Mid-Term Intraocular Pressure (Iop) After Toric Vs. Non-Toric Icl: Influence Of Lens Power And Biometric Parameters

To determine whether lens power, toric (TICL) vs. non-toric ICL status, lens size, white-to-white (WTW), vault, spherical equivalent (SE), and anterior chamber depth (ACD) significantly affect intraocular pressure (IOP) changes at 1 and 6 months after ICL surgery, while controlling for baseline (preoperative) IOP. By highlighting any differences between toric and non-toric lenses across a range of powers, we aim to assess potential risk factors for mid-term IOP elevation.

A single-surgeon, retrospective study conducted at a private refractive surgery practice. Consecutive ICL implantations were reviewed, with comprehensive preoperative and postoperative data collected, including follow-up IOP measurements at 1 and 6 months.

Data extracted included lens power (toric vs. non-toric), lens size (e.g., 12.1/12.6/13.2 mm), WTW, vault, SE, ACD, and pre-/postoperative IOP. Postoperative IOP changes from baseline were calculated at 1 and 6 months. Correlation and multiple regression analyses (controlling for baseline IOP) evaluated each factor’s relationship to IOP shifts over the mid-term. A p-value <0.05 was considered statistically significant.

Neither lens size, WTW, vault, SE, nor ACD demonstrated a statistically significant effect on IOP changes at 1 or 6 months after accounting for baseline IOP (all p>0.05). Subgroup analysis by toric vs. non-toric ICL and lens power similarly revealed no clinically meaningful differences in mid-term IOP changes. Mean IOP remained within normal limits across both timepoints, suggesting minimal clinical risk of IOP elevation tied to these biomechanical or refractive parameters. Regression (R²=0.18, p=0.04) confirmed no single factor (apart from baseline IOP) consistently predicted postoperative IOP shifts.

Under standard lens sizing and power selection protocols, neither lens power nor anatomical parameters (WTW, vault, SE, ACD) significantly impacted IOP at 1 or 6 months, regardless of toric or non-toric lens design. Baseline IOP emerged as the primary determinant, with no other factors showing robust predictive value. These findings underscore the safety of current ICL implantation practices, indicating that mid-term IOP elevations are unlikely in the absence of preoperative IOP concerns.