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Toric and Phakic IOLs for the Treatment of Astigmatism and/or High Myopia: Our Experience at Prince Hashem Hospital Zarqa

Aim: to share our experience in treating patients with high myopia and or astigmatism  using toric and phakic intraocular lenses at Prince Hashem Hospital in Jordan. 
Patients and Methods: This is a retrospective study of fifty eyes of 36 patients who were treated between June 2015 and July 2016 at Prince Hashem Hospital in Jordan. Patients’ age ranged between 22 years and 54 years. All patients had high myopia (≥6 dipoters) and/or astigmatism and were not eligible for surface laser ablation and intolerant to contact lenses. Preoperative best corrected visual acuity BCVA, ophthalmological slit lamp examination, manifest and cycloplegic refraction, corneal topography using Oculus Pentacam and IOL master were obtained in all patients. 
Results: In all the patients preoperative refraction ranged between -4 to -33 sphere and -3.5 to -8 cylinder. Phacoemulsification and implantation of toric intraocular lenses (IOL) was done in 21 patients, Visian implantable collamer lens (sphere and toric ICL) were implanted in 18 patients and toric iris claw lenses (Ophthec Artisan/ Artiflex) were used for the remaining 11 patients. All surgical procedures were done under local anesthesia. All patients showed improvement in their visual acuity after surgery and spectacle independence. 
Complications were minimal in the form of lens rotation resulting in decrease in BCVA seen in 3 patients with toric IOLs and two Visian ICLs patients.  High intraocular pressure was seen in one patient. 
Mean follow-up period was between 6 months to 1 year. 
Conclusion: Toric and phakic IOLs can be very useful in correcting astigmatism and or myopia. Proper patient selection and counseling is essential to ensure best refractive outcome and avoid complications.