Outcomes after implantable collamer lens surgery in a Canadian cohort

To describe refractive outcomes and complications after implantable collamer lens (ICL) implantation.

Retrospective, interventional case series.

A database search of ICL surgeries over a 5-year period (2009-2013) was conducted, and 83 eyes of 44 patients were included. The Visian ICL (STAAR Surgical, Monrovia, Calif.) was used in all eyes. The primary outcome measure was postoperative uncorrected distance acuity (UCDA). Secondary outcomes include predictability, safety, and adverse events.

Mean age was 31 years, and 59% of patients were female. Mean observation time was 14.9 months. Mean manifest refractive spherical equivalent (MRSE) was -11.1 ± 3.24 D preoperatively and -0.18 D ± 0.57 D postoperatively. Mean astigmatism was -1.90 ± 1.34 D, and 82% of eyes received toric ICLs, 93.4% of eyes achieved 20/40 UCDA, and 50.8% achieved 20/20 at last observation; 67.1% and 89.5% of eyes had MRSE within 0.5 and 1.00 D of target refraction, respectively. Safety index was 1.16 and overall improvement of 0.060 logMAR was observed. Eight (10.5%) eyes had residual astigmatism with 5 (6.5%) requiring laser enhancement. Glare and haloes were reported in 6 eyes (7.9%). Three eyes developed cataract. One eye had a retinal detachment.

Toric and nontoric ICL implantations show promising refractive outcomes and acceptable safety in moderate to high myopes and can be considered for patients who are noncandidates for refractive laser surgery.