Refractive, Visual And Safety Outcomes In Icl Implantation For High Myopia - A 15 Year Evaluation

To evaluate long term outcomes of implantable collamer lens implantation (V4) for high myopia with and without astigmatism, and to analyze visual outcomes, safety factors and review complications. 

Cornea & Refractive Service, Shroff Eye Centre, A-9, Kailash Colony, New Delhi – 110048, India.

216 eyes of 111 patients with a mean age of 42.16 + 1.32 years underwent ICL implantation for myopia ranging from -6.25 to -22.76 D sphere. All patients had a minimum 15 year follow up. At 15 years the main outcome measures were UDVA, CDVA, predictability, manifest refractive errors, vault, endothelial cell loss and complication rates. Contrast sensitivity, and patient satisfaction was also assessed.

UDVA at 15-years was 20/20 or better in 62.31% eyes and 20/40 or better in 85.62% eyes. Safety-index was 1.07 and efficacy-index was 1.05. The mean spherical equivalent was -0.81+1.82D. The mean vault-height was 562.21+151.6 microns at 6-months decreasing to 371.1+126.3 at 15-years. No significant decrease in endothelial cell density was observed at 15-years. There was no significant increase in IOP over time. Lens opacities developed in 28 eyes (7.76%). The mean vault in the lens opacity group was significantly lower in the clear lens group (p=.032). Patients who had ICL at a younger age never developed lens opacities.

ICL implantation for high myopia is safe and effective over a long term period with long term stability, good refractive outcomes and preserved corneal integrity. The average Quality of vision value improved with high patient satisfaction.