Posterior Chamber Phakic Intraocular Lens Implantation for the Correction of Myopia and

Myopic Astigmatism: A Retrospective 10-Year Follow-up Study

TOMOAKI NAKAMURA, NAOKI ISOGAI, TAKASHI KOJIMA, YOKO YOSHIDA, AND YASUO SUGIYAMA

PURPOSE: To assess the 10-year clinical outcomes of implantable collamer lens (ICL) implantation for myopia and astigmatism.

DESIGN: Retrospective observational case series.

METHODS: This study included 114 eyes of 61 patients who underwent ICL implantation for correction of

myopia and myopic astigmatism. We assessed the safety, efficacy, predictability, stability, and adverse events preoperatively,

at 6 months (106 eyes) and 1 (94 eyes), 3 (58 eyes), 5 (65 eyes), 8 (89 eyes), and 10 (70 eyes) years

postoperatively. Only the eyes with clinical data available at each follow-up time were analyzed.

RESULTS: The mean logMAR uncorrected and corrected distance visual acuities were –0.01 ± 0.24 and –0.18 ± 0.07 at 10 years postsurgery. The mean indices for safety and efficacy were 0.88 ± 0.15 and 0.66 ± 0.26, respectively. At 10 years postsurgery, 71.4% and 87.1% of the eyes were within 0.5 and 1.0 diopters (D), respectively, of the attempted spherical equivalent correction. The mean intraocular pressure was 13.1 ± 2.4 mmHg preoperatively and 13.1 ± 2.9 mmHg at 10

years postoperatively. The mean endothelial cell loss was 5.3% at 10 years postsurgery. Twelve of 114 eyes (10.5%) developed anterior subcapsular cataract during 5-10 years’follow-up; among these, 4 eyes (3.5%) were symptomatic and ICL explantation and phacoemulsification surgery were performed. No vision-threatening complications occurred during the observation period.

CONCLUSION: ICL implantation offered good overall outcomes in all measures of safety, efficacy, predictability,

and stability for the correction of myopia and myopic astigmatism throughout a long-term follow-up period of

10 years.

点评：本研究报告的是无中央孔的ICL（V4)的10年随访研究报告；目前使用的是改进型的带中央孔ICL（V4C）；其对眼内房水循环和晶状体代谢的影响更小，理论上其导致白内障发生的概率会减小。期待看到有中央孔的ICL（V4C)的10年随访报告。