12-Month Clinical Outcomes Of Implantable Collamer Lens For Myopic Regression After Laser Vision Correction

To evaluate 12-month clinical outcomes including higher-order aberrations (HOAs) of implantable collamer lens (ICL) implantation for myopic regression after laser vision correction (LVC).

A retrospective study conducted at Hanyang University College of Medicine and Apgujeong Eye Clinic, Seoul, South Korea.

We retrospectively reviewed 77 eyes from 40 patients with myopic regression after LVC between July 2019 and August 2023. Of these, 50 eyes (26 patients) had prior photorefractive keratectomy, while 27 eyes (14 patients) had laser assisted in-situ keratomileusis. Preoperative and 12-month postoperative assessments included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR), mean keratometry, pachymetry, endothelial cell count (ECC), and HOAs. ICL power and size were calculated using a modified vertex formula provided by the manufacturer, with age additionally considered for a more myopic target in patients aged 40 and older to account for presbyopia.

At 12 months, 94% of eyes achieved UDVA of 20/20 or better in Snellen, and no eyes experienced a loss of CDVA. The efficacy and safety indices were 1.06 and 1.07. Scatter plot analysis demonstrated high predictability with a slight undercorrection (slope = 0.90, R² = 0.96). Spherical equivalent refraction was within ±0.50 D in 73% and ±1.00 D in 96% of eyes. No significant changes were found in pachymetry, mean keratometry, ECC, or HOAs (p > 0.05). 27% of eyes showed a myopic shift greater than -0.50 D, with non-significant increases in pachymetry and keratometry (p > 0.05). Residual astigmatism was within ± 0.50 D in 87% eyes and within ±1.00 D in 99% of eyes. The mean vault was 373.2 ± 166.8 μm, excluding 3 eyes (4%) that missed the exam.

ICL implantation demonstrated safe, effective, and predictable outcomes at 12 months in treating myopic regression after LVC, without increasing HOAs. Despite its high predictability, a myopic shift was noted in some eyes, highlighting the need for long-term follow-up.