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Posterior chamber phakic intraocular lens implantation: comparison of efficacy and safety for the correction of low-to-moderate and high myopia

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First Author: J.Vasco Costa PORTUGAL

Co Author(s):    C. Pinto   M. João   C. Pinto   N. Franqueira   F. Faria-Correia   T. Monteiro     

Abstract Details

Purpose:

The EVO Implantable Collamer Lens (ICL Model V4c; STAAR Surgical, Monrovia, California, USA) is a single piece posterior chamber phakic intraocular lens with a 360 μm central hole that has become widely accepted for the correction of high myopia. Although ICL has not been considered as the first indication for the correction of low-to-moderate myopic eyes, the previous literature has shown promising results, even when compared with the visual performance after the standard wavefront-guided laser in situ keratomileusis. We conducted this study to compare the visual, refractive and safety outcomes of ICL implantation for low-to-moderate and for high myopia.

Setting:

Department of Ophthalmology, Hospital de Braga, Braga, Portugal.

Methods:

This retrospective study included 573 eyes of consecutive patients submitted to ICL implantation that completed a period of 12-month postoperative follow-up. The eyes were divided into groups depending on the degree of preoperative myopia. Group 1 comprised 167 eyes with a manifest spherical equivalent of -6 D or less. Group 2 comprised 406 eyes with a manifest spherical equivalent higher than -6 D. Effectiveness, predictability and stability as well as safety outcomes were compared preoperatively and 1, 6 and 12 months postoperatively.

Results:

At 1-year postoperative, uncorrected and corrected visual acuities were 0.02±0.80 and -0.01±0.92 logMAR (group 1) and 0.05±0.70 and 0.01±0.80 logMAR (group 2), with an efficacy index of 1.04±0.16 and 1.14±0.27. Respectively, 85.0% and 80.8% eyes were within 0.5 D of the targeted refraction and postoperative manifest refraction changes were -0.09±0.27D and -0.10±0.36D. Intraocular pressure did not change significantly. Mean rate of endothelial cell loss was 1.11% and 1.14%, respectively. We observed 1 case of anterior subcapsular cataract (group 2). ICL exchange occurred in 2 cases (group 1) and 4 cases (group 2). No vision-threatening complications were reported.

Conclusions:

In this real-life study, ICL implantation revealed a high visual and refractive performance with a good safety profile for the correction of both low-to-moderate and high myopia. After ICL implantation, we showed comparable 1-year postoperative efficacy, predictability and stability as well as comparable rates of complications for low-to-moderate and for high myopia patients.

Financial Disclosure:

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