Comparison between toric and spherical phakic intraocular lenses combined with astigmatic keratotomy for high myopic astigmatism

摘要

Background: To compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical PIOL combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism. Methods: This study enrolled patients with high myopic astigmatism, including 30 eyes (22 patients) that received a toric PIOL implantation (TCL group), and 32 eyes (24 patients) that received combined AK and a spherical PIOL implantation (AK+ ICL group). The outcomes were compared between the two groups before surgery, and at the following time points after surgery: 1 week, 1, 3, 6 months, and 1, 2 years. Results: Preoperatively, the mean manifest spherical equivalent (SE) was -14. 14 ± 2. 12 D in the TICL group and -14. 83 ± 2. 79 D in the AK + ICL group (P = 0. 28), and the mean manifest refractive cylinder, -2. 87 ± 1. 09 D and -2. 58±0. 85 D, respectively (P = 0. 28). Two years postoperatively, the mean safety index was 1. 53±0. 55 in the TICL group and 1. 60 ± 0. 70 in the AK + ICL group (P = 1. 00), and the mean efficacy index, 1. 18 ± 0. 45 and 1. 38±0. 52, respectively (P = 0. 86). The mean manifest refractive cylinder correction was 1. 94±1. 07 D in the TICL group and 1. 39±0. 71 D in the AK + ICL group (P = 0. 02). The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0. 50 D in both groups. Conclusions: Both TICL implantation and AK + ICL implantation are a good alternative for correction of astigmatism in addition to high myopia. TICL implantation has better predictability in correction of high myopic astigmatism. Trial registration: NCT03202485