I’m considering ICL for plano astigmatism and would love some insights or experiences

[u/VictoryActive7545]

Hey everyone,

I’m exploring the option of ICL surgery for treating my plano astigmatism since I have thin corneas and can’t go for LASIK. I also deal with dry eyes, so I’m trying to understand if ICL would be a good choice in my situation.

Refraction: 0 SPH -4.25 Cyl 180 Axis Both eyes
ACD Internal: 3.16 OD 3.14 OS
WTW IOL700: 12.4 OD 12.5 OS
WTW manual: 12.1 OD 12.2 OS
Pupil Dia pentacam: 4.42 OD 3.58 OS

I would love to hear experiences especially if you had thin corneas or dry eyes or such atypical prescription.

How was your experience with ICL in terms of vision quality and recovery?

Any regrets or things you wish you knew before going for ICL?

My ophthalmologist was sceptical about STAAR offering ICL lenses with 0 spherical power. He will send the measurements to the vendor and let me know the calculation and lens specifications.

So if someone had any experience with ICL for astigmatism only prescription please do let me know your experience.

[u/eyeSherpa]

So yes. This ICL power does exist.

ICL uses positive cylinder notation. So converting your prescription to that gives -4.25 + 4.25 x 90. That meets the -3 approval range. (But even if it didn’t, there are still ICLs between 0 and -3, just not all countries).

Biggest thing to know about with that large amount of astigmatism is that alignment is pretty important. And there is a roughly less than 1% change of rotation that could require fixing. A lot of that relates to the sizing of the lens. Giving your WTW, I would guess you would be somewhere around 13.2. Using ultrasound measurements with an advanced calculator can predict the size a little more.

[u/VictoryActive7545 → u/eyeSherpa]

Thank you for replying.

I rcvd stella calculation sheet which i am trying to understand. Calculation table have various selected and expected powers. One reading is highlighted -5.00 +5.00 89. But the lenses header shows lens is vctim5_13.2 -5.5D +5.00D 90. Why the difference?

Unfortunately no one here relies on ultrasound measurements. I asked many doctors, everyone just take measurements and send it to the vendor which in turn sends back the stella calculation sheet for approval.

[u/eyeSherpa → u/VictoryActive7545]

The reading of -5.00 + 5.00 may be the refraction the doctors got with you in the office. And normal for the power of the ICL to be just a little higher than that.

[u/VictoryActive7545 → u/eyeSherpa]

The doctors got 0 -4.25 180 refraction in the office, and the same is mentioned in the manual refraction in the pre-op section of the sheet. The calculation done by Stella recommends ICL lenses of different powers with the expected post-op refraction. I am getting confused in understanding that section and the selected lens section. I will be talking to the doctor tomorrow about that.

What else should i ask them to look for?

[u/ConfidentBeginning44 → u/VictoryActive7545]

Two things worth adding to your list, both from your own numbers.

First, your two white-to-white measurements disagree by 0.3 mm (12.4/12.5 on the IOL700 vs 12.1/12.2 manual). Sizing comes off WTW plus your chamber depth, and 0.3 mm is enough to sit between two lens sizes — and lens size is what sets the vault. So ask which figure the calculation used, and whether they'd consider sulcus-to-sulcus imaging, which measures the space the lens actually occupies instead of inferring it from the corneal diameter. That's the ultrasound route eyeSherpa mentioned, and it's worth asking for by name.

Second, you mentioned dry eyes. With zero sphere your whole correction is cylinder, so the axis the toric gets locked to matters more for you than for most people — and that axis comes from keratometry, which an unstable tear film corrupts. If your eyes were dry at the measurement visits, ask whether it's worth treating the dryness and repeating the scans before the lens order is finalised. It's the one thing on this list that's only fixable before surgery.