Correcting residual refractive error after multifocal IOL implantation with a low diopter piggyback toric implantable collamer lens: a prospective pilot study

Session Details

Session Title: Advanced Optic IOLs

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 09:46

Venue: Free Paper Forum: Podium 1

First Author: : G.Duncker GERMANY

Co Author(s): :    A. Sasse   T. Duncker                          

Abstract Details

Purpose:

To assess whether residual refractive error after in-the-bag multifocal intraocular lens (mIOL) implantation can precisely and safely be corrected with a piggy-back low diopter Visian Toric Implantable Collamer Lens (VTICL, STAAR Surgical, USA) placed in the ciliary sulcus.

Setting:

Institute of Ophthalmology, Halle, Germany

Methods:

Twenty-four eyes of 23 patients (mean age: 57.5 years) with diminished uncorrected distance visual acuity (UDVA) of ≥ 2 lines due to residual refractive error after mIOL implantation were included in the study. VTICL size was calculated using the standard STAAR Visian ICL calculation software for phakic eyes. Postoperative study visits (1 day, 1 week, 3 months and 6 months after VTICL implantation) included UDVA, corrected distance visual acuity (CDVA), VTICL axis alignment, vault (space between mIOL and VTICL), intraocular pressure and documentation of adverse events.

Results:

At 6 months, mean UDVA (logMAR) increased from 0.26 preoperatively to -0.01 (p<0.001) while mean CDVA remained unchanged. Mean VTICL misalignment from the preoperative target axis was 5.3° and mean vault was 1385 µm. In the initial phase of the study, 2 VTICL had to be exchanged due to oversizing. After modification of the algorithm to calculate VTICL size, no increase in intraocular pressure due to an oversized implant was observed anymore.

Conclusions:

Piggy-back low diopter VTICL can precisely correct residual refractive error after mIOL implantation and significantly increase UDVA. Advantages of this novel surgical approach include: VTICL availability in small diopter steps, no significant surgical induced astigmatism, atraumatic and reversible procedure.

Financial Disclosure:

None