Management of low astigmatism in implantable collamer lens surgery: opposite clear corneal incisions vs toric implantable collamer lens.

Autor:	González-Cruces T; From the Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, Cordoba, Spain (González-Cruces, Sánchez-Ventosa, Villarrubia, Cano-Ortiz); Department of Physics of Condensed Matter, Optics Area, University of Seville, Seville, Spain (González-Cruces, Sánchez-González)., Sánchez-Ventosa Á, Villarrubia A, Sánchez-González JM, Cano-Ortiz A
Jazyk:	angličtina
Zdroj:	Journal of cataract and refractive surgery [J Cataract Refract Surg] 2023 Dec 01; Vol. 49 (12), pp. 1249-1257.
DOI:	10.1097/j.jcrs.0000000000001297
Abstrakt:	Purpose: To compare 2 techniques to correct low astigmatism during implantable collamer lens (ICL) surgery: astigmatic opposite clear corneal incisions (OCCIs) and toric ICL (T-ICL). Setting: Arruzafa Ophthalmological Hospital, Cordoba, Spain. Design: Randomized prospective comparative study. Methods: The study comprised 152 myopic eyes undergoing ICL surgery. Patients were separated into 2 groups: Group 1 (57 patients; 76 eyes) received a spherical ICL with OCCIs and Group 2 (53 patients; 76 eyes) received a T-ICL. The inclusion criteria were refractive astigmatism up to 1.50 diopters (D), regular corneal astigmatism up to 2.00 D (Sim K, Pentacam), and agreement between the refractive and topographic corneal cylinders (discrepancies less than 30 degrees axis or 0.50 D). The outcomes were evaluated after a 1-month follow-up. Results: The T-ICL group achieved a mean postoperative spherical equivalent refraction and refractive astigmatism of -0.04 ± 0.17 D and -0.03 ± 0.12 D, respectively, vs -0.14 ± 0.33 D and -0.20 ± 0.36 D, in the OCCI group ( P < .001). Postoperative refractive astigmatism of less than 0.25 D was achieved in 94.74% of cases in the T-ICL group vs 73.68% in the OCCI group. Undercorrection of corneal astigmatism occurred in the OCCI group with a surgically induced astigmatism of 0.48 ± 0.24 D and correction index = 0.46. Conclusions: Both the T-ICL and OCCI techniques provided excellent results in terms of safety and efficacy. T-ICL surgery was shown to be more predictable and accurate for correcting low astigmatism with a lower postoperative spherical equivalent and less residual astigmatism compared to incisional management. (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)
Databáze:	MEDLINE
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