Comparison of Toric Implantable Collamer Lens and Toric Artiflex Phakic IOLs in terms of Visual Outcome, A paired Contralateral Eye Study

Abstract: Purpose To compare the postoperative visual outcomes of toric implantable collamer lens (T-ICL) and toric Artiflex (T-Artiflex) implantation. Design Alternating-treatment, contralateral eye matched clinical study Methods This study compared 82 eyes of 41 patients with toric ICL implantation in one eye and toric Artiflex implantation in the contralateral eye to correct myopic astigmatism. Safety, efficacy, predictability, astigmatic vector changes, contrast sensitivity, endothelial cell count, and possible adverse events were assessed at least 12 months postoperatively. Results After a mean follow-up of 12 months, the safety index was 1.40±0.70 (mean ± SD) in T-ICL group and 1.20±0.21 in the T-Artiflex group. Further, their mean efficacy index was 1.24±0.42 and 1.08±0.23, respectively (p=0.029). Thirty nine (95%) eyes in the T- ICL group and 41(100%) eyes in the T-Artiflex group were within ±1.00 D of emmetropia and 33(80%) eyes and 34(83%) were within ±0.5D of emmetropia, respectively. Vector analysis revealed mean index of success as large as 0.25±0.22 in the T-ICL group and 0.24±0.15 in the T-Artiflex group. Post-operative contrast sensitivities were equal in both groups under mesopic condition for any given spatial frequency. There was 2.18% and 1.95% endothelial cell loss In the T-ICL and in T-Artiflex groups, respectively. There was no significant complication in any of the groups. Conclusion Both lenses showed promising results in terms of safety, efficacy, and predictability for correction of myopic astigmatism. As shown in this paired eye study, most outcomes were almost identical and neither of these lenses were clinically superior to the other.