Abstract
Purpose: To assess the 8-year clinical outcomes of implantation of an implantable collamer lens (ICL) with a central port (KS-Aquaport; EVO-ICL) for moderate to high myopia and myopic astigmatism.Methods: This retrospective study comprised a total of 177 eyes of 106 patients with spherical equivalents of −7.99 ± 3.33 D [mean ± standard deviation], who underwent EVO-ICL implantation. We evaluated the safety, efficacy, predictability, stability, and adverse events of the surgery, at 1 month, and 1, 2, 4, 6, and 8 years postoperatively.Results: The logarithm of the minimal angle of resolution (LogMAR) uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were −0.07 ± 0.17 and −0.20 ± 0.09, respectively, at 8 years postoperatively. The safety and efficacy indices were 1.18 ± 0.24 and 0.89 ± 0.28, respectively. At 8 years, 83 and 93% eyes were within ± 0.5 D and ± 1.0 D of the targeted correction, respectively. Change in manifest refraction from 1 month to 8 years postoperatively was −0.13 ± 0.30 D. Three eyes (1.7%) that developed cataracts had a slight pre-existing peripheral anterior subcapsular cataract formation required simultaneous ICL extraction and cataract surgery at 2 or 3 years or ICL size change (1 size up) at 7 years postoperatively. We found that neither significant intraocular pressure (IOP) rise (including pupillary block) nor significant endothelial cell loss occurred in any case throughout the 8-year observation period.Conclusions: Current ICL implantation with central port technology offered good continuous outcomes for all measures of safety, efficacy, predictability, and stability for correcting moderate to high myopic errors over a long period, thereby suggesting its long-term viability as a surgical approach for the treatment of such eyes.
Highlights
Implantable Collamer Lens (EVO Visian ICLTM, STAAR Surgical, Monrovia, CA, USA), a posterior chamber phakic intraocular lens, has been well-recognized as a long-term safe and effective surgery all over the world to correct moderate to high refractive errors [1,2,3,4,5,6]
Long-term study on current implantable collamer lens (ICL) implantation with central port technology may give us intrinsic insights into understanding the long-term prognosis of the patients undergoing modern ICL surgery, assuming that postoperative complications such as cataract formation and a significant intraocular pressure (IOP) rise could be greatly reduced by introducing this promising technology
We found a significant difference between preoperative corrected distance visual acuity (CDVA) and 4, 6, and 8-year postoperative CDVAs (p < 0.001, p < 0.001, and p = 0.002, respectively)
Summary
Implantable Collamer Lens (EVO Visian ICLTM, STAAR Surgical, Monrovia, CA, USA), a posterior chamber phakic intraocular lens, has been well-recognized as a long-term safe and effective surgery all over the world to correct moderate to high refractive errors [1,2,3,4,5,6]. To the best of our knowledge, no long-term studies on current ICL implantation with central port technology have so far been conducted spanning more than 7 years. Long-term study on current ICL implantation with central port technology may give us intrinsic insights into understanding the long-term prognosis of the patients undergoing modern ICL surgery, assuming that postoperative complications such as cataract formation and a significant IOP rise could be greatly reduced by introducing this promising technology. As far as we can ascertain, this study assesses the longest-term (up to 8 years) follow-up outcomes in a cohort of patients undergoing current hole technology-based ICL surgery
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