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First Author: MajaBohac CROATIA
Co Author(s): Marija Anticic Mateja Koncarevic Ante Barisic Nikica Gabric
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To evaluate efficacy and safety of implantable collamer lens (ICL) implantation in moderate to high myopic astigmatism.
: Special Eye Hospital Svjetlost, Zagreb, Croatia; School of Medicine University of Rijeka, Rijeka, Croatia
Ongoing prospective nonrandomized observational study started in February 2013. 53 eyes (29 patients) completed 6 months follow up. Preoperative examination and postoperative follow up included measurement of sphere and cylinder refraction, uncorrected (UDVA) and corrected distance visual acuity (CDVA), aberrometry, intraocular pressure (IOP), anterior chamber depth (ACD) and endothelial cell count (ECC). Slit lamp and dilated funduscopic examination were also performed. The postoperative results at 6 months were compared to baseline values. Student t-test was used for statistical analysis with 5% significance.
Mean age of patients was 30±5 years (range 19-45), 48% of patients were men and 52% were women. Preoperatively mean CDVA was 0,64±0,15 decimal lines(0,4-1,0), mean sphere was -10,15±3,35D (-16,25 to -5,75), mean cylinder was -2,63±1,05D (-4,50 to -1,0). Mean anterior chamber depth was 3,13±0,37mm (2,82 to 3,6), mean IOP was 15,57±2,16mmHg (12-19), mean ECC was 2983±326cell/mm2 (2741 to 3426). There was no statistically significant difference between preoperative CDVA and postoperative UDVA at 6 months follow-up (p>0,05). 40% of patients gained one or more lines of CDVA. At 6 months follow-up mean sphere was -0,25±0,4D (-0,75 to +0,50) and mean cylinder was -0,29±0,6D (-1,00 to +0,75). Mean IOP increased for 1,3mmHg in the first postoperative week, however the difference was statistically insignificant (p>0,05). At 3 months follow-up IOP returned to baseline values. 5,1% decrease in ECC was observed at 1 week postoperatively (p<0,05), however there was no statistically significant change between 1 week and 6 months follow up (p>0,05). Changes in average values for coma, trefoil and spherical aberration were not significant for 5mm pupil (p>0,05). There were no intraoperative complications. 2 lenses were explanted in the first postoperative week because of rotation caused by under sizing of the lens.
ICL implantation showed excellent refractive and visual results with high predictability and fast visual recovery. Surgical and early postoperative complications were low. Longer follow up and larger series of patients are needed to evaluate late postoperative complications and safety for crystalline lens and corneal endothelium. Lifelong follow up of these patients is mandatory. FINANCIAL INTEREST: NONE