The Impact Of Intraoperative Image-Guided Navigation On Correction Outcomes Of Toric Implantable Collamer Lens For Ultra-High Myopic Astigmatism
Published 2026 - 44th Congress of the ESCRS
Reference: POREF130 | Type: Free paper | DOI: 10.82333/y7d3-3x90
Authors: Dr Jia Huang* 1 , Dr Yuliang Wang 1 , A/Prof. Xiaoying Wang 1 , A/Prof. Xingtao Zhou 1
1Department of Ophthalmology and Vision Science,Eye & ENT Hospital of Fudan University,Shanghai,China
Purpose
To evaluate the visual and refractive outcomes after the toric implantable collamer lens (TICL) surgery using image-guided marking (IGM) system (Callisto Eye System) for correction of high myopic astigmatism (≥ 4 diopters (D)).
Setting
This retrospective study included 54 patients who underwent TICL between January 2022 and December 2023 at the Refractive Surgery Center of the Department of Ophthalmology，the Eye & EENT hospital of Fudan University. This study adhered to the principles of the Declaration of Helsinki. We elucidated the benefits and risks of TICL for each patient and obtained signed informed consent forms.
Methods
In this retrospective clinical trial, 54 eyes of 54 patients, all of whom had ultra-high astigmatism (>4D), were treated with TICL, with 20 eyes in the IGM group and 34 eyes in the traditional manual marking (non-IGM) group. Visual and refractive parameters, and ocular higher-order aberrations were examined before and 6 months after surgery. The subjective quality of vision was scored using a validated questionnaire.
Results
The mean preoperative manifest cylinder was -4.60 ± 0.58 D in the IGM group and -4.82 ± 0.65 D in the non-IGM group (P = 0.191). At the postoperative 6-months visit, there were no statistically significant differences between both groups in UDVA(P = 0.383), SE (P = 0.051) and cylinder (P = 0.255). 60% and 39% of eyes were within ± 0.50 D of attempted astigmatism correction for the IGM and non-IGM group, respectively (P = 0.689). No significant differences in TIA (P = 0.194), SIA(P = 0.410), or AOE (P = 0.545) between IGM and non-IGM. The RMS of higher-order aberrations, coma, trefoil and sphere aberration revealed comparable outcomes.Halos (77.8%) and starbursts (66.7%) had the highest incidences after TICL implantation.
Conclusions
This study demonstrates that for TICL implantation in patients with ultra-high astigmatism (>4 D), both the image-guided marking and manual marking techniques produced equivalent refractive and visual quality outcomes.