MONOVISION BY POSTERIOR-CHAMBER PHAKIC IMPLANTABLE COLLAMER LENSES FOR MYOPIA CORRECTION IN EARLY PRESBYOPIA: A LARGE COHORT STUDY

This study aimed to investigate the safety and visual performance at far to near distances of Implantable Collamer posterior chamber phakic refractive lenses (EVO and EVO+ ICLs) in myopic patients with early presbyopia.

Single-center study

A retrospective study comprised 164 eyes of 82 early presbyopic patients (mean age: 44.2 ± 3.2 years, range: 40-52 years) who underwent bilateral EVO/EVO+ ICLs (spherical or TORIC) implantation between years 2016-2023 for myopic correction. Refractive target was set at emmetropia for the dominant eye (D-eye), and at slight myopia (mean -1.67 ± 0.58; range 0.75-1.75) diopters (D)) for the non-dominant eye (nD-eye). Outcome measures included uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent (SE), intraocular pressure (IOP), endothelial cell density (ECC), ICL vault, as well as presbyopic add power, visual acuity (logMAR) of D-eyes, nD-eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m were recorded at the last follow-up.

At last follow-up of 6.8 ±8.5 months, CDVA significantly improved, from 0.08 ± 0.12 preoperatively to 0.01 ± 0.03 logMAR at last follow-up (P<0.05). In D-eye, mean post-operative UDVA was 0.08 ± 0.20, with MRSE of -0.15 ± 0.61 D; whereas in nD-eye, the UDVA was 0.31 ± 0.27, with a mean MRSE of -0.90 ± 0.78 D. The aggregate safety index was favorable at 1.08 ± 0.18. The mean efficacy index was 0.96 ± 0.2 in D-eye only. The mean binocular VA was 0.17 logMAR at all distances (5.0, 0.8, 0.4 m). Most (96.4%) eyes were within ± 0.5 D of the targeted correction. No adverse events were observed. Subjects were satisfied with far and near VA compared to pre-operatively. 

This study demonstrates the safety and efficacy of monovision ICL surgery for the correction of myopes with presbyopia, with long-term efficacy at near and far distances and high patient satisfaction.