Posterior chamber collamer phakic intraocular lens implantation: Comparison of efficacy and safety for low and moderate-to-high myopia

Abstract

Purpose: To compare visual, refractive and safety outcomes of central-hole posterior chamber collamer phakic intraocular lens implantation for low and moderate-to-high myopia. Subjects/methods: This retrospective cohort study included 338 eyes submitted to posterior chamber collamer phakic intraocular lens implantation that completed a 12-month postoperative follow-up. Two groups were defined depending on preoperative spherical equivalent: group 1 comprised 106 eyes with manifest spherical equivalent of −6.00 D or less; group 2 comprised 232 eyes with manifest spherical equivalent higher than −6.00 D. Effectiveness, predictability, stability and safety outcomes were compared preoperatively and at 1, 6 and 12 months postoperatively. Results: At 1-year postoperative, uncorrected and corrected visual acuities were 0.02 ± 0.17 and −0.01 ± 0.12 logMAR (group 1) and 0.04 ± 0.20 and 0.01 ± 0.16 logMAR (group 2), with an efficacy index of 1.05 ± 0.17 and 1.17 ± 0.28. Respectively, 92 (86.8%) and 199 (85.8%) eyes were within ±0.50 D of targeted refraction, and postoperative manifest refraction changes were −0.07 ± 0.25 D and −0.07 ± 0.35 D. Intraocular pressure did not change significantly. The mean rate of endothelial cell loss was 1.12% and 1.10%, respectively. One case of anterior subcapsular cataract (group 2) was observed. ICL exchange occurred in one case (group 1) and three cases (group 2). No vision-threatening complications were reported. Conclusion: The posterior chamber collamer phakic intraocular lens implantation demonstrated high visual and refractive efficacy with an excellent safety profile for the correction of both low and moderate-to-high myopia, revealing equivalent 1-year outcomes regardless of the degree of preoperative myopia.

Eight-Year Outcomes of Implantation of Posterior Chamber Phakic Intraocular Lens With a Central Port for Moderate to High Ametropia

“…The EVO ICL with central port technology (KS-AquaPORT V4c and V5; EVO-ICL) was first developed by Shimizu et al ( 7 , 8 ) to rectify such drawbacks without significant deterioration in visual performance ( 9 ). It has been reported to effectively correct not only moderate to high myopia ( 10 – 14 ) but also low to moderate myopia ( 15 , 16 ). Moreover, ICL surgery is mainly reversible and allows for ICL exchange, unlike laser in situ keratomileusis (LASIK), even when the patients experience unexpected postoperative vision ( 17 ).…”

A Nationwide Multicenter Study on 1-Year Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Low Myopia

“…Until now, there have been several published studies on the outcomes of ICL implantation for low-to-moderate myopia, as summarized in Table 2 ( 16 – 19 ). Sanders et al firstly, reported that ICL implantation had advantages over LASIK even in eyes with low myopia ( 16 ).…”

“…Recently, Pinto et al showed comparable 1-year postoperative safety, efficacy, predictability, and stability results for patients with low (6 D or less) and moderate-to-severe (more than 6 D) myopia ( 16 ). It should be noted that all previous studies included patients with MSE <-8 D ( 16 , 17 ), <-6 D ( 18 ), or −6 D or less ( 19 ), as a definition of low or low-to-moderate myopia. Our findings for low myopia were consistent with the previous results for low-to-moderate myopia in almost all outcomes measured.…”

“…Hitherto, the surgical indication for ICL implantation has still been generally thought to be indicated for eyes with a moderate-to-severe myopia. However, several studies have shown promising results of ICL implantation for low-to-moderate myopia ( 16 – 19 ). Indeed, according to the Japanese guidelines for phakic intraocular lens implantation, the surgical indication of myopic ICL implantation has been previously indicated to be used with caution for myopia of −6 to −15 diopters (D) and myopia of −15 D or greater, but has recently expanded to be used with caution for myopia of −3 to −6 D. Furthermore, based on our findings that ICL implantation induces significantly fewer higher-order aberrations than wavefront-guided LASIK and that the contrast sensitivity function was significantly improved after ICL implantation but unchanged after wavefront-guided LASIK even in low-to-moderate myopic eyes ( 20 ), the surgical indication for ICL implantation might be further expanded to include low myopic eyes.…”

Effect of Implantable Collamer Lens on Anterior Segment Measurement and Intraocular Lens Power Calculation Based on IOLMaster 700 and Sirius

“…Implantable collamer lenses (ICLs) are gaining popularity for correcting myopia due to their good visual acuity [ 1 ], predictability [ 2 ], and reversibility [ 3 ]; however, previous literature reported anterior subcapsular cataract as a postoperative complication of ICL, which needed to be extracted with ICL removal and intraocular lens (IOL) implantation [ 4 , 5 ], though the reported incidence of anterior subcapsular cataract with the V4c ICL is vanishingly small (Packer M., 2018). In addition, due to the widespread use of ICL globally, a large number of patients with ICL will develop age-related cataracts and require cataract surgery in the future [ 6 ]. Ocular measurements and IOL calculations are crucial for the refractive outcome of cataract surgery.…”