Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism

Majid Moshirfar; Nour Bundogji; Alyson N Tukan; James H Ellis; Shannon E McCabe; Ayesha Patil; Yasmyne C Ronquillo; Phillip C Hoopes

doi:10.2147/OPTH.S321095

Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism

Clin Ophthalmol. 2021 Jul 6:15:2893-2906. doi: 10.2147/OPTH.S321095. eCollection 2021.

Authors

Majid Moshirfar^{1

2

3}, Nour Bundogji⁴, Alyson N Tukan⁴, James H Ellis⁵, Shannon E McCabe^{1

6}, Ayesha Patil⁵, Yasmyne C Ronquillo¹, Phillip C Hoopes¹

Affiliations

¹ Hoopes Vision Research Center, Hoopes Vision, Draper, UT, 84020, USA.
² John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
³ Utah Lions Eye Bank, Murray, UT, USA.
⁴ University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA.
⁵ University of Utah School of Medicine, Salt Lake City, UT, USA.
⁶ Mission Hills Eye Center, Pleasant Hill, CA, USA.

Abstract

Purpose: To report visual outcomes following surgical correction of myopic astigmatism with Visian Toric implantable collamer lens (ICL) (STAAR Surgical, Monrovia, CA, USA) at a single tertiary refractive center in the United States.

Patients and methods: Toric ICL was implanted in 96 eyes (55 patients) with mean preoperative sphere of -8.98 ± 3.04 diopters (D) and cylinder of -2.67 ± 1.02 D from December 2018 to February 2021. Primary visual outcomes of efficacy, safety, stability, predictability of refractive correction, and astigmatic analysis were reported at three and twelve months postoperatively. Secondary subjective outcomes included patient-reported dry eye symptoms and glare/halos at postoperative visits. Other secondary outcomes were biometric data and postoperative vault over time.

Results: At three and twelve months, 75 and 46 eyes were evaluated, respectively. At twelve months, the mean manifest refraction spherical equivalent (MRSE) was -0.23 ± 0.47 D with 93% achieving within ±1.00 D of target refraction. The manifest refractive cylinder (MRC) at twelve months was -0.73 ± 0.51 D, with 86% within ±1.00 D of target. Uncorrected distance visual acuity (UDVA) was 20/20 or better in 74% of eyes at twelve months. No patients lost ≥2 lines of corrected distance visual acuity (CDVA) at twelve months. The mean angle of error was -0.9 ± 10.2° at three months and -1.6 ± 12.8° at twelve months. One patient required bilateral lens rotation, four patients underwent secondary enhancement with LASIK/PRK, and seven patients underwent postoperative limbal relaxing incisions.

Conclusion: This initial single-site experience finds Toric ICL implantation for myopic astigmatism to be safe and effective. Patients can achieve markedly improved UDVA in a single surgery with stable vision over time and minimal adverse subjective symptoms.

Keywords: Toric ICL; myopic astigmatism; visian; visual outcomes.

Grants and funding

This study was funded by an unrestricted grant from Research to Prevent Blindness (RPB), 360 Lexington Avenue, 22nd Floor New York, NY 10017. No support was received for the publication of this article.