Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement (“Bioptics”) in the Treatment of High Myopic Astigmatism

Jabbour, Samir; Bower, Kraig S.

doi:10.2147/opth.s283888

Cited by 5 publications

(3 citation statements)

References 28 publications

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“… 2 Bioptics strives to address this limitation by distributing the large refractive correction between a corneal laser ablation and an implantable posterior chamber phakic intraocular lens. 3 , 4 With the approval of the Visian Toric Implantable Collamer Lens (STAAR Surgical, Monrovia, CA, USA) (Toric ICL) in 2018, patients with high myopic astigmatism now have an alternative option that decreases the need for a second surgery. Initial data concerning Toric ICLs shows promise for improved visual acuity with a safe and predictable outcome.…”

Section: Introductionmentioning

confidence: 99%

Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism

Moshirfar¹,

Bundogji²,

Tukan³

et al. 2021

OPTH

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Purpose: To report visual outcomes following surgical correction of myopic astigmatism with Visian Toric implantable collamer lens (ICL) (STAAR Surgical, Monrovia, CA, USA) at a single tertiary refractive center in the United States. Patients and Methods: Toric ICL was implanted in 96 eyes (55 patients) with mean preoperative sphere of −8.98 ± 3.04 diopters (D) and cylinder of −2.67 ± 1.02 D from December 2018 to February 2021. Primary visual outcomes of efficacy, safety, stability, predictability of refractive correction, and astigmatic analysis were reported at three and twelve months postoperatively. Secondary subjective outcomes included patient-reported dry eye symptoms and glare/halos at postoperative visits. Other secondary outcomes were biometric data and postoperative vault over time. Results: At three and twelve months, 75 and 46 eyes were evaluated, respectively. At twelve months, the mean manifest refraction spherical equivalent (MRSE) was −0.23 ± 0.47 D with 93% achieving within ±1.00 D of target refraction. The manifest refractive cylinder (MRC) at twelve months was −0.73 ± 0.51 D, with 86% within ±1.00 D of target. Uncorrected distance visual acuity (UDVA) was 20/20 or better in 74% of eyes at twelve months. No patients lost ≥2 lines of corrected distance visual acuity (CDVA) at twelve months. The mean angle of error was −0.9 ± 10.2° at three months and −1.6 ± 12.8° at twelve months. One patient required bilateral lens rotation, four patients underwent secondary enhancement with LASIK/PRK, and seven patients underwent postoperative limbal relaxing incisions. Conclusion: This initial single-site experience finds Toric ICL implantation for myopic astigmatism to be safe and effective. Patients can achieve markedly improved UDVA in a single surgery with stable vision over time and minimal adverse subjective symptoms.

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Section: Introductionmentioning

confidence: 99%

Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism

Moshirfar¹,

Bundogji²,

Tukan³

et al. 2021

OPTH

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“…Similar results demonstrating excellent long-term safety, predictability, and efficiency in addressing high myopic astigmatism were provided by Jabbour et al, who reported 3-year outcomes of spherical ICL followed by bioptics in eyes with high myopic astigmatism. 14 A recent analysis of the results of bioptics procedures for correction of high myopia (À16.50 to À28.00 D) by Brar et al revealed that most of the ICLs were the V4c model, which already came with a central port, and that the technique used for enhancement bioptics procedures was small-incision lenticule extraction. 10 Ten (67%) of the 15 eyes included in the study were within ± 0.50 D, whereas all eyes were within ± 1.00 D of spherical equivalent correction.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Visual outcomes of combined use of implantable collamer lens implantation and laser corneal visual correction for myopia over −18.00 diopters

Ortega-Usobiaga,

González-López,

Peng

et al. 2024

J Cataract Refract Surg

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Purpose: This retrospective comparative case series explores visual outcomes in patients with extreme myopia receiving an implantable collamer lens (ICL) at –18.00 diopters (D), with central port, followed by bioptics via laser vision correction (LASIK or PRK) to address residual myopia or myopic astigmatism. Setting: The study was conducted at Clínica Baviera – Aier Eye Hospital Group, Spain. Design: Retrospective analysis of cases. Methods: The study assessed uncorrected distance visual acuity, corrected distance visual acuity (CDVA), predictability, safety, efficacy, and patient satisfaction after implantation of the ICL and bioptics. The model implanted was V4c and EVO (Staar Surgical), with a correction of –18.00 D. Bioptics were performed at least 3 months after implantation, and patients were followed up for at least 3 months after LASIK or PRK. Results: The analysis included 125 eyes from 90 patients. Of these, 51.2% underwent LASIK and 48.8% PRK. Mean time from implantation to bioptics was 5.9 ± 9.4 months. Patients were followed up for a mean of 40.2 ± 37.9 months after bioptics. Median manifest refractive spherical equivalent was –2.89 D before bioptics and –0.49 D after. Median CDVA was 0.18 logMAR before bioptics and 0.17 after. The mean safety and efficacy indices were 2.22 ± 1.88 and 2.06 ± 1.85, respectively. Conclusion: Visual outcomes and safety indices following ICL implantation and subsequent LASIK or PRK in patients with extreme myopia are excellent.

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PRK plus crosslinking to correct refractive error after phakic intraocular lens repeated rotation: Bioptics Xtra

Balparda,

Herrera-Chalarca,

Franco-Sánchez

et al. 2024

JCRS Online Case Rep

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Introduction: Phakic intraocular lens (IOL) surgery is generally considered safe; however, spontaneous IOL rotation can occur in some patients. Repeat spontaneous rotation of the IOL presents a significant challenge that requires careful management. Patient and Clinical Findings: A 30-year-old man underwent bilateral phakic IOL implantation for high myopia in the context of a borderline cornea, characterized by keratometric asymmetry and anterior elevation at the location of the thinnest corneal point. The IOLs experienced spontaneous rotation, which was initially managed by surgical repositioning. However, the IOLs rotated spontaneously again less than a week after the repositioning. Diagnosis, Intervention, and Outcomes: The patient underwent topography-guided photorefractive keratectomy (PRK) combined with accelerated crosslinking (30 mW/cm2 for 90 seconds, totaling 2.7 J/cm2) in both eyes. 6-month post-PRK Xtra, his uncorrected vision improved to 20/20 in the right eye and 20/25 in the left eye. The IOLs have remained stable in their final rotated positions. Conclusions: This is the first reported case, to the authors' knowledge, of using PRK Xtra to manage residual refractive error in a patient experiencing repeated spontaneous rotation of phakic IOLs. This technique is feasible and may serve as an alternative to IOL exchange. It has been named “Bioptics Xtra.”

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Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement (“Bioptics”) in the Treatment of High Myopic Astigmatism

Cited by 5 publications

References 28 publications

Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism

Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism

Visual outcomes of combined use of implantable collamer lens implantation and laser corneal visual correction for myopia over −18.00 diopters

PRK plus crosslinking to correct refractive error after phakic intraocular lens repeated rotation: Bioptics Xtra

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