Efficacy And Safety Of Implantable Phakic Contact Lens Versus Implantable Collamer Lens: A Systematic Review And Meta-Analysis
Published 2026 - 44th Congress of the ESCRS
Reference: FP19.01 | Type: Free paper | DOI: 10.82333/wtg1-z143
Authors: Dr Nuno Rodrigues Alves* 1 , Catarina Barão 1 , Matheus Pedrotti Chavez 2 , Pedro Gil 1 , Diogo Hipólito Fernandes 1 , João Feijão 1 , Nuno Filipe Alves 1 , Prof. Dr Jorge L. Alió Del Barrio 3 , Prof. Dr Jorge L. Alió 3
1Department of Ophthalmology,Unidade Local de Saúde de São José,Lisbon,Portugal, 2Department of Ophthalmology,Universidade Federal de Santa Catarina,Florianópolis,Brazil, 3Cornea, Cataract and Refractive Surgery Unit,Research & Development Department VISSUM Innovation Alicante,Alicante,Spain;Division of Ophthalmology,School of Medicine, Universidad Miguel Hernández,Alicante,Spain
Purpose
To compare the efficacy and safety of Implantable Phakic Contact Lens (IPCL) versus Implantable Collamer Lens (ICL) implantation.
Setting
Department of Ophthalmology, Unidade Local de Saúde de São José, Lisbon, Portugal. Cornea, Cataract and Refractive Surgery Unit, Research & Development Department VISSUM Innovation Alicante, Alicante, Spain.
Methods
Following PRISMA 2020 guidelines (PROSPERO CRD420251207282), PubMed, Embase, and the Cochrane Library were searched for randomized and non-randomized studies comparing IPCL versus ICL implantation (V4c or V5 models with a central aquaport). Primary outcomes included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalent (SE). Secondary outcomes included postoperative vault, adverse events (cataract formation, acute glaucoma, endothelial cell loss, lens explantation, and rotation), and weighted mean efficacy and safety indices. Data were pooled using random-effects models, and heterogeneity was assessed using the I² statistic. Analyses were performed using R software.
Results
Nine studies including 1,187 eyes (IPCL 559; ICL 628) from 941 myopic patients were analyzed. Postoperative UDVA and CDVA were not significantly different between groups (p=0.223 and p=0.861). A significant difference favoring IPCL was observed for SE (MD=−0.06 D; 95%CI:−0.11 to −0.001; p=0.028; I²=37%), although clinically negligible. Secondary outcomes were comparable between groups, including vault (MD=57.26µm; p=0.404), cataract formation (RR=1.19; p=0.684), endothelial cell loss (MD=−3.36cells/mm²; p=0.652), and IOL exchange (RR=1.01; p=0.992). However, rotational stability in toric lenses significantly favored ICL (RR=3.49; 95%CI:1.16–10.49; p=0.026; I²=0%). Efficacy and safety indices were comparable (IPCL 1.09/1.20; ICL 1.11/1.18).
Conclusions
IPCL and ICL demonstrated comparable visual outcomes and safety profiles. IPCL showed a slightly better refractive predictability, whereas toric ICL provided superior rotational stability, supporting individualized lens selection based on refractive and astigmatic requirements. Future studies should evaluate long-term rotational stability and comparative outcomes across diverse patient populations to guide optimal lens selection.