Open AccessRepeated rotation of a toric implantable collamer lens
Author(s) -
Haorun Zhang,
Mengjun Fu,
Jiahao Wang
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000024986
Subject(s) - medicine , rotation (mathematics) , refraction , visual acuity , clockwise , subjective refraction , optometry , astigmatism , ophthalmology , optics , refractive error , physics , artificial intelligence , computer science
Abstract Introduction: Implantable collamer lens have been used widely worldwide, and have been accepted by more and more doctors and patients due to good safety, stability, and effectiveness. However, there is still a problem of crystal rotation. The large angle rotation (over 10°) would weaken the original astigmatism correction effect and even induce irregular astigmatism, seriously affecting the visual quality of patients. Herein, we reported a case who had 2 times of crystal rotations after toric implantable collamer lens (TICL) implantation. Patient concerns: The patient was a 38-year-old man who underwent TICL implantation for the correction of high myopic astigmatism in eyes. He presented a sudden decrease in the visual acuity (VA) of the left eye 4 months after the TICL implantation. The uncorrected visual acuity (UCVA) was 8/20 (refraction, +2.25 −5.25 × 68). Diagnosis: Rotation of TICL was diagnosed. The toric marks with a rotation of 75° counter-clockwise from the original position were observed. Interventions: The TICL was re-set to the original position, leading to the UCVA of 12/20 in the left eye (refraction, −0.00 −0.75 × 131), with the vaulting of 589 μm. Ten months after the TICL relocation, the patient again presented a sudden decrease in the VA of the left eye, with the UCVA of 2/20 (refraction, +2.25 −5.00 × 66). Again, the toric marks with a rotation of 75° counter-clockwise from the original position was observed, just at the same position as the last rotation. This time, the TICL was removed. The axis and power were recalculated, and a new TICL was implanted, with the rotation of 73° counter-clockwise from the horizontal line of the temporal side. Outcomes: The patient obtained a final UCVA of 12/20 in the left eye (refraction, +0.50 −0.50 × 26), which remained stable in the 6-month follow-up period, with the vaulting of 602 μm. Lessons: Rotation is a common complication after TICL surgery. Relocation or replacement of TICL are safe and efficient ways to recover VA due to TICL rotation.