Efficacy And Safety Of Posterior Chamber Implantable Collamer Lens Implantation In Different Anterior Chamber Depths: 5-Year Follow-Up Results
Published 2026 - 44th Congress of the ESCRS
Reference: POREF143 | Type: Free paper | DOI: 10.82333/ccyq-zs35
Authors: Dr Francisca Teixeira da Costa Maia* 1 , Dr Vera Araújo 1 , Dr Rui Silva 1 , Dr Chistophe Pinto 1 , Prof. Dr Tiago Monteiro 2
1Ophthalmology,Hospital de Braga,Braga,Portugal, 2Ophthalmology,Unidade Local de Saúde São João,Porto,Portugal;Faculdade de Medicina da Universidade do Porto,Porto,Portugal
Purpose
To compare the visual, refractive, safety, and anatomical outcomes of posterior chamber Implantable Collamer Lens (ICL) implantation for myopia correction according to preoperative anterior chamber depth (ACD).
Setting
This retrospective study was conducted at a tertiary referral hospital in Braga, Portugal.
Methods
Patients who underwent myopic posterior chamber phakic Implantable Collamer Lens (ICL; models V4C/V5) implantation with a minimum follow-up of 60 months were included. Eyes were divided into two groups according to preoperative ACD: Group 1 (2.80–2.99 mm) and Group 2 (≥3.00 mm). Outcomes evaluated included uncorrected and corrected distance visual acuity, manifest refraction, efficacy and safety indices, predictability, intraocular pressure, endothelial cell density, central vault, anterior chamber angle, and postoperative complications. A total of 247 eyes from 136 patients were analyzed: 62 eyes (25.1%) in Group 1 and 185 eyes (74.9%) in Group 2.
Results
At 60 months, the efficacy index was comparable(1.15±0.26 in Group 1 vs 0.98±0.25 in Group 2; p=0.184). The safety index was higher in Group 1(1.24±0.32 vs 1.11±0.23; p=0.001), with more eyes gaining corrected distance visual acuity lines. Predictability was similar, with 70.9% vs 68.7% within ±0.50D and 87.1% vs 89.1% within ±1.00D of target refraction in Groups 1 and 2. Mean central vault was lower in Group 1(160.4±118.5µm vs 327.1±150.9 µm; p<0.001). Anterior chamber angle decreased in both groups(p<0.001) but remained wider in Group 2. No differences were observed in intraocular pressure, endothelial cell density loss, or refractive stability. Complications were rare but higher in Group 1 (p=0.005); no cataract surgery was required.
Conclusions
Posterior chamber ICL implantation demonstrated long-term efficacy, predictability, and refractive stability in eyes with shallow anterior chambers. Despite a lower central vault and a higher incidence of minor complications, visual and refractive outcomes in eyes with reduced ACD were comparable to those achieved in eyes with deeper anterior chambers, supporting the safety and effectiveness of ICL implantation in carefully selected patients with shallow ACD.