Long-Term Follow-Up Of Phakic Collamer Intraocular Lenses In Patients With Hyperopia.

To evaluate the criteria of efficacy, predictability, safety and stability of the phakic lens of collamer material and support in the ciliary body ICL (Implantable Collamer Lens) in the correction of hyperopia. 

Instituto Universitario Fernández-Vega. Oviedo. Spain. 

The clinical study includes a sample of 127 eyes / 92 patients with a mean follow-up of 5.1 years (range 1 to 20). The inclusion criteria were: hyperopic sphere (+1.50 to +8.50 D), no refractive astigmatism, keratometric astigmatism ≤ 1.00 D, and anterior chamber depth > 2.6 mm (between 2.6 and 3.00 mm). A specific informed consent was made. An ICL (STAAR Surgical) lens model ICHV3 (NaCl) was implanted in surgeries performed between 2006 and 2010, and model ICHV4 (BSS) in surgeries between 2010 and 2024.  Visual acuity, efficacy and safety indexes, sphere and cylinder predictability, ECD, IOP, and postoperative vault were analyzed. In addition, associated intra- and postoperative complications and secondary surgeries were evaluated. 

The efficacy index was 0.96, slightly less than 1.00 due to the induction of refractive cylinder secondary to the incision (-0.27 ± 0.35; range -1.25 to 0.00). In terms of predictability of the sphere, 87.0% were within ± 0.50 D and 96.5% were within ± 1.00 D. Safety index was 1.14, and all patients maintained or gained lines of VA. The ECD, IOP and vault were within normal limits. No intra- or postoperative complications were observed throughout the follow-up. Secondary surgeries were performed in 12 eyes (9.4%): 5 refractive enhancements using FemtoLASIK, 5 repositioning or lens exchanges due to high vault in the immediate postoperative period, and 2 long-term cataract surgeries not related to the implantation of the ICL lens. 

The data confirm the good results of the implantation of the ICL lens to correct hyperopic refraction. The efficacy index is 0.96, slightly below 1.00, due to the induction of mild refractive astigmatism, and it can be confirmed that this is a predictable and safe technique.