Impact of veriflex and ICL on corneal biomechanics and endothelial cell density

To evaluate endothelial cell density (ECD) and corneal biomechanical changes following implantation of Veriflex and Implantable Collamer Lens (ICL) phakic intraocular lenses (pIOLs) over a 12-month period. Sixty patients (117 eyes) were included in this prospective comparative study. 58 eyes underwent implantation with the Veriflex lens (Group I), while 59 eyes received the ICL (Group II). Preoperative and postoperative ECD and corneal biomechanical values were assessed using specular microscopy and Corvis St at baseline, 6 months, and 1 year. Endothelial cell loss percentages and corneal biomechanical changes were calculated and compared between the 2 groups. Preoperatively, the mean ECD was 2683.4 ± 340.6 cells/mm² in Group I and 2732 ± 322.8 cells/mm² in Group II (P = 0.718). At 1 year, Group I exhibited a significantly greater reduction in ECD compared to Group II (P = 0.021), indicating higher endothelial cell loss with Veriflex. The mean endothelial cell loss at 12 months was 5.4% (145.7 ± 62.8 cells/mm²) in Group I compared to 1.53% (42 ± 17.3 cells/mm²) in Group II (P < 0.001). The Veriflex group showed greater corneal biomechanical changes, with a deformation amplitude (DA) increase to 1.15 ± 0.11 mm and a highest concavity time (HCT) of 17.2 ± 1.1 ms, while the ICL group demonstrated more stable biomechanics, with a DA of 1.09 ± 0.09 mm and an HCT of 16.6 ± 1.0 ms at one year postoperatively. Both Veriflex and ICL pIOLs resulted in a decrease in ECD over one year, with Veriflex showing a significantly higher rate of endothelial cell loss. These findings suggest that ICL may be a safer option for long-term endothelial preservation. Long-term studies are required to assess the continued impact of both lenses on corneal endothelial health.