Safety of the Minimum Ophthalmic Viscosurgical Device Technique in Phakic Implantable Collamer Lens Implantation

PURPOSE: To compare the safety of the minimum ophthalmic viscosurgical device (OVD) technique with the standard procedure in phakic Visian Implantable Collamer Lens (ICL) (STAAR Surgical AG, Nidau, Switzerland) implantation. METHODS: This retrospective cohort study evaluated a total of 147 eyes of 74 patients who underwent ICL implantation with the minimum OVD technique (minimum OVD group) and 154 eyes of 77 patients with the standard procedure (standard OVD group). Intraoperative and postoperative complications were recorded. Preoperative and postoperative visual acuity, intraocular pressure (IOP), aqueous depth (AQD), and central corneal endothelial cell density (ECD) were collected and analyzed over the 12-month follow-up. Lens vault and occurrence of paracentesis after surgery were also recorded. RESULTS: No intraocular complications were observed. No difference was found in visual outcomes, lens vault, and AQD at all time points between the two groups (P > .05). The minimum OVD group had significantly lower IOP than the standard OVD group at 2 hours (17.04 +/- 4.21 vs 19.40 +/- 6.78 mm Hg, P < .001) and 3 hours (15.12 +/- 3.38 vs 17.15 +/- 5.09 mm Hg, P < .001) postoperatively. The IOP gradually returned to the preoperative level after 24 hours postoperatively. The occurrence rate of paracentesis was significantly less in the minimum OVD group compared with the standard group (0.68% [1 of 147] vs 3.2% [5 of 154], P <.001). ECD was not significantly different between groups at all time points (P > .05). CONCLUSIONS: The minimum OVD technique could achieve visual and structural outcomes comparable to the standard procedure without additional damage to the corneal endothelial cells, while reducing the IOP fluctuations after surgery.