Icl Phakic Lenses Implanted In Vertical Meridian: Review Of Efficacy And Safety Outcomes

The purpose of this comprehensive study was to analyze the efficacy and safety of implantable collamer lens (ICL) surgery for correcting varying degrees of ametropia, specifically myopia with or without astigmatism, by placing the lens in the vertical meridian. This research aimed to provide a deeper understanding of the visual outcomes and ocular health implications of this less common surgical approach. 

Retrospective study at a refractive surgery clinic 

The study undertoo, a retrospective observational analysis of patients who had undergone vertical ICL implantation between 2018 and 2022, with a minimum follow-up duracion of one year. Lens sizing was meticulously calculated using biometric measurements from the IOLMaster, corneal tomography with Pentacam, and subjective refraction under both physiological and cyclopegic conditions. The OCOS online calculator by STAAR AG was employed for initial sizing, which was then refined using a clinic-specific nomogram developed from Ultrasonic Biomicroscopy (UBM) data. Postoperative evaluations at one month included subjetive refraction, Pentacam topography, and anterior segment OCT using Visante (Zeiss Meditec) to measure the resultant vault

Postoperative UDVA averaged at 1,11±0,23, with stable refractive outcomes. The mean vault was 442,82±212,45 microns. Efficacy and safety indices were hign, and IOP remained unchanged post-surgery.

The findings suggest that vertical implantation of ICL lenses is both effective and safe for the correction of ametropia. The lack of significant changes in intraocuar pressure post-implantation underscores the procedure´s safety. The study also highlights the clinical importance of relying on surgeon expertise for final lens sizing , as the traditional predictive models may not always align with the surgical outcomes , particularly concerning postoperative vault prediction.