Predictability Of Refractive Outcomes After Toric Icl Implantation

Visual outcomes and safety parameters of patients who underwent toric ICL (Implantable Collamer Lens) implantation were evaluated.

Department of Ophthalmology, Goethe University, Frankfurt

This retrospective study evaluated one-month, single-center postoperative data for 109 eyes meeting inclusion criteria and undergoing ICL implantation from 2016 to 2023. Lens size (mm), lens power (diopters of spherical and cylindrical power), preoperative best corrected visual acuity, preoperative spherical equivalent from manifest refraction, achieved postoperative uncorrected visual acuity, postoperative refraction, and adverse events were included.

A total of 109 eyes underwent toric ICL implantation. The most common ICL size was 13.2mm (63.3%), followed by 12.6mm (25.7%). 78% of eyes achieved postoperative UCVA of 20/20, and 40 % achieved 20/16. When comparing preoperative and postoperative CDVA, no eye lost 2 or more Snellen lines.  About 87% of eyes were within a spherical equivalent target of ±0.50 D and 100% within ±1.00 D. Comparing achieved and attempted spherical equivalent showed a strong correlation (R2 = 0,9874). Regarding postoperative residual astigmatism, 69% of eyes were lower than 0.50 D and 99% lower than 1.00 D. In total, 2.75% of eyes received laser vision correction (LVC) enhancements, 1.83% ICL-explantation, and 1.83% of eyes underwent ICL-rotation.

This study presents promising initial findings regarding visual outcomes and rare occurrences of adverse events, affirming the safety and efficacy of ICL implantation. While acknowledging study limitations, the results emphasize the effectiveness of using ICLs to correct myopia of different magnitudes. Future research should focus on refining patient selection criteria and evaluating the long-term effects of ICL implantation.