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Year : 2023  |  Volume : 116  |  Issue : 1  |  Page : 15-23

Toric implantable phakic contact lens versus bioptics for the correction of moderate to high myopia and astigmatism

Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
MBBCh, MSc, MD Hoda T El Shiwy
Department of Ophthalmology, Faculty of Medicine, Kasr Al Ainy Hospitals, Cairo University, PC 11559, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejos.ejos_116_22

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Purpose To compare refractive and visual outcomes and patient satisfaction of toric implantable phakic contact lens (T-IPCL) versus bioptics (IPCL followed by femtosecond laser assisted in-situ keratomileusis) in myopia (moderate to high) with astigmatism. Patients and methods A total of 13 eyes underwent T-IPCL implantation, and 11 eyes were corrected using bioptics. Complications, uncorrected and corrected distance visual acuities, refraction, safety, efficacy, predictability, tear-film break-up time, contrast sensitivity, and patient satisfaction were assessed 6 months postoperatively. Results No complications were reported. Mean spherical equivalent was −0.62±0.49 D in T-IPCL and −0.55±0.26 D in the bioptics group (P=0.464). In 10 (76.9%) eyes of T-IPCL and 11 (100%) eyes of bioptics, the spherical equivalent and astigmatism were within ±1 D, respectively. A significantly better astigmatic correction was demonstrated in the bioptics group as confirmed by vector analysis (P<0.001). Loss of lines was not reported; both uncorrected and corrected distance visual acuities improved significantly (P<0.05), with no significant differences (P>0.05). Safety indices were 1.15±0.08 and 1.1±0.09 and efficacy indices were 1.04±0.11 and 1.03±0.06 in T-IPCL and bioptics groups, respectively, which were insignificant. The contrast sensitivity and tear-film break-up time were significantly better in the T-IPCL group (P<0.001). Distant vision satisfaction was better in the bioptics group, whereas glare, halos, and dry eye satisfaction were better in the T-IPCL group (P<0.05). Conclusion Both T-IPCL and bioptics can successfully correct moderate to high myopia with astigmatism. The T-IPCL carries better optical quality with less glare, halos, and dry eye. Bioptics gives better astigmatic correction and distant vision satisfaction but carries the risk of a second surgical intervention.

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