Refractive outcomes of posterior chamber phakic (Spheric and toric implantable Collamer lens) intraocular lens implantation with a central port design.

Abstract

Purpose : The aim of the present study is to evaluate the visual and refractive outcomes of ICL implantation with a central port design.

Methods : A retrospective, observational study performed by chart review from data including patients with diagnosis of myopia and myopic astigmatism treated with ICL V4c model and Toric ICL V4c model between 2013-2022. Patients over 21 years who fulfilled surgical criteria were included.
Before surgery, all patients went through complete ophthalmological examination, including UDVA, CDVA, manifest and cycloplegic refraction, slit lamp examination, IOP, gonioscopy, and fundoscopy. Preoperative analysis was performed with Orbscan® IIz and OCULUS Pentacam®.

Results : A total of 254 eyes of 134 patients who underwent ICL V4c model and the Toric ICL V4c model implantation were included. 173 (68 %) were of female and 81 (32 %) male. Ages ranged from 21 to 47 years, with a mean age of 27.86 years. Of the 254 ICLs implanted, 228 (89.7 %) were toric ICLs. Almost all eyes (94.48 %) had some degree of astigmatism, being myopic astigmatism the most common refractive error (240 eyes). Mean follow-up was 15.05±15.12 months (0 -91 months).
Mean preoperative sphere was -9.54±4.69 D (-25.00 - 7.25 D) and postoperative sphere was 0.07±1.12 (-5.75 - 2.50 D) (p <0.001). Mean pre- and postoperative cylinders were of -3.17±1.61 D (-8.00 - 0.00 D) and -0.96±0.83 D (-6.50 - 0.75 D) respectively (p <0.001). Preoperative mean spherical equivalent was -11.13±4.59 D (-25 - 6.25 D) and -0.4±1.23 D (-6.75 - 2.12 D) postoperatively, (p <0.001). Mean preoperative UDVA was 1.58±0.44 (0.4 - 2.5) (20/800 Snellen) and the mean postoperative UDVA was 0.17±0.17 (0 - 1.18) (20/30 Snellen) (p<0.001). Mean preoperative CDVA was 0.15±0.1 (0 - 0.6) (20/30 Snellen) and the postoperative CDVA was 0.08±0.09 (0 - 0.54 D) (20/20 Snellen), (p<0.001). Mean WTW was 11.68±0.32 (10.8 - 12.9), and the mean ACD was 3.53±0.32 (2.55 - 4.39). Complication rate was 12.99 %, being elevation of IOP the most common observed in 19 eyes, all of which responded well to topical antihypertensives.

Conclusions : The ICl lens is a good alternative for myopic and astigmatic refractive errors. This device shows promising results in postop best corrected visual acuity accompanied by good device tolerance. The number of complications was limited with an excellent response to treatment.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.