Visual Outcomes And Patient’s Satisfaction After Icl And Ticl Correction For Moderate To High Myopia And Myopic Astigmatism
Ammar Hamood Nasser Al-Arabi, Mahfouth Abdullah Bamashmus, Mohamed Elhassan Ali Elawad
كلية الدراسات العليا-جامعة النيلين · السودان
ABSTRACT The study aimed to determine pre and postoperative visual outcomes, patient’s satisfaction, correlations between satisfaction’s scale and clinical parameters, evaluate visual symptoms, and to identify factors that motivate patients to seek ICL and TICL for high myopia and myopic astigmatism.This prospective study included 204 eyes of 112 patients (79 females and 33 males) who had undergone ICL and TICL treatment to correct myopia and myopic astigmatism, their ages ranged between 18 and 45 years participating in the Yemen Magrabi Eye Hospital (Sana’a). The procedures were performed by two surgeons. Clinical data from pre and postoperative examinations documented included uncorrected visual acuity (UCVA), best spectaclecorrected visual acuity (BSCVA), intraocular pressure (IOP), and refraction. Subjective patient satisfaction evaluation of the treatment was assessed by a questionnaire self-administered by patients at 3 months postoperatively.The study revealed the following results: The preoperative mean manifest refraction spherical equivalent (MRSE) in myopia was -9.66 ±3.96 D and mean manifest cylinder was 1.85±1.33 D. At 3 months of ICL surgery, the spherical equivalent in myopia and cylinder was - 0.31±0.56 D and 0.32±0.53 D respectively. 26.5% of eyes had MRSE between (-0.25 and -0.50D) 8.8% had a MRSE of (-.75 to -1.00D), 4.0% had a MRSE between (-1.25 and -2.00D) and only 2.4% had a MRSE between (-2.25 and 4.00D) of the targeted correction. At 3 months postoperatively, 24.5% of eyes (n=50) with 20/20 UCVA compared to 10.3% of eyes (n=21) with 20/20 preoperative BSCVA. The study showed means IOP were 13.6±2.39 ranged (10 to 19 mmHg) preoperatively, and 15±2.52 ranged between (10 and 21 mmHg) postoperatively, no significant difference.The mean score for the overall satisfaction was 2.67±0.45 (SD) (scale 1 to 3). A total of 98.2% of patients were happy with their surgery, 99.9% considered their main goal of surgery achieved, all patients 100 % recommends ICL treatment to a friend. Satisfaction with uncorrected vision was 2.56±0.59 (SD). A total of 15.2% of patients (n=17) reported complaint of haloes, 13.4% (n=15) reported complaint of perception of stars around lights, and 23.2% (n=26) had complaint of glare.The present study showed significant positive correlations between global satisfaction and mean post-op UCVA(r = 0.228, P = 0.029), also showed significant negative correlation between global satisfaction and mean post-op SE (r = -0.261, P = 0.012).Self-perceived uncorrected vision after ICL surgery for the correction of myopia and myopic astigmatism appears to be very good and is related to the postoperative residual error. The findings of this study were consistent with other studies and confirmed that ICL achieved high patient satisfaction with only a small numbers of dissatisfied patients. This study suggested that ICL and TICL is an effective procedure for the treatment of moderate to high myopia and myopic astigmatism with comparable refractive and visual outcomes.Key wordsImplantable collamer lens, myopia, Refraction, Vision, Visual acuity, Overall satisfaction, Correlations