Five-Year Follow-up of Toric Posterior Chamber Phakic Intraocular Lens With Central Port Design in Patients With Low...

To assess the clinical outcomes and postoperative complications of the EVO Toric Implantable Collamer Lens (TICL) (STAAR Surgical) with a central port correction over a 5-year follow-up in patients with low and normal vault.

This retrospective study included 240 eyes from 120 patients divided in two groups based on early postoperative vault: low (< 250 μm; n = 77) and normal (⩾ 250 μm; n = 163). Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, astigmatism vectorial analysis, complications, and secondary surgeries were assessed at 1 month, 12 months, and 5 years postoperatively.

At 5 years, both groups showed significant improvement in UDVA and CDVA (P < .001), with no intergroup differences. The safety index was 1.17 ± 0.25 in the low vault group and 1.18 ± 0.32 in the normal vault group (P = .634); efficacy index was 1.02 ± 0.24 and 1.00 ± 0.29, respectively (P = .542). Manifest cylinder at 5 years was similar between groups: -0.41 ± 0.56 and -0.48 ± 0.61 diopters (P = .526). Both groups demonstrate a similar tendency for undercorrection, with target induced astigmatism values higher than surgically induced astigmatism values, at 1 (P = .813) and 5 (P = .466) years. The mean deviation vector and correction index was statistically similar between groups (P > .05). The absolute mean angle of error was also similar between groups (P = .128). TICL axis repositioning occurred in 4 cases (5.19%) in the low vault group and in 5 cases (3.08%) in the normal vault group.

TICL implantation provides excellent long-term refractive and rotational stability regardless of vault height. Low vault was not associated with significant safety concerns, supporting TICL efficacy across a broad range of postoperative vault values.