Abstract
To compare rotational stability of the Implantable Collamer Lens (ICL) between horizontal and vertical implantation. Zhongshan Ophthalmic Center, China. Prospective 1:1 matched design. 94 cases (185 eyes with a vertical elliptical ciliary sulcus) were included with a 1:1 matched design based on ciliary sulcus morphology, preset deviation angle, and vault. Follow-ups at 4 days, 1 month, 3 months, and 6 months post-surgery measured rotational angles using slit-lamp photography. Latent class trajectory modeling was employed to investigate the postoperative rotational angle trajectories. Six months after surgery, both groups exhibited similar visual acuity and refractive outcomes. The horizontal group had a significantly greater rotation angle than the vertical group (F group = 13.638, P < 0.001). Additionally, a statistically significant difference (P = 0.004) in the average trajectories of rotational angles was observed. The vertical group displayed a greater presence in the low-stable trajectory subgroup while demonstrating a reduced presence in the moderate-increase and high-fluctuation trajectory subgroups compared to the horizontal group. The horizontal group had a 3.750 times higher risk of rotation angle ≥3° compared to the vertical group, which represented a statistically significant difference (95% CI: 1.346∼10.446). In both groups, a positive correlation between the preset deviation angle and the rotation angle was observed, with correlation coefficients of 0.320 (P = 0.030) and 0.371 (P = 0.011), respectively. Vertical ICL implantation showed better rotational stability than horizontal implantation in eyes with a vertical elliptical ciliary sulcus, offering guidance for ICL surgery.
Published Version
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