15-month outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth
Abstract Background: High myopia with shallow anterior chamber depth (ACD < 2.8 mm) is not rare. This observational study aims to: evaluate clinical outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. Methods: A prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for 15.35 ± 4.90 months (12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after the surgery. Results: All surgeries were performed safely and no complication was observed during the follow-ups. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ± 1.0 D and 35 eyes (69%) were within ± 0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 µm (90 to 700µm). The ECD was reduced by 8.38 ± 0.06% compared to the preoperative value (p < 0.001). No significant change was observed in IOP (p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed. Conclusions: In this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation. Trial Registration: This trial was retrospectively registered on 05/08/2018 under the number (ChiCTR1800017594)