Long-term efficacy and safety profiles after posterior chamber phakic intraocular lens implantation in eyes with more than 10 years of follow-up

Purpose: To evaluate long-term efficacy, safety, predictability, and stability of a posterior chamber phakic intraocular lens (Visian implantable collamer lens [ICL]) in eyes with >= 10 years of follow-up. Setting: Instituto de Microcirugia Ocular, Barcelona, Spain. Design: Retrospective study. Methods: Eyes undergoing ICL implantation from 2008 to 2011 with >= 10 years of follow-up were included. Variables analyzed were preoperative, 1-month, 1-year, 5-year, and last follow-up uncorrected distance (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent (SE), endothelial cell count (ECC), and intraocular pressure (IOP). Descriptive statistics were performed and results reported following the Standard for Reporting Refractive Surgery Outcomes. Results: 45 eyes (26 patients) were analyzed; the mean follow-up 11.35 +/- 1.30 years. The mean preoperative SE was -10.06 +/- 3.40 diopters (D) and the mean preoperative cylinder -1.55 +/- 1.45 D. At the last follow-up, efficacy and safety indices were 0.79 and 1.12, respectively. In total, 32 eyes (71%) achieved an UDVA of >= 20/40. 22 eyes (49%) gained >= 1 line of CDVA, and 2 eyes (4%) lost >= 2 lines of CDVA. At the final follow-up, 19 eyes (42%) and 29 eyes (64%) were within +/- 0.50 D and +/- 1.00 D of attempted SE correction, respectively. 31 eyes (69%) had <= 1.00 D of postoperative astigmatism, and 29 eyes (74%) were within +/- 15 degrees from the intended correction axis. At the last visit, a statistically significant myopic progression of -0.75 +/- 1.20 D was observed (P =.01). ECC loss at the last follow-up was 9.85 +/- 11.35%. IOP remained stable. There were no intraoperative complications. 3 eyes (7%) developed cataract after 10 years. Conclusions: The long-term results demonstrated that ICL was effective, predictable, stable, and safe. Copyright (c) 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS