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Lens-pupil offset of a posterior chamber phakic implantable collamer lens with central hole (Visian®ICL™ V4C)

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Session Details

Session Title: Phakic IOLs I

Session Date/Time: Monday 07/09/2015 | 14:30-16:30

Paper Time: 15:57

Venue: Room 10

First Author: : A.Schuster GERMANY

Co Author(s): :    U. Vossmerbaeumer                    

Abstract Details


The aim of this study was to evaluate the postoperative position of the Visian® ICL™ V4C with centraFLOW™ (STAAR Surgical, Nidau, Schweiz) – a posterior chamber phakic Implantable Collamer Lens and to investigate whether the offset of the central waterport is correlated to disturbing visual phenomena.


This study was performed as a retrospective hospital-based study in a consecutive case series. University Eye Clinics, University Medical Center Mainz, Germany


The position of the implanted phakic posterior chamber intraocular lens was determined by measuring the centration of the central opening of the IOL in relationship to the limbus and the pupil. For this purpose anterior segment photographs were analyzed using ImageJ software (NIH, Bethesda, MD). The position of the limbus and of the pupil were determined by measuring its elliptical position, while the central artificial hole was measured with a circle. All patients were asked to report and grade perceived halos. Statistical analysis was performed with SPSS 21 (Chicago, IL).


We included 10 eyes of 5 patients in this study. The mean preoperative myopic refraction was -6.66±2.20D spherical equivalent, the postoperative refraction was -0.24±0.44D. We found a statistically significant offset of the central hole from the center of the pupil with a temporal shift (p<0.05). The mean temporal shift was 0.13±0.066mm and reached from 0.05 to 0.27 mm. There was no statistically significant difference in the vertical position from the center of the pupil, but with regard to the limbus (p<0.05) indicating a very slight inferior position (0.09±0.04mm). The ICLs were horizontally centered with respect to the limbus.


Due to the slightly nasal decentration of the pupil with regard to the corneal apex the center of a sulcus-based phakic IOL has a temporal offset. This is correlated to subjective disturbance from halos. The temporal offset of the central hole with resulting interference from the edge might be a reason for perceived visual phenomena after ICL implantation.

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