Visual and optical performance before and after rotation of a misaligned STAAR Toric Implantable Collamer Lens

To document the use of the NIDEK OPD-Scan II/Station as a monitoring tool and clinical aid in the evaluation and re-rotation of a misaligned STAAR Toric Implantable Collamer Lens (TICL).

A 22-year-old man underwent bilateral TICL implantation. Emmetropia was achieved in the left eye after TICL implantation; however, the right eye showed residual compound myopic astigmatism. Both eyes were evaluated using the OPD-Scan II/Station, and re-rotation of the TICL in the right eye was planned using the internal wavefront and corneal topography maps. The remaining residual error after re-rotation was treated using photorefractive keratectomy (PRK).

The left eye showed excellent axis alignment and optical quality. The right eye showed a difference of 8 degrees to 10 degrees in axis of orientation and an under-calculation of the lens power, which resulted in poor optical quality. After rotation of the lens and PRK, emmetropia was achieved and the patient reported resolution of symptoms. Higher order aberrations were reduced by 0.535 microm and the modulation transfer function increased 42% compared to initial TICL implantation.

Internal and corneal surface aberrometry allowed proper evaluation and precise realignment of a TICL. The objective assessment of the internal astigmatism, optical quality, and visual performance aids in planning complicated surgical cases that require combination surgery to restore visual quality.