Comparison of toric implantable collamer lens and bioptics for correction of high myopia with astigmatism

This work aims to offer a comparison of toric implantable collamer lens and bioptics for correction of high myopia with astigmatism, focusing on their clinical efficacy, safety profiles, complications and patient satisfaction. High myopia with astigmatism poses significant challenges to visual correction, affecting not only the quality of life but also daily functioning. Toric Implantable Collamer Lenses (TICL) and Bioptic (implantation of spherical ICL followed by laser vision correction to the residual astigmatism) procedures, represent two effective surgical interventions for correction of high myopia with astigmatism. This study was designed as a prospective interventional case study. Thirty-six eyes with High myopia with astigmatism were enrolled: 18 eyes of 11 patients (7 patients had bilateral surgery and 4 patients had unilateral surgery) underwent Toric ICL while 18 eyes of 10 patients underwent Bioptics (8 patients had bilateral surgery and 2 patients had unilateral surgery). Spherical and astigmatic refractive errors, spherical equivalent, UnCorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA), satisfaction score, predictability, efficacy, safety and complications were reported in all cases during the postoperative follow up period which extended to 18 months with the average of 12 months. We observed that the postoperative (UCVA) was comparable in both TICL and Bioptics, even though postoperative UCVA was higher in bioptics group. As regard postoperative spherical equivalent, no statistically significant difference was detected between both groups ( p = 0.353). Regarding safety, efficacy and predictability, all were comparable in both TICL and bioptics, although efficacy index was slightly higher in the TICL group. Also, mean safety was higher in the TICL group. While, predictability was higher in the bioptics group may be due to the slightly better results of the astigmatic component. Both TICL and Bioptics are excellent options for correction of high myopia with astigmatism, Both showing comparable refractive and visual results and satisfaction scores.