title: Myopic astigmatism correction: comparison of a Toric Implantable Collamer Lens and a bioptics technique by an adaptive optics visual simulator.
abstract: OBJECTIVE
  To compare the optical and visual quality of a simulated Toric Implantable Collamer Lens (TICL) and a bioptics technique to treat high myopic astigmatism.
  
  
  METHODS
  An adaptive optics visual simulator was used to simulate the vision after TICL implantation and a bioptics procedure from the wavefront aberration pattern for moderate and high-myopic astigmatism. Visual acuity (VA) at different contrasts and contrast sensitivity (CS) at 10, 20 and 25 cycles degree(-1) were measured for 3 and 5-mm pupils. Modulation Transfer Function (MTF) and Point Spread Function (PSF) were calculated for a 5-mm pupil.
  
  
  RESULTS
  At a 3-mm pupil we only found statistically significant differences in VA between the two simulated surgeries at low-contrast for moderate- and high-myopic astigmatism (p < 0.05). Statistically significant differences were found in CS at 3-mm pupil between both procedures at the highest spatial frequency for moderate-myopic astigmatism and at all frequencies for high-myopic astigmatism (p < 0.05). At a 5-mm pupil we found statistically significant differences in VA and CS between both simulated surgeries at all contrasts and frequencies evaluated for both groups (p < 0.05). In all cases VA and CS were better with the TICL than with the bioptics technique. MTFs for the bioptics technique were worse than those computed for the TICL. The TICL showed less spread out of the PSF than the bioptics procedure.
  
  
  CONCLUSIONS
  Simulated TICL and bioptics procedures provided good optical and visual quality, although TICL implantation provided slightly better outcomes than the bioptics procedure, especially when the pupil diameter was increased.
authors.affiliation: GIO, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain. cari.perez@uv.es
authors.forename: Cari
authors.initials: C
authors.lastname: Pérez-Vives
authors.forename: Alberto
authors.initials: A
authors.lastname: Domínguez-Vicent
authors.forename: David
authors.initials: D
authors.lastname: Madrid-Costa
authors.forename: Teresa
authors.initials: T
authors.lastname: Ferrer-Blasco
authors.forename: Robert
authors.initials: R
authors.lastname: Montés-Micó
mesh_terms: D057128:Aberrometry / Q000295:instrumentation*; D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000628:therapy*; D015350:Contrast Sensitivity / Q000502:physiology; D057108:Corneal Wavefront Aberration / Q000628:therapy; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000628:therapy*; D054120:Phakic Intraocular Lenses; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult