Efficacy and safety after posterior chamber Implantable Collamer Lens implantation according to preoperative anterior chamber depth: Short-term comparative study

Abstract

Purpose

To compare visual, refractive, and safety outcomes of posterior chamber Implantable Collamer Lens (ICL) implantation for the correction of myopia according to the preoperative anterior chamber depth (ACD).

Methods

Retrospective, comparative study, patients submitted to implantation of myopic posterior-chamber phakic Implantable Collamer Lens (ICL), model V4C/V5, minimum follow-up of 12 months; two groups were created: Group 1 (ACD 2.80 to 2.99 mm) and Group 2 (ACD equal to or greater than 3.00 mm). The parameters evaluated were uncorrected and corrected visual acuity, subjective refraction, efficacy and safety index, predictability, endothelial cell density, central vault, anterior chamber angle and postoperative complications. A total of 558 eyes from 298 patients were evaluated: 111 eyes (19.9%) in group 1 and 447 eyes (80.1%) in group 2.

Results

At 12 months, the efficacy index was similar in both groups (p = 0.264); the safety index was higher in group 1 (p = 0.031); the mean central Vault was significantly lower in group 1 (212.8 vs 410.6 μm; p < 0.001). Respectively, 93 (83.8%) and 366 (84.1%) eyes were within ±0.50 D of targeted refraction. Anterior chamber angle significantly decreased during follow-up in both groups (p < 0.001; p < 0.001). Intraocular pressure did not change significantly (p = 0.310 and p = 0.446, respectively). There were no significant differences in endothelial cell density loss (p = 0.278) or in the rate of complications observed (p = 0.733).

Conclusions

ICL implantation is an effective and safe procedure in eyes with shallow anterior chambers, with visual and refractive results and complication rates identical to those obtained in deeper anterior chambers.

Keywords

Refractive Phakic IOLs<REFRACTIVE SURGERY complications of refractive surgery<REFRACTIVE SURGERY REFRACTIVE SURGERY corneal topography/imaging systems<REFRACTIVE SURGERY examination techniques: specular microscopy<CORNEA/EXTERNAL DISEASE

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References

Packer

. The Implantable Collamer Lens with a central port: review of the literature. Clin Ophthalmol 2018; 12: 2427–2438.

Alfonso

Fernandez-Vega-Cueto

Alfonso-Bartolozzi

, et al. Five-year follow-up of correction of myopia: posterior chamber Phakic intraocular lens with a central port design. J Refract Surg 2019; 35: 169–176.

Guell

Morral

Kook

, et al. Phakic intraocular lenses part 1: historical overview, current models, selection criteria, and surgical techniques. J Cataract Refract Surg 2010; 36: 1976–1993.

Kohnen

Kook

Morral

, et al. Phakic intraocular lenses: part 2: results and complications. J Cataract Refract Surg 2010; 36: 2168–2194.

Packer

. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol 2016; 10: 1059–1077.

Kamiya

Ando

Tsujisawa

, et al. Effect of angle opening parameters on corneal endothelial cell density and intraocular pressure after posterior chamber Phakic intraocular lens implantation. J Clin Med 2020; 9(9): 2704.

Niu

Miao

Han

, et al. Visual outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth. BMC Ophthalmol 2019; 19: 121.

Lim

Lee

Chung

, et al. Clinical results of posterior chamber phakic intraocular lens implantation in eyes with low anterior chamber depth. Am J Ophthalmol 2014; 158: 447–454.

Kamiya

Shimizu

Igarashi

, et al. Posterior chamber Phakic intraocular lens implantation in eyes with an anterior chamber depth of less than 3 mm: a multicenter study. Sci Rep 2018; 8: 13322.

10.

Shajari

Herrmann

Buhren

, et al. Anterior chamber angle, volume, and depth in a normative cohort-A retrospective cross-sectional study. Curr Eye Res 2019; 44: 632–637.

11.

Rabsilber

Khoramnia

Auffarth

. Anterior chamber measurements using Pentacam rotating Scheimpflug camera. J Cataract Refract Surg 2006; 32: 456–459.

12.

Gonvers

Bornet

Othenin-Girard

. Implantable contact lens for moderate to high myopia: relationship of vaulting to cataract formation. J Cataract Refract Surg 2003; 29: 918–924.

13.

Goukon

Kamiya

Shimizu

, et al. Comparison of corneal endothelial cell density and morphology after posterior chamber phakic intraocular lens implantation with and without a central hole. Br J Ophthalmol 2017; 101: 1461–1465.

14.

Pinto

Monteiro

Franqueira

, et al. Posterior chamber collamer phakic intraocular lens implantation: comparison of efficacy and safety for low and moderate-to-high myopia. Eur J Ophthalmol 2022; 32: 894–901.

15.

Fernandez-Vigo

Macarro-Merino

Fernandez-Vigo

, et al. Effects of Implantable Collamer lens V4c placement on iridocorneal angle measurements by Fourier-Domain optical coherence tomography. Am J Ophthalmol 2016; 162: 43–52. e1.

16.

Eissa

Sadek

El-Deeb

. Anterior chamber angle evaluation following Phakic posterior chamber Collamer lens with CentraFLOW and its correlation with ICL vault and intraocular pressure. J Ophthalmol 2016; 2016: 1383289.