1. Collamer copolymer lens for hyperopia and astigmatism
First experience with
Collamer copolymer lens
for hyperopia and astigmatism
Jaime Aramberri
(SPAIN)
Ó k u l a r
Vitoria-Gasteiz
Financial Disclosure: Staar Surgical has paid travelling costs to this meeting

2. INTRODUCTION
Since 2010 Visian ICL (Staar Surgical) can correct mixed astigmatism and
hyperopic astigmatism
This is the first phakic IOL than can correct such
refractive defects through small incision (2.7 mm)
This poster presents the first cases implanted in
the world with > 6 months follow up.

3. PATIENTS AND METHODS Seeking for refractive surgery
Hyperopia and astigmatism
No general or ocular illness
No familiar hystory of glaucoma
ACD (endoth.-lens): > 2.8 mm ( Scheimpflug image)
Personal nomogram combining:
Sulcus to sulcus (UBM)
ACD (Scheimpflug)
HWTW (Scheimpflug)
INCLUSION CRITERIA
ICL SIZING
Corneal marks: Slit lamp
Topical anesthesia (5% lydocaine)
2.75 mm temporal limbar incision
Healon™, Acetil coline;
SURGERY
Subj/Obj cyclo refraction
Total aberrometry (COAS, Wavefront Sci)
Scheimpflug tomography (Sirius, CSO; Galilei, Ziemer)
Corneal Hysteresis (ORA, Reichert)
Ocular biometry (Lenstar, Haag Streit)
UBM (Vumax II ,Sonomed)
YAG iridotomy (x2)
ICL sph and cy calcs by STAAR
PREOP STUDY
6 months
Vault measurent: OCT (RTVue, OptoVue)
FOLLOW UP

4. RESULTS
AGE
SPH
CYL
AXIS
SPH CYCLO
Sph Eq
BCVA P. J. 27 OD 4 -3 10
5.5 1 OS
6.25
-3.75
155
7.5
5.62 S. A. 42 5
-2.5 20 7
5.75
0.45 L. 29
6.75
-4.75 15
7.75
5.37
0.9
8.5
-5.75
173
9.5
6.62
0.55
7.50
5.63
0.90
1.72
1.32
1.44
0.95
0.26
PREOP
MEDIAN
STD DEV
SURGERY
ICL SIZE
ICL SPH
ICL CYL
ICL AXIS
UCVA
BCVA
VAULT
SPH
CYL
AXIS
Sph Eq
17/06/2010
12.6 2 4 97 1
640
10/06/2010
4.5
5.5 67
620
07/06/2010
3.5
118
0.45
600
0.5
-0.5 20
0.25
12.1 6 82
0.95
200
31/05/2010 3
103
0.50
350
-1.25
170
-0.12
4.50
5.50
-0.50
0.00
1.56
1.17
0.29
0.28
197
0.27
0.51
0.17
POSTOP
MEDIAN
STD DEV

5. VECTOR ANALYSIS (Alpins method)
RESULTS
VECTOR ANALYSIS (Alpins method)
SPH
PREOP
CYL PREOP
AXIS PREOP
SPH POSTOP
CYL POSTOP
AXIS POSTOP
TIA
TIA AXIS
SIA
SIA AXIS DV
DV AXIS
ERROR MAGNITUDE
ANGLE OF ERROR
CORRECTION ANGLE
ADJUSTM. COEFF.
INDEX OF SUCCES 4 -3 10
0.01 3
2.99
180
-0.01 60
1.00
0.00
6.25
-3.75
155
3.75
3.74 5
-2.5 20
0.5
-0.5
2.5
2.00
-0.50 80
1.25
0.20
6.75
-4.75 15
4.75
4.26 14
-0.49 -1
1.12
0.11
8.5
-5.75
173
-1.25
165
5.75
4.56
175
-1.19 2 45
1.26
0.22
0.50
1.32
1.03
0.51
0.48
0.13
0.10
MEDIAN
STD DEV
PREOP / POSTOP
SIA

6. SUBJECTIVE VISUAL QUALITY
SPH
CYCLO
Eq Sph
CYL
0=Very bad
1=Bad
2=Regular
3=Godd
4=Very good
All eyes were scored 4
Surgical Incidences: No incidence was reported. Lens manipulation was
undistinguishable from other models (ICH, ICM or TICM)
Postop Incidences: Eye nº 5 had a postop Rx = +1 sph cyl x 165º since first
postop day. Misalignment was surgically corrected on Oct 5th
Safety index: (BCVA postop / BCVA preop): 1.00
Efficacy index: (UCVA postop / BCVA preop): 0.99

7. DISCUSSION
First cases implanted with the new hyperopic toric ICL show an excellent
efficacy / safety balance in 6 months follow up.
Postoperative UCVA was very close to preop BCVA showing a very accurate sphere and cylinder lens calculation.
There was no difference between BCVA pre and postop. No patient lost VA lines and all of them were subjectively satisfied with visual quality. No haloes
or other optic secondary effects were reported.
Cartridge loading, intraocular injection, unfolding and sulcus placement
maneouvres were similar to other ICL models

8. DISCUSSION
The new hyperopic toric (VTICH) ICL corrects
such errors through small incision (2.75 mm)
There are some design differences respect
the old ICH (hyperopic) or TICM (toric myopic) models:
4 penetrating holes
2 longer alignment marks
Stored in BSS:
The available dioptric range is: 0 to +10 (sph) and 0.5 to 6 (cyl)
Optical zone is 5.73 mm for all hyperopic toric ICLs.

9. CONCLUSSIONS
First experience with the new hyperopic toric (VTICH) ICL is very promising
Refractive correction efficacy is high: Both in terms of Sph. Equivalent and
astigmatism
Safety is very good with no VA impairment or optical side effects

10. Thank You