Purpose To compare the visual quality of implantable collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering.

Methods An adaptive optics visual simulator (crx1, Imagine Eyes, Orsay, France) was used to simulate the –3, –6 and –12 dioptres (D) conventional and Hole ICLs in three conditions: centred and decentred 0.3 and 0.6 mm. Visual acuity (VA) at high-contrast, medium-contrast and low-contrast and contrast sensitivity (CS) were measured in 15 observers for 3 and 4.5 mm pupils.

Results No statistically significant differences in VA and CS were found between conventional and Hole ICLs for any ICL powers and pupil sizes evaluated (p>0.05). Regarding the effect of the ICL decentration on visual performance, we did not find statistically significant differences in VA and CS between centred, 0.3 and 0.6 mm decentred (p>0.05). Moreover, the ICL decentration affected the same manner on the conventional and Hole ICLs.

Conclusions The outcomes showed that conventional and Hole ICLs provided good and comparable visual performance for all powers and pupil sizes evaluated. Besides, ICL decentering affects the same manner both ICL models evaluated. The ICL decentering did not have any effect on the visual performance.