Abstract
PURPOSE:
To compare the 2-year visual and refractive outcomes with the Eyecryl Phakic Toric IOL (EP TIOL) (Biotech Vision Care Pvt Ltd) and Visian Toric ICL (TICL) (STAAR Surgical) for correction of high myopic astigmatism.
METHODS:
This prospective, interventional, non-randomized comparison study included eligible patients who underwent toric phakic IOL surgery in one or both eyes with either the EP TIOL or TICL for myopic astigmatism. Two years postoperatively, both lenses were compared for their safety, efficacy, stability, and patient satisfaction. Vector analysis of astigmatism was performed using the Alpins method with the ASSORT software (ASSORT Party Ltd).
RESULTS:
A total of 50 eyes were included, of which 25 eyes received EP TIOL implantation and the remaining 25 received TICL implantation. Preoperative mean ± standard deviation of spherical equivalent (SE) and cylinder was −10.15 ± 4.04 and −2.08 ± 0.86 diopters (D) in the EP TIOL group and −10.21 ± 3.97 and −2.17 ± 0.95 D in the TICL group, respectively. At 2 years of follow-up, there was no significant difference between the mean uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, and residual astigmatism between the two groups (P > .05 for all parameters). Ninety-two percent of eyes in the EP TIOL group and 88% of eyes in the TICL group were within ±0.50 D of refractive astigmatism. Vector analysis of astigmatism showed a comparable Correction Index of 0.98 in the EP TIOL group and 0.94 in the TICL group, signifying a mild undercorrection of 2% and 6%, respectively. Two eyes in the TICL group underwent exchange for high vault and one eye required realignment due to significant postoperative rotation.
CONCLUSIONS:
At least for the first 2 years postoperatively, both toric phakic IOLs were safe and effective in managing high myopic astigmatism with comparable visual results and patient satisfaction.
[J Refract Surg. 2021;37(1):7–15.]
- 1.Menezo JL, Peris-Martínez C, Cisneros AL, Martínez-Costa R. Phakic intraocular lenses to correct high myopia: Adatomed, Staar, and Artisan. J Cataract Refract Surg. 2004; 30(1):33–44.
10.1016/j.jcrs.2003.11.023 > Crossref MedlineGoogle Scholar - 2.Huang D, Schallhorn SC, Sugar A, Phakic intraocular lens implantation for the correction of myopia: a report by the American Academy of Ophthalmology. Ophthalmology. 2009; 116(11):2244–2258.
10.1016/j.ophtha.2009.08.018 > Crossref MedlineGoogle Scholar - 3.Moya T, Javaloy J, Montés-Micó R, Beltrán J, Muñoz G, Montalbán R. Implantable collamer lens for myopia: assessment 12 years after implantation. J Refract Surg. 2015; 31(8):548–556.
10.3928/1081597X-20150727-05 > LinkGoogle Scholar - 4.El Danasoury MA, El Maghraby A, Gamali TO. Comparison of iris-fixed Artisan lens implantation with excimer laser in situ keratomileusis in correcting myopia between −9.00 and −19.50 diopters: a randomized study. Ophthalmology. 2002; 109(5):955–964.
10.1016/S0161-6420(02)00964-8 > Crossref MedlineGoogle Scholar - 5.Alio JL, Peña-García P, Pachkoria K, Alió JL, El Aswad A. Intraocular optical quality of phakic intraocular lenses: comparison of angle-supported, iris-fixated, and posterior chamber lenses. Am J Ophthalmol. 2013; 156(4):789–799.
10.1016/j.ajo.2013.05.013 > Crossref MedlineGoogle Scholar - 6.Pineda R, Chauhan T. Phakic intraocular lenses and their special indications. J Ophthalmic Vis Res. 2016; 11(4):422–428.
10.4103/2008-322X.194140 > Crossref MedlineGoogle Scholar - 7.Sanders DR, Doney K, Poco MICL in Treatment of Myopia Study Group. United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up. Ophthalmology. 2004 111(9):1683–1692.
10.1016/j.ophtha.2004.03.026 > Crossref MedlineGoogle Scholar - 9.Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016; 10:1059–1077.
10.2147/OPTH.S111620 > Crossref MedlineGoogle Scholar - 10.Karimian F, Baradaran-Rafii A, Hashemian SJ, Comparison of three phakic intraocular lenses for correction of myopia. J Ophthalmic Vis Res. 2014; 9(4):427–433.
10.4103/2008-322X.150805 > Crossref MedlineGoogle Scholar - 11.Igarashi A, Shimizu K, Kamiya K. Eight-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia. Am J Ophthalmol. 2014; 157(3):532–9.e1.
10.1016/j.ajo.2013.11.006 > Crossref MedlineGoogle Scholar - 12.Lee J, Kim Y, Park S, Long-term clinical results of posterior chamber phakic intraocular lens implantation to correct myopia. Clin Exp Ophthalmol. 2016; 44(6):481–487.
10.1111/ceo.12691 > Crossref MedlineGoogle Scholar - 13.Vasavada V, Srivastava S, Vasavada SA, Sudhalkar A, Vasavada AR, Vasavada VA. Safety and efficacy of a new phakic posterior chamber IOL for correction of myopia: 3 years of follow-up. J Refract Surg. 2018; 34(12):817–823.
10.3928/1081597X-20181105-01 > LinkGoogle Scholar - 14.Yasa D, Ürdem U, Agca A, Early results with a new posterior chamber phakic intraocular lens in patients with high myopia. J Ophthalmol. 2018; 2018(3):1329874. > MedlineGoogle Scholar
- 15.Urdem U, Agca A. Refractive results and endothelial cell density after eyecryl phakic intraocular lens implantation. Beyoglu Eye J. 2019; 4:17–22. > Google Scholar
- 16.Yasa D, Köse B, Agca A. Rotational stability of a new posterior chamber toric phakic intraocular lens. J Ophthalmol. 2020; 2020(5):1624632. > MedlineGoogle Scholar
- 17.Dougherty PJ, Rivera RP, Schneider D, Lane SS, Brown D, Vukich J. Improving accuracy of phakic intraocular lens sizing using high-frequency ultrasound biomicroscopy. J Cataract Refract Surg. 2011; 37(1):13–18.
10.1016/j.jcrs.2010.07.014 > Crossref MedlineGoogle Scholar - 18.Ganesh S, Brar S, Pawar A. Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism. Clin Ophthalmol. 2017; 11:1253–1263.
10.2147/OPTH.S127101 > Crossref MedlineGoogle Scholar - 19.Rizk IM, Al-Hessy AA, El-Khouly SE, Sewelam AM. Visual performance after implantation of two types of phakic foldable intraocular lenses for correction of high myopia. Int J Ophthalmol. 2019; 12(2):284–290.
10.18240/ijo.2019.02.16 > Crossref MedlineGoogle Scholar - 20.Alpins NA. Vector analysis of astigmatism changes by flattening, steepening, and torque. J Cataract Refract Surg. 1997; 23(10):1503–1514.
10.1016/S0886-3350(97)80021-1 > Crossref MedlineGoogle Scholar - 21.Alpins N. Astigmatism analysis by the Alpins method. J Cataract Refract Surg. 2001; 27(1):31–49.
10.1016/S0886-3350(00)00798-7 > Crossref MedlineGoogle Scholar - 22.Sanders DR, Schneider D, Martin R, Toric Implantable Collamer Lens for moderate to high myopic astigmatism. Ophthalmology. 2007; 114(1):54–61.
10.1016/j.ophtha.2006.08.049 > Crossref MedlineGoogle Scholar - 23.Kamiya K, Shimizu K, Kobashi H, Igarashi A, Komatsu M. Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for moderate to high myopic astigmatism. PLoS One. 2013; 8(2):e56453.
10.1371/journal.pone.0056453 > Crossref MedlineGoogle Scholar - 24.Sari ES, Pinero DP, Kubaloglu A, Toric implantable collamer lens for moderate to high myopic astigmatism: 3-year follow-up. Graefes Arch Clin Exp Ophthalmol. 2013; 251(5):1413–1422.
10.1007/s00417-012-2172-8 > Crossref MedlineGoogle Scholar - 25.Kaur M, Titiyal JS, Falera R, Sinha R, Sharma N. Indications for explant of implantable collamer lens. Eye (Lond). 2018; 32(4):838–840.
10.1038/eye.2017.307 > Crossref MedlineGoogle Scholar - 26.Fernandes P, González-Méijome JM, Madrid-Costa D, Ferrer-Blasco T, Jorge J, Montés-Micó R. Implantable collamer posterior chamber intraocular lenses: a review of potential complications. J Refract Surg. 2011; 27(10):765–776.
10.3928/1081597X-20110617-01 > LinkGoogle Scholar - 27.Ganesh S, Brar S. Comparison of surgical time and IOP spikes with two ophthalmic viscosurgical devices following Visian STAAR (ICL, V4c model) insertion in the immediate postoperative period. Clin Ophthalmol. 2016; 10:207–211. > MedlineGoogle Scholar
- 28.Mertens EL. Toric phakic implantable collamer lens for correction of astigmatism: 1-year outcomes. Clin Ophthalmol. 2011; 5:369–375.
10.2147/OPTH.S7259 > Crossref MedlineGoogle Scholar - 29.Alfonso JF, Fernández-Vega L, Lisa C, Fernandes P, González-Méijome JM, Montés-Micó R. Collagen copolymer toric posterior chamber phakic intraocular lens in eyes with keratoconus. J Cataract Refract Surg. 2010; 36(6):906–916.
10.1016/j.jcrs.2009.11.032 > Crossref MedlineGoogle Scholar - 30.Lindland A, Heger H, Kugelberg M, Zetterström C. Vaulting of myopic and toric Implantable Collamer Lenses during accommodation measured with Visante optical coherence tomography. Ophthalmology. 2010; 117(6):1245–1250.
10.1016/j.ophtha.2009.10.033 > Crossref MedlineGoogle Scholar - 31.Li DJ, Wang NL, Chen S, Li SN, Mu DP, Wang T. Accuracy and repeatability of direct ciliary sulcus diameter measurements by full-scale 50-megahertz ultrasound biomicroscopy. Chin Med J (Engl). 2009; 122(8):955–959. > MedlineGoogle Scholar
- 32.Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016; 10:1059–1077.
10.2147/OPTH.S111620 > Crossref MedlineGoogle Scholar
