Management of low astigmatism in implantable collamer lens surgery: opposite clear corneal incisions versus toric implantable collamer lens
Timoteo González-Cruces, Álvaro Sánchez-Ventosa, Alberto Villarrubia, José-María Sánchez-González, Antonio Cano-Ortiz- Sensory Systems
- Ophthalmology
- Surgery
Abstract
Purpose:
To compare two techniques to correct low astigmatism during implantable collamer lens (ICL) surgery: astigmatic opposite clear corneal incisions (OCCIs) and toric ICL (T-ICL).
Setting:
Arruzafa Ophthalmological Hospital, Cordoba, Spain.
Design:
Randomized prospective comparative study.
Methods:
The study comprised 152 myopic eyes undergoing ICL (STAAR Surgical) surgery. Patients were separated into two groups: group 1 (57 patients; 76 eyes) received a spherical ICL with OCCIs and group 2 (53 patients; 76 eyes) received a T-ICL. The inclusion criteria were refractive astigmatism up to 1.50 diopters (D), regular corneal astigmatism up to 2.00 D (Sim K, Pentacam), and agreement between the refractive and topographic corneal cylinders (discrepancies less than 30º axis or 0.50 D). The outcomes were evaluated after a one-month follow-up.
Results:
The T-ICL group achieved a mean postoperative spherical equivalent refraction and refractive astigmatism of -0.04 ± 0.17 D and -0.03 ± 0.12 D, respectively, versus -0.14 ± 0.33 D and -0.20 ± 0.36 D, in the OCCI group (
Conclusions:
Both the T-ICL and OCCI techniques provided excellent results in terms of safety and efficacy. T-ICL surgery was shown to be more predictable and accurate for correcting low astigmatism with a lower postoperative spherical equivalent and less residual astigmatism compared to incisional management.