Astigmatism correction: Laser in situ keratomileusis versus posterior chamber collagen copolymer toric phakic intraocular lens implantation.
OBJECTIVE
To compare the stability and predictability of astigmatism correction between toric phakic intraocular lens (pIOL) implantation and laser in situ keratomileusis (LASIK).


METHODS
Nagoya Eye Clinic, Nagoya, Japan.


METHODS
Comparative case series.


METHODS
Consecutive patients who had Implantable Collamer Lens pIOL implantation or LASIK were divided into 3 subgroups according to the amount of refractive cylinder correction (low, 0.00 to 1.25 diopters [D]; moderate, 1.50 to 2.75 D; high, ≥ 3.00 D). Manifest refraction was measured preoperatively and 1, 3, 6, and 12 months postoperatively. Based on these data, the predictability and stability of the refractive cylinder correction, error of the refractive cylinder correction, and error of the refractive cylinder correction axis were evaluated.


RESULTS
The study comprised 338 eyes (196 patients) in the toric pIOL group and 351 eyes (202 patients) in the LASIK group. In the moderate cylinder subgroup, more eyes were corrected within ± 0.50 D of the postoperative refractive cylinder in the LASIK group (132 eyes [91%]) than in the toric pIOL group (111 eyes [79%]). In the high refractive cylinder subgroup, the error of the refractive cylinder correction in the LASIK group was significantly higher than in the toric pIOL group (P=.032). The postoperative manifest refractive cylinder did not change in either group during the follow-up period.


CONCLUSIONS
The stability of the refractive cylinder after toric pIOL implantation was as high as after LASIK. Although predictability in the LASIK group was higher than in the toric pIOL group in eyes with moderate refractive cylinder, the toric pIOL group had higher predictability than the LASIK group in eyes with high refractive cylinder.
Department of Ophthalmology, Social Insurance Chukyo Hospital, Aichi, Japan.
Asato
A
Hasegawa
Takashi
T
Kojima
Naoki
N
Isogai
Akeno
A
Tamaoki
Tomoaki
T
Nakamura
Kazuo
K
Ichikawa
D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003094:Collagen; D003315:Cornea / Q000503:physiopathology; D005260:Female; D006025:Glycosaminoglycans; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D006025:Glycosaminoglycans; C058506:collagen-glycosaminoglycan copolymer; D003094:Collagen