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A critical evaluation of longitudinal changes of astigmatism following implantation of toric implantable collamer lens (TICL): a comparison between treated and untreated cases over 4 years

  • Refractive Surgery
  • Published:
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Abstract

Purpose

To evaluate residual astigmatism following correction with toric implantable collamer lens (TICL) (group I) over a period of 4 years and compare with the change of astigmatism in spectacle wearers (group II).

Methods

Groups I (86 cases implanted with TICL [EVO + Visian ICL, Staar Surgical, Nidau, Switzeland], preop refractive error [sphere and cylinder] − 22.25 DS to − 1.00 DS and − 5.50 DC to − 1.00 DC) and II (80 cases initial refractive error [sphere and cylinder] − 18.00 DS to 0.00 DS and − 7.00 DC to − 1.00 DC) were reviewed annually. Refractive and tomography data were subjected to vector analysis to determine surgically induced astigmatism (SIA), angle of error [Δθ° = angle of target-induced astigmatism (TIA) − angle of SIA], and ΔC [TIA-SIA powers] and total corneal astigmatism (TCA) in group I and induced change in astigmatism (ICA) in group II.

Results

In group I, on all occasions, SIA correlated with TIA (p < 0.05); differences between SIA and TIA means were insignificant and changes in TCA were not correlated with ΔC. Mean (± sd, 95% CI) residual astigmatic powers (RA) in attending group I cases (1–4 years) were − 0.40 DC (0.58, − 0.52 to − 0.28), − 0.40 DC (0.59, − 0.52 to − 0.27), − 0.41 DC (0.58, − 0.54 to − 0.28), and − 0.61 DC (0.74, − 0.82 to − 0.40). In group II, the corresponding ICA powers were − 0.47 DC (0.53, − 0.61 to − 0.32), − 0.49 DC (0.48, − 0.69 to − 0.29), − 0.60 DC (0.40, − 0.76 to − 0.44), and − 0.86 DC (0.71, − 1.19 to − 0.52). Differences between RA and ICA were not significant. Of the group I cases presenting at 1–4 years postop, 23, 18, 16, and 28 had RA powers ≤  − 0.75 DC. Of these 12, 10, 6, and 16 were associated with Δθ° > 5° (ΔC − 0.50 to 0 DC) and 5, 1, 4, and 4 were related to ΔC (Δθ° < 5°).

Conclusion

The development of astigmatism after TICL implantation is on par with the natural change in astigmatism in untreated cases. In about 50% of TICL cases presenting with astigmatism ≤  − 0.75 DC, the residual astigmatism could be neutralized by realigning the TICL.

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Data availability

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Authors and Affiliations

  1. Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia

    Maja Bohac, Alma Biscevic, Ivan Gabric, Kresimir Gabric, Violeta Shijakova & Sudi Patel

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  1. Maja Bohac
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Contributions

Maja Bohac: conception and design, investigation, data curation, formal analysis, methodology, project administration, validation, visualization, writing the manuscript.

Alma Biscevic: conception and design, investigation, data curation, formal analysis, methodology, project administration, validation, visualization.

Ivan Gabric: conception and design, formal analysis, interpretation of data, methodology, critical revision.

Kresimir Gabric: conception and design, methodology, supervision, validation.

Violeta Shijakova: conception and design, data curation and interpretation, project administration, critical revision.

Sudi Patel: conception and design, analysis and interpretation of data, writing the manuscript, critical revision.

All authors approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Maja Bohac.

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Bohac, M., Biscevic, A., Gabric, I. et al. A critical evaluation of longitudinal changes of astigmatism following implantation of toric implantable collamer lens (TICL): a comparison between treated and untreated cases over 4 years. Graefes Arch Clin Exp Ophthalmol 260, 1377–1386 (2022). https://doi.org/10.1007/s00417-021-05449-w

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