Long axial length, long anterior chamber depth, and small toric ICL implantation: the apparent cause of more than one ICL rotations and residual astigmatism

Session Details

Session Title: Presented Poster Session: Intraocular Refractive Surgery

Venue: Poster Village: Pod 2

First Author: : K.Varna-Tigka GERMANY

Co Author(s): :    T. Kohnen                       

Abstract Details

Purpose:

To show how ICL rotated I in an eye with AXL of 25,77mm and ACD (Int.) of 2.94mm, and the consecutive ICL rotations back to the original axis.

Setting:

The patient had refractive error of -3,5/-2,5/A79° in OS. He underwent ICL implantation without complications. The first day post-OP, he had an unsatisfactory visual outcome and UCVA of 0,50logMAR. We recommended therapy with artificial tears and follow-up.

Methods:

Two weeks later, the refractive error was +0,25/-1,50/A115° and BCVA 0,00logMAR. The lens was not correctly positioned, was off axis about 11 degrees. We decided to rotate the lens to original calculated axis. One week after rotation, the ICL was again off axis and this time was 13 degrees off. We re-rotated it in his original axis and achieved the correct position.

Results:

The refraction showed UCVA=0,10 logMAR and residual error of +0,50/ -1,25/ cyl A40° , the axis was the right one and our patient was kept in regularly follow ups.

Conclusions:

This case shows the risks of implanting a toric lens with a large axial length, as the ACD does not reassure the stable position of the lens.We had also thought the option of lens explantation and implantation of another one with bigger diameter. After the second rotation fortunately the lens remained in the right position and we suggested follow ups to monitor the results.

Financial Disclosure:

None