Factors leading to realignment or exchange after implantable collamer lens implantation in 10 258 eyes
Ruoyan Wei1, Meiyan Li, Aruma Aruma
1From the Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China (Wei, Li, Aruma, Yang, Wang, Yao, Zhou); NHC Key Laboratory of Myopia, Fudan University, Shanghai, China (Wei, Li, Aruma, Yang, Wang, Yao, Zhou); Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China (Wei, Li, Aruma, Yang, Wang, Yao, Zhou); FreeVis LASIK Zentrum, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany (Knorz); Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China (Yu); Kresge Eye Institute/Department of Ophthalmology, Wayne State University, Detroit, Michigan (Choi).
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.
