Eight-Year Outcomes of Implantation of Posterior Chamber Phakic Intraocular Lens With a Central Port for Moderate to High Ametropia

Kazutaka Kamiya; Kimiya Shimizu; Masahide Takahashi; Wakako Ando; Hideki Hayakawa; Nobuyuki Shoji

doi:10.3389/fmed.2021.799078

Eight-Year Outcomes of Implantation of Posterior Chamber Phakic Intraocular Lens With a Central Port for Moderate to High Ametropia

Front Med (Lausanne). 2021 Dec 16:8:799078. doi: 10.3389/fmed.2021.799078. eCollection 2021.

Authors

Kazutaka Kamiya¹, Kimiya Shimizu², Masahide Takahashi², Wakako Ando³, Hideki Hayakawa³, Nobuyuki Shoji³

Affiliations

¹ Visual Physiology, School of Allied Health Sciences, Kitasato University, Tokyo, Japan.
² Department of Ophthalmology, Sanno Hospital, Tokyo, Japan.
³ Department of Ophthalmology, School of Medicine, Kitasato University, Tokyo, Japan.

Abstract

Purpose: To assess the 8-year clinical outcomes of implantation of an implantable collamer lens (ICL) with a central port (KS-Aquaport; EVO-ICL) for moderate to high myopia and myopic astigmatism. Methods: This retrospective study comprised a total of 177 eyes of 106 patients with spherical equivalents of -7.99 ± 3.33 D [mean ± standard deviation], who underwent EVO-ICL implantation. We evaluated the safety, efficacy, predictability, stability, and adverse events of the surgery, at 1 month, and 1, 2, 4, 6, and 8 years postoperatively. Results: The logarithm of the minimal angle of resolution (LogMAR) uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were -0.07 ± 0.17 and -0.20 ± 0.09, respectively, at 8 years postoperatively. The safety and efficacy indices were 1.18 ± 0.24 and 0.89 ± 0.28, respectively. At 8 years, 83 and 93% eyes were within ± 0.5 D and ± 1.0 D of the targeted correction, respectively. Change in manifest refraction from 1 month to 8 years postoperatively was -0.13 ± 0.30 D. Three eyes (1.7%) that developed cataracts had a slight pre-existing peripheral anterior subcapsular cataract formation required simultaneous ICL extraction and cataract surgery at 2 or 3 years or ICL size change (1 size up) at 7 years postoperatively. We found that neither significant intraocular pressure (IOP) rise (including pupillary block) nor significant endothelial cell loss occurred in any case throughout the 8-year observation period. Conclusions: Current ICL implantation with central port technology offered good continuous outcomes for all measures of safety, efficacy, predictability, and stability for correcting moderate to high myopic errors over a long period, thereby suggesting its long-term viability as a surgical approach for the treatment of such eyes.

Keywords: EVO-ICL; efficacy; long-term prognosis; myopia; phakic IOL; predictability; safety; stability.