A prospective pilot study using a low power piggy-back toric implantable Collamer lens to correct residual refractive error after multifocal IOL implantation
Authors Duncker GIW, Sasse AC, Duncker T
Received 21 June 2019
Accepted for publication 15 August 2019
Published 3 September 2019 Volume 2019:13 Pages 1689—1702
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Gernot IW Duncker, Anna C Sasse, Tobias Duncker
Institute of Ophthalmology, Halle, Germany
Correspondence: Tobias Duncker
Institute of Ophthalmology, Rathenauplatz 12, 06114 Halle, Germany
Purpose: To assess whether residual refractive error after in-the-bag multifocal intraocular lens (mIOL) implantation can efficaciously and safely be corrected with a piggy-back low power Visian Toric Implantable Collamer Lens® (VTICL, STAAR Surgical) placed in the ciliary sulcus.
Patients and 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), IOP 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.
Conclusion: Piggy-back low power VTICL can efficaciously 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.
Keywords: multifocal intraocular lens, ICL, Visian Implantable Collamer Lens®; piggy-back, add-on, residual refractive error
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