Toric implantable collamer lens for moderate to high myopic astigmatism: 3-year follow-up.
BACKGROUND
To evaluate the 3-year clinical outcomes after toric implantable collamer lens (ICL) implantation for the management of moderate to high myopic astigmatism.


METHODS
Thirty-four eyes of 20 patients who underwent toric ICL implantation were reviewed. All eyes completed 3-year follow-up. Uncorrected (UDVA) and corrected (CDVA) distance LogMAR visual acuities, refraction, endothelial cell density (ECD), and surgical complications were evaluated. Vectorial analysis of astigmatic correction was also done.


RESULTS
A significant improvement in UDVA, CDVA, manifest spherical and cylindrical refraction was observed at 1 week and remained stable after 3 years. Twenty-six eyes (76.5%) gained lines of CDVA, and two eyes (5.9%) showed a loss of 1 line of CDVA. The spherical equivalent (SE) was within ±0.50 D of emmetropia in 18 eyes (52.9%) and within ±1.00 D in 28 eyes (82.4%). Differences between target-induced astigmatism (TIA) and surgically-induced astigmatism (SIA) were statistically significant (p < 0.01), and a trend to undercorrection of the refractive astigmatism was present after 3 years. The magnitude of flattening effect (FE) was found to be significantly lower than the magnitude of TIA (p < 0.01). The magnitude of the torque vector was always positive, with a value below 0.50 D in all cases. No vision-threatening complications were observed during the follow-up.


CONCLUSIONS
Toric ICL implantation is an effective and safe surgical option that provides a relatively predictable and stable refractive correction of myopic astigmatism. Further improvements are needed to minimize the degree of undercorrection.
Kartal Training and Research Hospital, Istanbul, Turkey.
Esin Sogutlu
ES
Sari
David P
DP
Pinero
Anil
A
Kubaloglu
Pinar Sorgun
PS
Evcili
Arif
A
Koytak
Isil
I
Kutlutürk
Yusuf
Y
Ozerturk
D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D002452:Cell Count; D019781:Corneal Topography; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D009216:Myopia / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult