Ocular higher-order aberrations changes after implantable collamer lens implantation for high myopic astigmatism

Purpose: To investigate the changes in higher-order aberrations (HOAs) induced by the implantation of implantable collamer lenses (ICLs) and Toric ICL (TICL) in eyes with high myopia and high myopic astigmatism. Methods: We investigated 33 eyes of 18 consecutive patients (in a prospective, interventional case series study), with spherical equivalent errors of 6.00 to 21.09 diopters (D) and cylindrical errors of 0.5 to 4.75 D, who underwent ICL and TICL implantation. Before and after 5 days, 2 and 6 months of surgery, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), defocus and adverse events of the surgery were assessed. Ocular HOAs were also evaluated by Hartmann-Shack aberrometry (Technolas PV, Rochester, New York, USA) before and after 6 months of surgery. Results: At 6.0 months after surgery, the UCVA and BCVA in 40% and 66.7% of eyes were 20/20, respectively. Mean defocus refraction and astigmatism was reduced to 0.66 and 0.65 D from 12.79 and 2.18 at baseline, respectively. For a 6 mm pupil, HOAs were not significantly changed, merely from 0.417 ± 0.162 m before surgery to 0.393 ± 0.119 m after surgery (P ¼ 0.45). Spherical aberration (Z400) increased significantly (P ¼ 00.0). Surgical induced astigmatism was lower than 0.25 D, and there were no changes in trefoils and coma aberration. No vision-threatening complications occurred during the observation period. Conclusion: This study shows that the ICL and TICL performed well in correcting high myopic astigmatism without significant changes in HOAs during a 6-month observation period, although the spherical aberration (Z400) increased significantly.