Risk Factors For Post-Operative Intraocular Pressure Elevation Following Evo Icl Implantation
Published 2026 - 44th Congress of the ESCRS
Reference: PP07.07 | Type: Free paper | DOI: 10.82333/e5wh-fv45
Authors: Mr Laurence Cox* 1 , Mr Prashant Shah 1 , Mr Allon Barsam 1 , Mr Ali Mearza 1 , Ms Laura De Benito Llopis 1 , Mr Mark Wilkins 1 , Ms Masara Laginaf 1 , Mr Emil Kurniawan 1 , Mr Romesh Angunawela 1
1OCL Vision,London,United Kingdom
Purpose
To identify preoperative risk factors for post-operative intraocular pressure (IOP) elevation following Evo Implantable Collamer Lens (ICL) implantation.
Setting
This retrospective multicentre study was conducted at OCL vision in London, United Kingdom.
Methods
Retrospective analysis of 203 eyes (103 patients) undergoing Evo ICL implantation. Univariate and multivariate logistic regression identified predictors of post-operative IOP >21 mmHg and ≥25 mmHg.
Results
Post-operative IOP>21mmHg occurred in 48 eyes (23.6%) and IOP≥25mmHg in 29 eyes (14.3%). Myopia ≥6D was the strongest predictor at both thresholds (OR=16.90 and OR=8.63, both p<0.05). In multivariate analysis, corneal thickness (OR=1.99 per SD, p=0.005) and axial length (AL) (OR=2.32 per SD, p=0.014) were the strongest predictors at >21mmHg; AL dominated at ≥25 mmHg (OR=2.26, p=0.019). AL≥27mm and corneal thickness ≥540µm carried 37.6% and 40.0% rates of IOP>21mmHg, versus 8.5% and 15.9% below such thresholds. Eyes with all three risk factors showed 55% and 35% elevation rates at respective thresholds, versus 0% with none. IOP elevation was predominantly bilateral (88% concordance, p<0.0001). Model discrimination was excellent (AUC=0.843).
Conclusions
Axial length ≥27mm and corneal thickness ≥540µm are the strongest independent predictors of post-operative IOP elevation. Bilateral concordance supports anatomical rather than surgical variables as primary drivers.