Topography-Guided Lasik For Treating Residual Low Astigmatism After Toric Implantable Collamer Lens Surgery

To describe a case of correcting residual astigmatism after TICL using Topography-Guided LASIK.

Dongguan Aier Eye Hospital

A 33-year-old male patient with a preoperative refractive error of -3.75DS/-1.50DC*175º in the left eye, preoperative BCVA of 20/20, underwent Toric ICL(EVO ICL,STARR) surgery. The OCOS calculation determined an lens size of 13.2, with a lens of spherical -6.5D, cylinder +1.5D, axis of 85, and SEQ +0.18D. The surgery was successful, and the postoperative lens position did not rotate in 9-months follow-up. CIA was -0.25DC*160º. On the first day post-ops and at 9 months post-ops, UCVA of the left eye was 20/25 with residual astigmatism of -0.50DC*155º, and BCVA was 20/16. Vector calculations indicated that lens repositioning could not fully correct the astigmatism. Replacing the lens could lead to overcorrection. The final decision was to correct the residual refractive error with topography-guided LASIK. VISUMAX 3.0 (ZEISS) femtosecond laser was used to create the flap, and the EX500 excimer laser performed the topography-guided LASIK. One month post-surgery, the patient's vision was 20/12, with a refractive diopter of Plano. The patient was satisfied.

TICL for moderate to low myopia may result in astigmatism residuals.Topography-guided LASIK should be considered as an option for correcting this refractive error.