Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age

Abstract

Purpose. To assess the efficacy, safety, and predictability of the Visian Implantable Collamer Lens (ICL) model having a central port in patients over 40 years of age. Methods. This study included 33 eyes from 21 patients who underwent V4c ICL implantation for the correction of myopia and myopic astigmatism. We assessed uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events occurring over a 1-year period. Results. Mean age of the patients at the time of implantation was 43.52 ± 4.49 years (range: 40 to 56 years). Efficacy and safety indexes were 1 and 1.09, respectively. Surgical outcomes for CDVA were as follows: no eye lost any lines, 19 eyes (57.58%) showed no CDVA changes, 7 eyes (21.21%) gained 1 line, 4 eyes (12.12%) gained 2 lines, and 3 eyes (9.09%) gained ≥3 lines. Mean postoperative spherical equivalent (SE) was −0.09 ± 0.47 D. A total of 29 eyes (87.8%) were within ±0.50 D and 31 eyes (93.9%) were within ±1.00 D of the desired SE. At 1-year, mean IOP was 15.27 ± 3.03 mmHg (range: 9 to 20 mmHg, p=0.12 pre vs. post) and mean ECD was 2516 ± 234 cells/mm2 (p=0.29 pre vs. post). Mean postoperative vault was 320 ± 136 μm, with 201–300 μm being the most prevalent vault range for 9 eyes (31.03%). None of the eyes showed a vault >701 μm. There were neither intraoperative nor postoperative complications; in fact, all ICL implantation procedures were uneventful. Conclusions. Our study’s findings support the use of this lens in patients over 40 years of age. A long follow-up period is advisable to monitor ICL position relative to the crystalline lens.

Long-term evaluation of anterior lens density after implantable collamer lens V4c implantation in patients with myopia over 40 years old

“…Previous research findings from a 3-year follow-up of 184 eyes of 92 patients indicated indices of 1.03 and 0.90, respectively, 16 while a recent study involving a 1-year follow-up after ICL V4c implantation in patients >40 years confirmed that the two indices were 1.09 and 1. 17 In the current study, the safety indices at the three postoperative follow-up time points were not statistically different. Intriguingly, significant differences in efficacy index were found between 3 months postoperatively and at last follow-up.…”

Long-term follow-up for monovision surgery by Implantable Collamer Lens V4c implantation for myopia correction in early presbyopia

“…With the clinical application of ICL with a central hole (hole ICL), or ICL V4c, the misgivings regarding possible effect of ICL on cataract formation in the elderly population have been dispelled as it improves aqueous humor circulation [ 6 , 7 ]. ICL V4c is also safe for the correction of ametropia in myopic people aged 40 years or above [ 8 ]. ICL V4c implantation is reversible; therefore, its application in monocular refractive surgery is worthy of further study.…”

Multicenter clinical outcomes of hole implantable collamer lens implantation in middle-aged patients

“…In this multicenter study, the patients were aged 45 years or older and were at a high risk of developing cataract with conventional ICL 4 . There are only a few reports 6 – 8 on the postoperative outcomes after hole ICL implantation in middle-aged and older patients, which are summarized in Table 5 . All previous reports 6 – 8 had short observation periods and small sample sizes.…”

“…There are only a few reports 6 – 8 on the postoperative outcomes after hole ICL implantation in middle-aged and older patients, which are summarized in Table 5 . All previous reports 6 – 8 had short observation periods and small sample sizes. In this study, the mean observation period was 2.2 years (cases with more than 1 year of follow-up), and the safety index was 1.08.…”

“…ICL power calculation was performed by the manufacturer (STAAR Surgical) using a modified vertex formula. In this study, we set the target refractive power taking presbyopia into account, as described previously 6 – 8 . The target refractive power was emmetropia in 50.9% (54/106), monovision in 24.5% (26/106), and intentional under-correction in 24.5% (26/106).…”