Long-Term Outcome And Related-Risk Factors In Implantable Collamer Lens (Icl) Implantation Of High Myopia
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1234 | Type: Poster | DOI: 10.82333/919r-mr75
Authors: Yong Hee Kim* 1 , Chang Ho Yoon 1 , Mee Kum Kim 1
1Department of Ophthalmology,Seoul National University College of Medicine,Seoul,Korea, Republic Of;Department of Ophthalmology,Seoul National University Hospital,Seoul,Korea, Republic Of;Laboratory of Ocular Regenerative Medicine and Immunology,Seoul National University Hospital,Seoul,Korea, Republic Of
Purpose
To investigate the long-term efficacy and safety of posterior chamber implantable collamer lens (ICL) implantation in high myopia, and the risk factors associated with endothelial cell loss (ECL) or cataract development.
Setting
From August 2005 to March 2019, a retrospective examination of medical records was conducted on 94 eyes of 55 patients who underwent ICL implantation surgery by a single surgeon (M.K.K.) at the Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea. Patients with ocular conditions such as retinal diseases, cataract, and glaucoma were excluded from the study.
Methods
Medical records of 64 eyes of 36 patients who underwent ICL implantation for high myopia were retrospectively analyzed with a mean follow-up of 12 years. Changes in LogMAR best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive power, and endothelial cell density (ECD) over time were analyzed with the incidence of cataract and IOP elevation. Risk factors were analyzed for their association with ECL or cataract development.
Results
At 10 years after surgery, the mean uncorrected visual acuity (UCVA) was 0.06 and the spherical equivalent (SE) was -0.90 D. By year 10, the cataracts were present in 19% (13/64), whereas the glaucoma was found in 1.5% (1/64). Although the IOP remained within normal limits, IOP was continuously elevated over time (p<0.05). The cataract group had a lower vault of ICL and a higher mean age at surgery (P<0.05). The ECD remained above 2000/mm² in 98.5% of cases, with an average annualized rate of decline of 1.13%. The high annualized rate group (>1.13% loss/year) had a lower mean age than in the low annualized rate group (vs < 1.13% loss/year, P<0.05).
Conclusions
It indicates that ICL implantation is effective for high myopia, and main complication is a cataract by 10 years. It also suggests that IOP should be regularly monitored. Age and low-vault ICL may affect either ECL or cataract.