ESCRS - FP18.05 - Non-Toric Implantable Collamer Lens With Postoperative Adjunctive Lasik In The Treatment Of High Astigmatism In Mypic Patients With Abnormal Posterior Chamber Structure

Non-Toric Implantable Collamer Lens With Postoperative Adjunctive Lasik In The Treatment Of High Astigmatism In Mypic Patients With Abnormal Posterior Chamber Structure

Published 2025 - 43rd Congress of the ESCRS

Reference: FP18.05 | Type: Free paper | DOI: 10.82333/mxbh-he33

Authors: Reshma Ranade* 1 , Sangeeta Wagh 1 , Kiran Phartale 1 , Aparna Vaidya 1

1Wagh Eye Clinics,Pune,India

Purpose

To assess the refractive and visual outcomes of a spherical Implantable Collamer Lens (ICL) followed by planned postoperative adjunctive laser-assisted in situ keratomileusis (LASIK) in the treatment of high astigmatism in mypic patients with abnormal posterior chamber structure which means a large iris -ciliary angle (ICA) ccompanied by a short ciliary body.

Setting

Wuhan Hongshan Aier Eye Hospital

Methods

This prospective study included eyes with abnormal posterior chamber structures and ≥-2.00 D of astigmatism, which underwent surgery involving implantation of a spherical ICL followed by planned adjunctive LASIK (3-7 months postoperatively). Outcome measures included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent (SEQ), defocus equivalent (DEQ), efficacy index, safety index, and astigmatism vector analysis.

Results

A total of 20 eyes were included, with a mean sphere of -7.85± 2.15D and mean cylinder of 3.69 ± 0.89 D preoperatively. After ICL implantation and LASIK, 100% of eyes achieved a UDVA within 1 line of preoperative CDVA. Efficacy and safety indices were 1.24 ± 0.13 and 1.00 ± 0.13, respectively.We obtained near-to-emmetropia SEQ postoperatively (mean + 0.13 ± 0.23D), and the scatterplot of attempted versus achieved refractive correction revealed a predictable procedure (R(2) = 1.08).Additionally, 100% of eyes achieved target SEQ within 0.50D, and 100% of eyes were within 0.25 D of intended plano cylinder.

Conclusions

Non-toric ICL with postoperative adjunctive LASIK is safe and effective with good early visual and refractive outcomes. The combined modality is a promising approach for managing high astigmatism in patients with abnormal posterior chamber structure where toric ICL is not available.