Comparison of Collamer toric contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism

Purpose

To compare the postoperative visual outcomes after implantation of a Collamer toric implantable contact lens (ICL) and after wavefront-guided laser in situ keratomileusis in high myopic astigmatism.

Setting

Department of Ophthalmology, Kitasato University, Kanagawa, Japan.

Methods

This study comprised 30 eyes (18 patients) having toric ICL implantation and 24 eyes (17 patients) having wavefront-guided LASIK (Technolas 217z) to correct high myopic astigmatism (manifest spherical equivalent [SE] ≤−6.0 diopters [D]; manifest refractive cylinder ≥1.0 D). The safety, efficacy, predictability, stability, and adverse events were assessed preoperatively and 1 week and 1, 3, and 6 months postoperatively.

Results

At 6 months, the mean safety index was 1.28 ± 0.25 (SD) in the ICL group and 1.01 ± 0.16 in the LASIK group and the mean efficacy index, 0.87 ± 0.15 and 0.83 ± 0.23, respectively. All eyes in the ICL group and 71% of eyes in the LASIK group were within ±1.00 D of the targeted SE correction at 6 months. The mean change in manifest refraction from 1 week to 6 months was −0.04 ± 0.24 D in the ICL group and −0.60 ± 0.49 D in the LASIK group. There were no significant complications in the ICL group; 2 eyes (8.3%) in the LASIK group required enhancement ablations.

Conclusion

Toric ICL implantation was better than wavefront-guided LASIK in eyes with high myopic astigmatism in almost all measures of safety, efficacy, predictability, and stability, suggesting that toric ICL implantation may become a viable surgical option to treat high myopic astigmatism.