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Comparison of surgically-induced astigmatism after phacoemulsification vs phakic implantable collamer lens implantation

Poster Details

First Author: I.Romac Coc UAE

Co Author(s):    B. Armstrong                    

Abstract Details


To compare the amount of surgically induced astigmatism (SIA) after phacoemulsification with the amount of SIA after posterior chamber phakic Implantable Collamer Lens (Visian ICL, STAAR Surgical) implantation.


Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE


40 eyes of 30 patients who underwent phacoemulsification through a 2.4 mm clear corneal incision and 30 eyes of 18 patients who underwent ICL implantation through a 3.2 mm temporal clear corneal incision were retrospectively examined. The patients age at the time of surgery was 31.5 years (mean age; range 24 to 39) in the ICL group and 52.5 years (mean age; range 40 to 65) in the phacoemulsification group. SIA was assessed using corneal tomography (Galilei Dual Scheimpflug Analyzer, Ziemer) comparing the amount of corneal astigmatism preoperatively and at least 3 months postoperatively.


All surgeries were performed by one surgeon and incisions were created under surgical guidance with the Callisto Eye imaging system (Zeiss). When operating temporally, the centroid value SIA was 0.34 diopters (D) for right eye and 0.2 D for the left eye in the phacoemulsification group compared to a centroid value of 0.2 D for the right and left eyes in ICL group. All incisions were temporal in location in ICL group, but incision location varied in the phacoemulsification group. SIA was higher when operating superiorly or inferiorly, and centroid value SIA ranges from 0.35 D to 0.54 D.


Visual rehabilitation after phacoemulsification and ICL implantation may sometimes be disappointing due to induction of corneal astigmatism. ICL implantation is done as a refractive procedure and even a small amount of cylindrical error can be noticeable to patients. Although the size of incision for ICL implantation is bigger than the incision for phacoemulsification, unexpectedly SIA was slightly lower after ICL implantation. This can be explained by less intraocular manipulation of the surgical wound during uneventful ICL implantation surgery.

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