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The ICL performed well for the correction of both low-to-moderate myopia and high myopia throughout the 1-year observation period. The clinical outcomes of ICL implantation for low-to-moderate myopia are essentially equivalent to those for high myopia.

Aim To assess the early clinical outcomes of an ICL with a central hole (Hole ICL) implantation for the correction of moderate to high myopia. Methods This study evaluated 20 eyes of 20 patients with spherical equivalents of À7.3662.13 D (mean6SD) who underwent Hole ICL implantation. Before surgery and at 1 week and 1, 3 and 6 months after surgery, we assessed the safety, efficacy, predictability, stability and adverse events of the surgery. Results Logarithm of the minimum angle of resolution (logMAR) uncorrected visual acuity and logMAR best spectacle-corrected visual acuity were À0.2060.12 and À0.2560.06, respectively, 6 months after surgery. The safety and efficacy indices were 1.1360.24 and 1.0360.30, respectively. At 6 months, 95%, and 100% eyes were within 60.5 and 61.0 D of the targeted correction, respectively. Change in manifest refraction from week 1 to month 6 was 0.0660.28 D. No significant rise in intraocular pressure (including pupillary block) or a secondary cataract occurred in any case during the period of observation. Conclusions Implantation of a newly developed Hole ICL offered good results for all measures of safety, efficacy, predictability and stability for the correction of moderate to high myopic errors, even without peripheral iridectomy, suggesting its viability as a surgical option for the treatment of such eyes.

Anterior and posterior corneal surface height data obtained by enhanced ectasia display, effectively discriminates keratoconus from normal corneas. Elevation difference measurements may provide useful information for improving the diagnostic accuracy of keratoconus, especially in the early stage of the disease.

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The study shows a promising next-generation surgical option for the correction of moderate to high ametropia. Hole implantable collamer lens (ICL), STAAR Surgical, is a posterior chamber phakic intraocular lens with a central artificial hole. As yet, however, no long-term comparison of the clinical results of the implantation of ICLs with and without such a hole has hitherto been conducted. A prospective, randomized, controlled trial was carried out in order to compare the long-term clinical outcomes of the implantation, in such eyes, of ICLs with and without a central artificial hole.Examinations were conducted of the 64 eyes of 32 consecutive patients with spherical equivalents of −7.53 ± 2.39 diopters (D) (mean ± standard deviation) in whom implantation of a Hole ICL was performed in 1 eye, and that of a conventional ICL was carried out in the other, by randomized assignment. Before 1, 3, and 6 months, and 1, 3, and 5 years after surgery, the safety, efficacy, predictability, stability, intraocular pressure, endothelial cell density, and adverse events of the 2 surgical techniques were assessed and compared over time.The measurements of LogMAR uncorrected and corrected distance visual acuity 5 years postoperatively were −0.17 ± 0.14 and −0.24 ± 0.08 in the Hole ICL group, and −0.16 ± 0.10 and −0.25 ± 0.08 in the conventional ICL group. In these 2 groups, 96% and 100% of eyes, respectively, were within 1.0 D of the targeted correction 5 years postoperatively. Manifest refraction changed by −0.17 ± 0.41 D and −0.10 ± 0.26 D occurred in from 1 month to 5 years in the Hole and conventional ICL groups, respectively. Only 1 eye (3.1%), which was in the conventional ICL group, developed an asymptomatic anterior subcapsular cataract.Both Hole and conventional ICLs corrected of ametropia successfully throughout the 5-year observation period. It appears likely that the presence of the central hole does not significantly affect these visual and refractive outcomes.Trial Registration: UMIN000018771.

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