Toric posterior chamber phakic lens is safe and effective at one year

According to Alaa El Danasoury and colleagues, Toric ICL (TICL; STAAR Surgical) implantation is safe, effective and predictable in its correction of compound myopic astigmatism.

A prospective study conducted at the Magrabi Eye Hospital, Jeddah, Saudi Arabia, enrolled 32 eyes of 21 patients to receive a myopic Toric ICL through a temporal clear corneal incision. All eyes had spherical equivalent (SE) refraction between -5.00 and -15.00 D, spectacle corrected visual acuity (VA) of 20/20 or better, stable manifest refraction for at least one year, endothelial cell counts above 2,200 cell/mm² and anterior chamber depths of 2.7 mm or more.

Preoperatively the mean SE refraction was -9.32±2.31 D. Twelve months postoperatively this had improved to -0.12±0.45 D. More than 88% of subjects had an uncorrected VA of 20/20 or better and 20/30 or better in all eyes. Two lines or more of spectacle corrected VA was gained by 22% of eyes, while axis misalignment occurred in one eye.

The researchers concluded that implantation of the Toric ICL appears to be effective, predictable and relatively safe for the correction of compound myopic astigmatism, though longer follow-up would be necessary to validate this claim.

A second study conducted by Baha Toygar and co-workers from the Dunya Eye Hospital, Istanbul, Turkey further supported the safety and efficacy of the TICL for the correction of high levels of myopic astigmatism.

A prospective study was conducted that included 27 eyes of 17 subjects whose mean preoperative SE was -10.74±2.17 D, and whose mean preoperative astigmatism was recorded at -2.65±1.03 D. In each patient, the TICL was inserted in the anterior chamber through a temporal corneal incision. After implantation into the sulcus the lens was rotated to the correct axis.

Postoperatively, mean SE was -0.67±1.00 D and mean residual astigmatic error was 0.50±0.45 D. A total of 67% of the eyes were within ±0.50 D of emmetropia and 82% ±1.0 D. Preoperative uncorrected VA improved from 0.02±0.01 to 0.65±0.24 and best corrected VA improved from 0.52±0.23 to 0.78±0.22. In one eye, TICL exchange was performed because of high amounts of vaulting. Furthermore, cataract surgery was performed in one eye after repositioning and then exchanging the TICL.

Toygar concluded that the TICL implantation procedure is both safe and effective.

Ophthalmology Times Europe reporting from the XXIV Congress of the ESCRS, London, 9-13 September, 2006.