Comparison Of ICL Implantation Combined With Modified LRI And TICL Implantation In The Treatment Of High Myopia With Astigmatism

Objective:To explore the efficacy of ICL implantation combined with modified LRI and TICL implantation in the treatment of high myopia with astigmatism.Methods:From January 2020 to July 2021,we selected 81 eyes of 57 patients with high myopia and astigmatism who were operated in the Department of refraction,affiliated ophthalmic hospital of Nanchang University and were randomly divided into lytic group(22 cases,40 eyes)and treated with ICL V4 c implantation combined with modified LRI,41 eyes of 35 cases in the TICL group underwent TICL implantation only.UDVA,CDVA,IOP,SE and optometry were enforced before surgery and 1 day,1 week,1 month and 3 months after surgery.Alpins vector analysis was used to calculate the relevant parameters such as TIA,SIA,DV,CI and IOS,and to evaluate the efficacy of the two surgical methods in correcting astigmatism.Results:There was no significant difference in preoperative age,intraocular pressure,spherical lens power,cylindrical lens power,UDVA and CDVA between the lytic group and the TICL group(All P>0.05).The UDVA of the lytic group before and 3months after surgery were(1.27±0.39)Log MAR,(-0.01±0.03)Log MAR;the TICL group was(1.19±0.38)Log MAR,(-0.01±0.04)Log MAR;the UDVA of the two groups after surgery was higher than that before surgery,and the difference was statistically significant(P<0.05).Three months after surgery,there was no significant statistical difference in UDVA between the two groups(P=0.91).The mean preoperative astigmatism of the lytic group before and 3 months after surgery were(2.14±0.39)D,(0.26±0.24)D;the TICL group was(2.13±0.38)D,(0.26±0.27)D;the mean preoperative astigmatism after surgery was significantly lower than that before surgery between the two groups,and the difference was statistically significant(all P<0.05).The results of corneal astigmatism vector analysis showed that the TIA of the two groups before surgery were(2.14±0.39),(2.13±0.38),with no significant difference(P=0.81);three months after surgery,the SIA of the two groups were(1.97±0.48),(2.19±0.49),and the difference was not statistically significant(P=0.07);The postoperative IOS of the two groups were(0.13±0.13),(0.12 ± 0.12),with no significant difference(P=0.89);The CI of the two groups were(0.92±0.13),(1.03±0.07);the difference was statistically significant(P<0.001),indicating that there was slight undercorrection in the lytic group.Conclusion:ICL V4 c implantation combined with modified limbal relaxing incisions and TICL implantation are safe and effective in the correction of high myopia with astigmatism.