Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia

Purpose: To report the long-term clinical outcomes, including efficacy and safety, of implantable collamer lens (ICL) implantation to treat myopia. Setting: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Design: Retrospective case series. Methods: Medical records of patients who had ICL implantation were reviewed. The preoperative and postoperative visual acuity, spherical equivalent (SE), endothelial cell density (ECD), and intraocular pressure (IOP) were analyzed. The postoperative vault and complication rate, including cataract and glaucoma, were evaluated. Patients were placed in the lens opacity group or clear lens group based on whether lens opacity developed postoperatively. Results: One hundred ten eyes (60 patients) were analyzed. The mean preoperative age was 30.3 years ± 8.3 (SD). The mean SE was −12.01 ± 3.70 diopters (D) preoperatively and −0.65 ± 1.09 D 10 years postoperatively. The mean vault height was 562.4 ± 175.9 μm 6 months postoperatively, decreasing to 352.9 ± 171.8 μm at 10 years. There were no significant changes in the ECD and IOP at any timepoint. Lens opacities developed in 21 eyes (12.1%) during the 10-year follow-up. The mean vault in the lens opacity group was significantly lower than in the clear lens group after 4 years. No patient who had ICL implantation when they were 30 years or younger developed lens opacity or required phacoemulsification. Conclusions: The results indicate that ICL implantation provided long-term stability and good refractive outcomes. Performing this surgery in young patients, especially those 30 years or younger, may be safe in terms of long-term cataract formation.