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Correction of High Myopic Astigmatism by Toric Implantable Contact Lenses (T-ICL).

Andrey I. Kovalev , Oksana S. Averyanova AILAS Medical Center Kiev, Ukraine. Correction of High Myopic Astigmatism by Toric Implantable Contact Lenses (T-ICL). The authors of this poster have no financial interest in any products and technologies mentioned in this presentation. Introduction.

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Correction of High Myopic Astigmatism by Toric Implantable Contact Lenses (T-ICL).

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  1. Andrey I. Kovalev, Oksana S. Averyanova AILAS Medical Center Kiev, Ukraine Correction of High Myopic Astigmatism by Toric Implantable Contact Lenses (T-ICL). The authors of this poster have no financial interest in any products and technologies mentioned in this presentation.

  2. Introduction • Key point of successfulT-ICL implantation is exact lens axis alignment. • Starting point: estimation and marking of main meridian of the cornea (horizontal or vertical). • Second step: having main meridian as a reference, estimation and marking of the exact meridian of the lens alignment.

  3. Classical 2 Steps Approach for Estimation and Marking of Corneal Meridians: First Step (Pre-Operative): Second Step (Intra-Operative): • Estimation and Marking of Horizontal Meridian: • «By Sight» • By Gravity Marker • By Horizontal Slit of Slit Lamp • marking of the exact meridian of the lens alignment (Mendoz Ring or Similar Instruments).

  4. Advantages and Disadvantages of 2 Steps Classical Corneal Marking: Advantages: Disadvantages: ? ? ? ? ? • Time Consuming • Additional Intra-Operative Manipulations • Grating Period of Instruments – 10 Degree of Arc = Low Accuracy

  5. Optimal Marking: • Pre-Operative • One Step • By Precision Protractor Optimal Instrument: Slit Lamp with 360° ocular protractor

  6. Corneal Marking, NOT Conjunctival • Conjunctival Marker size • is ≈ 5 Degree of Arc • Corneal Spatula • is More Precise

  7. Purpose: Methods: • To evaluate the efficacy, safety and stability of High Myopic Astigmatism correction by Phakic Posterior Chamber Toric Intraocular Lens (T-ICL, STAAR, Switzerland). • Retrospective analysis of 2 Groups of Patients withHigh Myopic Astigmatism corrected by T-ICL implantation. • Both groups were matching in age, statue and degree of myopia: Patients were followed up 1 day, 1 week, 1, 3, and 6 months postoperatively.

  8. Group 2: 89 T-ICLs Group 1: 33 T-ICLs • T-ICLs aligned by direct preoperative marking of horizontal and exact axis of the lens orientation under SL with 360° ocular protractor + • limbal-corneal tunnel • T-ICLs aligned by classical 2 Steps procedure + • clear corneal tunnel • Real T-ICL patient photo

  9. Results: 6 months

  10. Comments: • Twice Better Alignment of the Lenses in Group 2. • Twice Less Corneal Astigmatism Induced in Group 2 NO T-ICL Rotation in Any Group of Patients

  11. Conclusions: • Toric ICL are safe and effective for correction of High Myopic Astigmatism. • Limbal (versus Clear Corneal) tunnels are more astigmatically neutral. • Preoperative meticulous marking of the axis under SL facilitates more accurate alignment of the lenses. • T-ICLs have very good rotational stability.

  12. www.ailas.com.ua Thank You for Attantion

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