Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation

Abstract

Purpose To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. Methods We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. Results ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. Conclusion There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.

Evaluation of biometric indicators of anterior segment parameters after ICL implantation by swept-source optical coherence tomography

“…As a kind of intraocular refractive surgery, implantable collamer lens (ICL; Staar Surgical, Nidau, Switzerland) implantation has been widely affirmed for its safety and effectiveness in correcting moderate and high myopia [ 3 , 4 ]. However, the intraocular lens is implanted into the posterior ciliary sulcus during ICL implantation, which has a particular impact on the anatomical structure of the anterior segment and may affect the drainage of aqueous humor due to narrowing or closure of the anterior chamber angle (ACA), resulting in elevated eye pressure or secondary glaucoma [ 5 – 7 ].…”

Evaluation of biometric indicators of anterior segment parameters after ICL implantation by swept-source optical coherence tomography

“…As a kind of intraocular refractive surgery, implantable collamer lens (ICL; Staar Surgical, Nidau, Switzerland) implantation has been widely a rmed for its safety and effectiveness in correcting moderate and high myopia [5,6]. However, the intraocular lens is implanted into the posterior ciliary sulcus in the ICL implantation operation, which has a particular impact on the anatomical structure of the anterior segment and may affect the drainage of aqueous humor due to the reduction or closure of the anterior chamber angle (ACA), resulting in elevated eye pressure or secondary glaucoma [7][8][9].…”

Refractive surgery for the glaucoma suspect

“…Special consideration must also be given when performing other refractive procedures such as intraocular implantable collamer lenses (ICL) in patients with any degree of glaucoma. A recent review of perioperative complications related to intraocular ICL implantation from Zhang et al [42 ▪ ] reported high IOP and secondary glaucoma among the most common, accounting for 4.4% of all postoperative complications. They reported these outcomes were due to steroid response, pupillary block, iris pigmentation and narrow anterior chamber angle (ACA).…”