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Safety and Efficacy of Toric ICL John Chang Jr. MD Director of Guy Hugh Chan Refractive Surgery Centre Hong Kong Sanatorium & Hospital April 2008 ASCRS.

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Presentation on theme: "Safety and Efficacy of Toric ICL John Chang Jr. MD Director of Guy Hugh Chan Refractive Surgery Centre Hong Kong Sanatorium & Hospital April 2008 ASCRS."— Presentation transcript:

1 Safety and Efficacy of Toric ICL John Chang Jr. MD Director of Guy Hugh Chan Refractive Surgery Centre Hong Kong Sanatorium & Hospital April 2008 ASCRS

2 Toric Implantation Collamer Lens (TICL) is now in phase III of the U.S. FDA study

3 TICL Lens power range (Visian TICL) Sphere ranges from -3D to - 23D Cylinder ranges from +1DC to +6DC Customized axis Can correct up to -18DS/- 0.75DC or -14DS/-5.0DC From 04/2004 to 04/2007 No. of patients:27 No. of eyes:42 Bilateral TICL:15 Age range:23 to 44 yrs Mean age:32.1 ± 6.7 yrs Mean FU:6 months

4 TICL - Results PreOpPostOp at 12M Mean Sphere ± 2.83D-0.20 ± 0.42 D Range-7.00 to D+0.50 to -1.0D Mean cyl 2.64 ± 0.89D 0.60 ± 0.49D Range1.00 to 4.50D0 to 2.0D Mean MSE ± 2.79D+0.10 ± 0.33D Range-6.00 to D-0.50 to 1.13D

5 TICL - Results Within ± 0.5DWithin ± 1.0D MRSE95% Cylinder57%91% PostOp Rx at 12M

6 TICL - Stability

7 TICL - Results – 12M

8 TICL - Safety – 12M No eye lost any vision

9 TICL - Complications 1 eye (2.9%) transient IOP rise at 1 month Steroid induced 1 lens rotated 15 o clockwise Patient with RE preop Rx /+3.50 x100 Implanted with TICL -23.0/+3.50/099 After surgery the lens rotated clockwise by 15 o Residual Rx -2.00/+2.50x120 (20/20), UCVA 20/80 Lens dialed 6M after surgery UCVA 20/25; MRx -0.50/+1.00 x 65 (20/20)

10 TICL - Surgical Technique Same as Non Toric Laser PI 1week prior to lens implantation Temporal mm self sealing incision Lens injected via foldable injector into AC Lens dialed into sulcus Surgery done under topical anesthesia Toric lens supplied correct Power for Sphere and Cylinder but axis can be different by up to 22 o During surgery the axis of the lens to be positioned is marked. Temporal incision is made to match that axis Need to dial lens into position (surgical planner software supplied)

11 TICL - Advantages & Disadvantages Advantages Technically not difficult (Avg surgery time 25 mins) No / Minimal night vision problems Short learning curve – easier than Phaco Lens is removable Disadvantages Sizing can be difficult, Orbscan not always reliable Sizing even more important than non-toric ICL Glaucoma? Pigment dispersion? Expensive 2 Procedures: Laser P.I. First (uncomfortable), then lens implantation

12 TICL - Conclusion Toric ICL results very encouraging (100% 20/20 UCVA) Transient IOP rise 2° to steroid use Accuracy as good / better than LASIK for high myopia Much better immediate and long term stability than LASIK. No cataract with TICL


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