title: Comparison of visual and refractive results of Toric Implantable Collamer Lens with bioptics for myopic astigmatism.
abstract: OBJECTIVE
  To compare visual and refractive results of Toric Implantable Collamer Lens (TICL) and bioptics (ICL plus excimer corneal surgery) to treat myopic astigmatism.
  
  
  METHODS
  Eighty-one eyes underwent TICL implantation and 83 eyes were treated with bioptics (corneal ablation was performed between 1.5 and 6 months after ICL implantation). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, adverse events, safety, and efficacy were evaluated 12 months postoperatively.
  
  
  RESULTS
  At 12 months postoperatively, the mean spherical equivalent was -0.15 ± 0.36 diopters (D) in the TICL group and -0.08 ± 0.26 D in the bioptics group (p = 0.099). Sixty-six (81.5 %) and 78 (94.0 %) eyes were within ±0.50 D for TICL and bioptics groups, respectively. The mean Snellen UDVA was not statistically different between both procedures (p = 0.909); 53 (65.4 %) and 54 (65.1 %) eyes achieved at least 20/25 or better in TICL and bioptics groups, respectively. No eye had lost more than two lines of CDVA, and 32.1 % of eyes (26/81) in the TICL group and 57.8 % of eyes (48/83) in the bioptics group had better postoperative UDVA than preoperative CDVA (p < 0.001). Safety was not statistically different between groups (p = 0.464) while efficacy was significantly higher in the bioptics group (p = 0.000). Two eyes with a TICL were treated to correct TICL decentration.
  
  
  CONCLUSIONS
  Bioptics showed slightly better outcomes in some clinical measures such as uncorrected visual acuity, efficacy, and refractive predictability. TICL implantation shows reliable results similar to bioptics. A single procedure with TICL implantation might be preferred, eliminating the inherent risks of laser treatments and the risks of a second surgical procedure.
authors.affiliation: Fernández-Vega Ophthalmological Institute, Avda Dres Fernández-Vega 114, 33012 Oviedo, Spain. j.alfonso@fernandez-vega.com
authors.forename: J F
authors.initials: JF
authors.lastname: Alfonso
authors.forename: C
authors.initials: C
authors.lastname: Lisa
authors.forename: L
authors.initials: L
authors.lastname: Fernández-Vega Cueto
authors.forename: P
authors.initials: P
authors.lastname: Fernandes
authors.forename: J M
authors.initials: JM
authors.lastname: González-Méijome
authors.forename: R
authors.initials: R
authors.lastname: Montés Micó
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D055095:Optics and Photonics; D054120:Phakic Intraocular Lenses; D018903:Photorefractive Keratectomy; D012029:Refraction, Ocular / Q000502:physiology*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult