Phakic Collamer Lens (ICL) Implantation Followed by Excimer Laser Treatment (Bioptics) to Correct Hyperopia with Astigmatism

Résumé

PURPOSE: To evaluate the efficacy and safety results of excimer corneal surgery following posterior chamber phakic Implantable Collamer Lens (Bioptics) to treat hyperopia with astigmatism. SETTING: Fernández-Vega Ophthalmological Institute, Oviedo, Spain. METHODS: This cohort study included 62 eyes who underwent ICH V3 implantation followed by photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) to treat residual refractive errors (mainly astigmatism). Mean follow-up was 9.3±4.7 months after laser ablation (range 1 to 29 months). RESULTS: Preoperatively the average manifest refractive sphere (MRSE) was 5.73±1.79 diopters (D) (range 1.50 to 11.00) and manifest refractive cylinder (MRCYL) was –2.07±1.03 D (range –4.00 to 0.00). Following ICH implantation, the mean spherical equivalent (SE) was –0.07±0.09 D (range –2.88 to 0.75 D); after laser treatment the mean MRSE was –0.01±0.08 D (range –0.5 to 0.25) and MRCYL was –0.19±0.36 D (range –1.50 to 0.00). The mean UDVA was at least 20/25 in almost 70% of laser-treated eyes; over 90% of the eyes achieved UDVA of 20/32 or better. No eye lost ≥2 lines of preoperative CDVA and a loss of 2 lines of UDVA after laser treatment compared to the CDVA after ICH implantation was noted in 4 (6.5%) eyes. After bioptics all eyes were within ±1.00 D and 60 eyes (96.8%) within ±0.50 D of SE. CONCLUSION: Bioptics procedure combining posterior chamber phakic IOL implantation and corneal refractive surgery showed to be a safe procedure to treat hyperopia associated with astigmatism