Analysis After Posterior Chamber Phakic Intraocular Lens Implantation: A 17 to 19-Year Follow-up Study

Abstract

Purpose: To evaluate the clinical outcomes of the Visian implantable collamer lens (ICL) in eyes with≥17 years of follow-up. Methods: Seventy eyes from 38 patients who underwent surgery between 2002-2006 with V4 ICL implantation were analyzed. Pre-intervention data included corrected distance visual acuity (CDVA), refraction, and intraocular pressure (IOP). At the 19-year mark, CDVA, refraction, IOP, endothelial count, and vault were measured using Tomey Casia 2 anterior pole tomography, along with recording long-term events. Setting: Single-center. Design: Retrospective observational study Results: The operated patients had a spherical correction between -4 and -21D and a cylinder up to 7.5D. The mean CDVA (decimal) at the 17-year check-up was 0.89±0.18, with a spherical equivalent of -1.05±1.36D. Intraocular pressure has remained stable, as mean measurements prior to surgery and currently, was 15.16 ± 2.54mmHg and 16.19 ± 3.29 mmHg respectively. The endothelial cell count showed values of 2191 ± 386 cells/mm2, with a maximum of 2804 cells and a minimum of 1125 cells. Finally, the vault obtained was 348.53 ± 234.58mm. Over the years, 2 eyes developed angle closure glaucoma, and 9 eyes were operated on for the development of anterior subcapsular cataracts. Conclusions: Visian ICL implantation demonstrated long-term visual and refractive stability, indicating it as a low-risk procedure. The ICL V4 model yielded satisfactory results for myopia and astigmatism correction after 17 years.