Seven-Year Clinical Outcomes Of Implantable Collamer Lens Implantation Versus Klex For Myopia Correction: A Contralateral Eye Analysis
Published 2025 - 43rd Congress of the ESCRS
Reference: FP18.02 | Type: Free paper | DOI: 10.82333/esn4-9t52
Authors: Giuseppe Giannaccare* 1 , Giulia Coco 2 , Filippo Lixi 1 , Carmen Sannace 3
1Department of Surgical Sciences,University of Cagliari,Cagliari,Italy, 2Department of Clinical Sciences and Translational Medicine,University of Rome Tor Vergata,Rome,Italy, 3Sannace Eye Clinic,Gioia del Colle,Italy
Purpose
This study aims to compare the seven-year clinical outcomes of Implantable Collamer Lens (ICL) implantation and Keratorefractive Lenticule Extraction (KLEx) for the correction of myopia in patients with anisometropia, with a focus on evaluating long-term refractive stability, visual quality, and patient satisfaction.
Setting
This is a prospective contralateral eye study at Eye and ENT Hospital of Fudan University, Shanghai, China.
Methods
A contralateral eye analysis was conducted on 25 patients with stable myopia. Comprehensive preoperative evaluations included assessments of visual acuity, refractive error, corneal topography, and endothelial cell density. ICL V4c implantation and KLEx were performed following standardized surgical protocols. Postoperative follow-up evaluations at 1 month and 7 years included measurements of visual acuity, refractive stability, wavefront aberrations, retinal image quality, and patient-reported visual disturbances.
Results
At the 7-year follow-up, both ICL and KLEx demonstrated high levels of safety and efficacy. ICL exhibited superior visual outcomes, as evidenced by lower intraocular scattering (OSI: 1.13 ± 0.42 vs. 1.57 ± 0.62, p = 0.012) and a higher Strehl ratio (0.20 ± 0.03 vs. 0.16 ± 0.03, p = 0.024). Refractive stability was maintained in both groups, although axial length increased more significantly in the ICL group (0.35 ± 0.33 mm vs. 0.21 ± 0.21 mm, p = 0.002). KLEx was associated with lower whole-eye higher-order aberrations for a 3 mm pupil diameter (0.10 ± 0.06 µm vs. 0.12 ± 0.14 µm, p = 0.043). No significant differences were observed in disk halo size or pupil dynamics between the two groups.
Conclusions
Both ICL and KLEx are effective for long-term myopia correction, with ICL offering superior visual quality and stability, particularly in patients with high myopia. The combination of these techniques in anisometropic patients is feasible and provides a personalized treatment approach, ultimately enhancing overall visual outcomes and patient satisfaction.