Visual And Refractive Outcomes Following Visian Toric Implantable Collamer Lens (Icl) (Staar Surgical, Usa) Implantation For Myopic Astigmatism - Beginner’S Experience

To report Visual and Refractive outcomes following Visian Toric implantable Collamer lens (ICL)  (STAAR Surgical, USA) implantation for surgical correction of myopic astigmatism at 15 days. 3 months, 6 months and 1 year by a beginner surgeon.

Cure Sight Laser Centre, Ahmedabad, India

Toric ICL was implanted in 100 eyes (57 patients) with mean preoperative sphere of -10.13 ± 3.77 diopters (D) and cylinder of -2.31 ± 1.22 D. Primary visual outcomes such as UDVA, CDVA, refractive sphere and cylinder were evaluated at day1, day 15, 3 months and 1 year. Secondary outcomes were endothelial cell density (ECD), post operative vault height and patient reported glare/halos at post operative visits.

At 12 months, mean manifest refraction spherical equivalent was -0.32 ± 0.67 D with 93% achieving within ±1.00 D of target refraction. The manifest refractive cylinder was -0.23 ± 0.42 D with 90% eyes within ±1.00 D of target and all eyes within ±1.50 D of target. UDVA was 20/20 or better in 68% of eyes at 12 months. No patients lost >= 2 lines of CDVA at 12 months. One patient required ICL rotation in 1 eye and 1 patient underwent ICL exchange in 1 eye. 2 eyes had high vault (>750 micron) and was kept under observation. 2 patients (4 eyes) underwent enhancement with Laser In Situ Keratomileusis (LASIK) for residual refraction (bioptics). All patients reported significantly reduced glare/halos at last followup as compared to initial visits.

Toric ICL implantation was found safe and effective by a beginner surgeon for the treatment of myopic astigmatism. Patients achieved markedly improved UDVA with the single surgery and stable vision over 1 year. Minimal adverse subjective symptoms were noted by the patients. There is a substancial learning curve with the surgery but one can master it with practice.