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Comparison of visual and refractive results of Toric Implantable Collamer Lens with bioptics for myopic astigmatism

  • Refractive Surgery
  • Published:
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Abstract

Purpose

To compare visual and refractive results of Toric Implantable Collamer Lens (TICL) and bioptics (ICL plus excimer corneal surgery) to treat myopic astigmatism.

Methods

Eighty-one eyes underwent TICL implantation and 83 eyes were treated with bioptics (corneal ablation was performed between 1.5 and 6 months after ICL implantation). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, adverse events, safety, and efficacy were evaluated 12 months postoperatively.

Results

At 12 months postoperatively, the mean spherical equivalent was −0.15 ± 0.36 diopters (D) in the TICL group and −0.08 ± 0.26 D in the bioptics group (p = 0.099). Sixty-six (81.5 %) and 78 (94.0 %) eyes were within ±0.50 D for TICL and bioptics groups, respectively. The mean Snellen UDVA was not statistically different between both procedures (p = 0.909); 53 (65.4 %) and 54 (65.1 %) eyes achieved at least 20/25 or better in TICL and bioptics groups, respectively. No eye had lost more than two lines of CDVA, and 32.1 % of eyes (26/81) in the TICL group and 57.8 % of eyes (48/83) in the bioptics group had better postoperative UDVA than preoperative CDVA (p < 0.001). Safety was not statistically different between groups (p = 0.464) while efficacy was significantly higher in the bioptics group (p = 0.000). Two eyes with a TICL were treated to correct TICL decentration.

Conclusions

Bioptics showed slightly better outcomes in some clinical measures such as uncorrected visual acuity, efficacy, and refractive predictability. TICL implantation shows reliable results similar to bioptics. A single procedure with TICL implantation might be preferred, eliminating the inherent risks of laser treatments and the risks of a second surgical procedure.

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Acknowledgments and disclosure

The authors have no proprietary interests in any of the materials mentioned in this article. This research was supported in part by a Universitat de Valencia Research Grant to Robert Montés-Micó (#SAF2009-13342 and #SAF2008-01114-E#) and Fundação para a Ciência e Tecnologia of Portugal through a Grant to Paulo Fernandes (#FCT-SFRH-BD-34303-2007#).

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Authors and Affiliations

  1. Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain

    J. F. Alfonso, C. Lisa & L. Fernández-Vega Cueto

  2. Surgery Department, School of Medicine, University of Oviedo, Asturias, Spain

    J. F. Alfonso

  3. Clinical & Experimental Optometry Research Lab; Center of Physics, School of Sciences, University of Minho, Braga, Portugal

    P. Fernandes & J. M. González-Méijome

  4. Optics Department, Faculty of Physics, University of Valencia, Valencia, Spain

    R. Montés Micó

Authors
  1. J. F. Alfonso
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  2. C. Lisa
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  3. L. Fernández-Vega Cueto
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  4. P. Fernandes
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  5. J. M. González-Méijome
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  6. R. Montés Micó
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Correspondence to J. F. Alfonso.

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Alfonso, J.F., Lisa, C., Fernández-Vega Cueto, L. et al. Comparison of visual and refractive results of Toric Implantable Collamer Lens with bioptics for myopic astigmatism. Graefes Arch Clin Exp Ophthalmol 251, 967–975 (2013). https://doi.org/10.1007/s00417-012-2155-9

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  • DOI: https://doi.org/10.1007/s00417-012-2155-9

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