Clinical Efficacy And Rotation Stability Study Of Toric Implantable Collamer Lens In Different Implantation Orientations.

To compare the clinical efficacy,vault,and rotational stability of horizontal,oblique,and vertical implantation of Toric implantable collamer lens ( TICL).

To achieve clinically safe and desirable outcomes, the TICL must be accurately and stably placed in the ciliary sulcus with an appropriate vault.Studies have rarely explored the clinical efficacy, vault,and rotational stability in vertical or oblique TICL implantation.

Retrospective cohort study. A total of 92 cases( 120 eyes ) who underwent TICL implantation from July 2018 to March 2022 and had regular follow- up for at least 1 a postoperatively(1d,1wk, 1, 3, 6mo,and 1a ) at Wuhan Bright Eye Hospital were collected.The patients were divided into three groups , with 34 cases (45 eyes) in horizontal implantation group,25 cases ( 29 eyes )  in oblique implantation group ( 29 cases ), and 33 cases ( 46 eyes) in vertical implantation group. Uncorrected distance visual acuity ( UDVA ),corrected distance visual acuity (CDVA),diopters,vault, and rotation angle (deviation of the actual axis of TICL from the expected axis).

All surgeries were uneventful.No eye lost lines of CDVA at 1 a postoperatively, and the safety index and efficacy index both with no statistically significant differences among the three groups.There was a significant difference in postoperative vault among the three groups ( P = 0. 003 ), and the vaults at different follow-up time points within each group showed significant differences ( P<0.001 ) , all decreased over time. Furthermore,there was no significant difference in residual astigmatism among the three groups. Additionally,no  significant differences  in rotation angle were observed among the three groups , but there were differences at different follow-up time points within each group ( P< 0.001 ) .

The implantation of TICL in different orientations has good safety and efficacy,the postoperative rotational stability is good,and the appropriate angle can be selected to implant TICL according to the clinical situation.