spain.

Methods

A randomized prospective study was carried out at Arruzafa Ophthalmological Hospital, Cordoba, Spain. The study comprised 100 myopic eyes undergoing ICL (STAAR Surgical) surgery. Patients were separated into two groups: group 1 (50 eyes) received a spherical ICL with 3.2 mm OCCIs and group 2 (50 eyes) received a T-ICL. The inclusion criteria were refractive astigmatism up to 1.50 diopters (D), regular corneal astigmatism up to 2.00 D (Sim K, Pentacam), and agreement between the refractive and topographic corneal cylinders (discrepancies less than 30º axis or 0.50 D). The outcomes were evaluated after a one-month follow-up.

Results

Both techniques were effective in correcting low astigmatisms with a similar efficacy index, 1.00 ± 0.22 and 1.04 ± 0.17 for group 1 and 2, respectively (p= 0.40). However, the T-ICL group achieved a low mean postoperative spherical equivalent refraction and refractive astigmatism of -0.05 ± 0.21 D and -0.02 ± 0.10 D, respectively, versus -0.15 ± 0.33 D and -0.20 ± 0.37 D, obtained in the OCCI group (P<0.001). Undercorrection of corneal astigmatism occurred in group 1 (surgically induced astigmatism = 0.47 ± 0.23 front target induced astigmatism = 1.17 ± 0.32) with a correction index = 0.44 ± 0.26.

Conclusions

Both techniques provided good visual outcomes in correcting low refractive astigmatism in ICL surgery. However, T-ICL surgery was shown to be more accurate in refractive terms, with a lower spherical equivalent refraction and residual astigmatism compared to incisional approach.