Factors leading to realignment or exchange after implantable collamer lens implantation in 10 258 eyes. Issue 10 (30th October 2022)

• Record Type: Journal Article
• Authors: Wei, Ruoyan; Li, Meiyan; Aruma, Aruma; Knorz, Michael C.; Yang, Dong; Yu, Yongfu; Wang, Xiaoying; Choi, Joanne; Yao, Peijun; Zhou, Xingtao
• Is Part Of: Journal of cataract and refractive surgery. Volume 48:Issue 10(2022)
• Page Start: 1190
• Page End: 1196
• Publication Date: 2022-10-30
• Subjects: 617.7
• DOI: 10.1097/j.jcrs.0000000000000950
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : ICL is a safe procedure with a low incidence of secondary surgery. Realignment, including vertical rotation, and exchange are practicable for the management of misalignment and excessive vault. Abstract : Purpose: To evaluate the incidence, causes, and outcomes of implantable collamer lens (ICL) realignment or exchange after implantation of the EVO-ICL. Setting: Eye and ENT Hospital of Fudan University, China. Design: Retrospective study. Methods: The study included 10 258 consecutive eyes after ICL implantation. Preoperative refractive and biometric measurements were compared between eyes with and without realignment or exchange. For eyes with ICL realignment or exchange, visual and biometric outcomes were also compared before and after ICL realignment or exchange. Results: The overall incidence of ICL realignment or exchange was 0.21% 22 eyes. 12 eyes (0.12%) underwent ICL realignment by axis rotation (10 eyes) or ICL exchange (2 eyes) due to toric ICL (TICL) misalignment. After realignment, uncorrected distance visual acuity improved, and residual cylinder decreased from −1.75 ± 0.48 diopters (D) to −0.87 ± 0.59 D ( P = .01). 10 eyes (0.10%) underwent vertical rotation of ICL (3 eyes) or ICL exchange (7 eyes) due to excessive vault. After either vertical rotation or ICL exchange, vault decreased significantly ( P < .05). Conclusions: The incidence of ICL realignment or exchange after ICL implantation is low. TICL misalignment and excessive vault are 2 main causes. Implant exchange may be performed for excessive vault or misalignment with an insufficient vault. In addition, vertical rotation of an ICL may be a less invasive method to treat excessive vault in certain cases.