Background To evaluate the changes in corneal endothelium cell density (ECD) and the correlated factors after Implantable Collamer Lens (ICL) V4c implantation.
Methods In this retrospective, consecutive study, 48 eyes of 25 patients with myopia who underwent ICL V4c implantation were enrolled. Patients were followed up for at least 4 years, during which manifest refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, ECD, anterior chamber depth, anterior chamber volume (ACV), anterior chamber angle (ACA), vault and distance from the corneal endothelium to the central ICL (C-ICL) were measured. Spearman’s correlation analysis was used to identify variables correlated with changes in ECD, and generalised estimating equation model adjusting within-patient intereye correlations was used to predict changes in ECD.
Results All surgeries were performed safely with no complications during follow-up (average 52±2.9 months). Safety and efficacy indices were 1.23±0.22 and 1.04±0.16, respectively. No eyes had decreased CDVA, and 67% gained one or more lines. Further, 79% were within ±0.50 D, and 100% were within ±1.0 D of the attempted refraction. Additionally, a 4.03%±2.2% reduction in ECD compared with the preoperative value was observed at the last follow-up visit. Changes in ECD were significantly correlated with vault, C-ICL, change in ACA and change in ACV. Vault was the most significant factor for changes in ECD.
Conclusions ICL V4c implantation is safe and effective for myopia correction. Anterior segment biometric parameters including the vault, ACA and C-ICL may influence changes in ECD; specifically, the vault plays a major role.
- intraocular pressure
- posterior chamber
- treatment surgery
- optics and refraction
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WY and JZ are joint first authors.
WY and JZ contributed equally.
Correction notice This paper has been updated since it was published online. The affiliations and correspondence address have been corrected.
Contributors The study concept and design; drafting of the manuscript and critical revision of the manuscript were done by WY, JZ and XZ. Data collection and analysis and interpretation of data were undertaken by WY, JZ, LS, LN and XW. Supervision was done by XZ. WY and JZ contributed equally to this work and should be considered as equal first authors.
Funding Supported in part by the National Natural Science Foundation of China (Grant no. 81770955); Joint research project of new frontier technology in municipal hospitals (SHDC12018103); the Project of Shanghai Science and Technology (Grant no.17411950200); the National Natural Science Foundation of China for Young Scholars (Grant no. 81600762); the Project of Shanghai Science and Technology (Grant no. 19140900700) and the Shanghai Shenkang Hospital Development Center (Grant no. SHDC12016207).
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval This study followed the tenets of the Declaration of Helsinki and was approved by the ethics committee of the Eye and ENT Hospital of Fudan University.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Our data are available when all authors agree. Email: email@example.com.
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