Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism.
OBJECTIVE
To compare the effectiveness of toric foldable iris-fixated phakic intraocular lens (pIOL) implantation and non-toric foldable iris-fixated pIOL implantation with limbal relaxing incisions (LRIs) for correcting moderate-to-high astigmatism in myopic eyes.


METHODS
The medical records of 146 patients (195 eyes) with myopic astigmatism who underwent toric foldable iris-fixated pIOL implantation (toric group; 94 eyes) or non-toric foldable iris-fixated pIOL implantation with concurrent LRIs (LRI group; 101 eyes) were retrospectively reviewed. For subgroup analysis, the two groups were subdivided according to preoperative astigmatic severity [moderate, 2.00 to <3.00 diopters (D); high, 3.00-4.00 D]. Visual and astigmatic outcomes were compared 6 months postoperatively.


RESULTS
The uncorrected distance visual acuity was at least 20/25 in 100% and 98% of the toric and LRI group eyes, respectively. The toric group had lower mean residual cylindrical error (-0.67±0.39 D vs. -1.14±0.56 D; p<0.001) and greater mean cylindrical error change (2.17±0.56 D vs. 1.63±0.72 D; p<0.001) than the LRI group, regardless of the preoperative astigmatic severity. The mean correction index (1.10±0.16 vs. 0.72±0.24; p<0.001) and success index (0.24±0.14 vs. 0.42±0.21; p<0.001) also differed significantly between the groups.


CONCLUSIONS
Both surgical techniques considerably reduced astigmatism and had comparable visual outcomes. However, toric foldable iris-fixated pIOL implantation was more reliable for correcting moderate-to-high astigmatism in myopic eyes.
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Jeihoon
J
Lee
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.|Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
Hun
H
Lee
The Institute of Vision Research, Eyereum Eye Clinic, Seoul, Korea.
David Sung Yong
DS
Kang
The Institute of Vision Research, Eyereum Eye Clinic, Seoul, Korea.
Jin Young
JY
Choi
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.|Corneal Dystrophy Research Institute, Severance Biomedical Science Institute, and Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Eung Kweon
EK
Kim
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. tikim@yuhs.ac.
Tae Im
TI
Kim
D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D016850:Limbus Corneae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D054140:Refractive Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
Lenses; astigmatism; intraocular; limbus corneae