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Purpose
To examine the long-term efficacy and safety of the Implantable Collamer Lens (ICL) in a military population.
Methods
We present a retrospective longitudinal observational study of 2,956 eyes of patients 18-55 years old who underwent ICL implantation at a single US Military medical treatment facility, followed for up to 11 years. All patients received a standard preoperative refractive surgery exam including visual acuity, IOP, manifest and cycloplegic refractions, corneal topography, corneal tomography, qualitative grading of perceived ectatic risk, ophthalmic biometry, and baseline endothelial cell counts. Postoperative measures included visual acuity, IOP, vault size, manifest refraction, and ECC. Long term follow-up data was drawn from the US Military electronic medical record system.
Results
Patients received ICLs either due to abnormal topography (68%) or due to high myopia (32%). Close to 80% of eyes maintained UCVA of 20/25 of better up to 8 years postoperatively. Predictability of achieving the desired refractive correction was 97% at one year and 90% at eight years. Stability of these outcomes was also shown by minimal change in patients’ refraction. Documented mean ECC loss was 22% at post-operative year five. Over eleven years, the overall rate of adverse events was 1.2% including visually significant cataract formation, glaucoma, retinal detachment, and traumatic incision opening. Of implanted ICLs, 4.5% were removed and/or replaced typically due to low vaults.
Conclusion
ICL implantation was found to be effective, predictable, stable, and safe. Vault sizes decreased over time suggesting an increased risk of cataract formation after seven years. A decrease in mean ECC of 22% at postoperative year five suggests further study is necessary to assess long term clinical significance.
To examine the long-term efficacy and safety of the Implantable Collamer Lens (ICL) in a military population.
Methods
We present a retrospective longitudinal observational study of 2,956 eyes of patients 18-55 years old who underwent ICL implantation at a single US Military medical treatment facility, followed for up to 11 years. All patients received a standard preoperative refractive surgery exam including visual acuity, IOP, manifest and cycloplegic refractions, corneal topography, corneal tomography, qualitative grading of perceived ectatic risk, ophthalmic biometry, and baseline endothelial cell counts. Postoperative measures included visual acuity, IOP, vault size, manifest refraction, and ECC. Long term follow-up data was drawn from the US Military electronic medical record system.
Results
Patients received ICLs either due to abnormal topography (68%) or due to high myopia (32%). Close to 80% of eyes maintained UCVA of 20/25 of better up to 8 years postoperatively. Predictability of achieving the desired refractive correction was 97% at one year and 90% at eight years. Stability of these outcomes was also shown by minimal change in patients’ refraction. Documented mean ECC loss was 22% at post-operative year five. Over eleven years, the overall rate of adverse events was 1.2% including visually significant cataract formation, glaucoma, retinal detachment, and traumatic incision opening. Of implanted ICLs, 4.5% were removed and/or replaced typically due to low vaults.
Conclusion
ICL implantation was found to be effective, predictable, stable, and safe. Vault sizes decreased over time suggesting an increased risk of cataract formation after seven years. A decrease in mean ECC of 22% at postoperative year five suggests further study is necessary to assess long term clinical significance.
View More Presentations from this Session
This presentation is from the session "SPS-104 Refractive Procedure Outcomes: SMILE, SMILE & CXL, ICL" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.