Causes Of Long-Term Follow-Up Loss In Myopia Patients After Posterior Chamber Intraocular Lens Implantation In China

To study the factors and causes contributing to the Long-Term Loss of follow up in myopia patients undergoing implantable collamer lens (ICL) surgery in China. We seek to examine the factors of this problem in a large population of patients undergoing ICL surgery in the long term. Then to further understand the impact of refractive outcomes on bias in follow up and the long-term safety after this operation.

The long-term safety of ICL surgery have gained increasing significance in the field of medicine as physicians seek to understand not only objective metrics of treatment but also the patient experience and complications.However, all surgeons are facing with the problem of lost follow-up of patients after surgery, especially in the long term, so that we cannot obtain the examination data of patients after surgery, nor can we understand it in detail. 

It was a multicenter cross-sectional study. Patients from 3 sites (Chongqing, Wuhan and Changsha Aier Eye Hospitals) with complete 5-year or more follow up were selected which underwent ICL surgery from December 2009 to December 2014. By dialing the telephone number to contact the patient to back to the hospital for reexamination, ask the patient's visual symptoms, and understand the patient's willingness for follow-up, and collect complications after surgery.

A total of 1156 cases (2292 eyes) were operated in the three hospitals five years ago, of which 387 (33.5%) cases were invalid phone numbers, 287 (24.8%) were unable to connect, and 482 (41.7%) were able to connected to. Among all patients, only 43 (3.7%) insisted on regular follow-ups; 116(23.8%) said they had not known about the regular follow-ups. Among all got connected, 98 patients (20%) felt good eyesight and were unwilling to follow up, 47 said they were too busy to come, 14 patients in remote places were inconvenient, and 6 were worried about the high cost. The follow-up rate of the two hospitals with special preoperative instruction and education for patients was higher than the other. About 32 eyes(1.4%)  appeared complications.

Most patients felt good visual quality was the main reason for long-term loss of follow-up. The surgeon's education on regular follow-up was helpful to improve the return visit rate. Since there were few complications, it could be inferred that the ICL demonstrated high safety.