Changes in anterior lens density after Implantable Collamer Lens V4c implantation: a 4-year prospective observational study.

Purpose

To investigate the changes in anterior lens density with a Pentacam after Implantable Collamer Lens (ICL) V4c implantation in patients with myopia.

Methods

This prospective case series examined 62 eyes of 32 patients (mean age, 28.5 ± 5.73 years) with myopia or myopic astigmatism after ICL V4c implantation. Uncorrected distance vision acuity, corrected distance vision acuity (CDVA), manifest refraction, intraocular pressure, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), endothelial cell density and Pentacam images of lens density were obtained pre- and postoperatively. The vault was obtained during the follow-ups.

Results

Patients were followed up for an average of 51 ± 2.7 months (range, 48-57 months). All surgeries were uneventful, without any complication. The efficacy and safety indices at the last follow-up were 1.03 ± 0.2 and 1.22 ± 0.22, respectively. No eye had decreased CDVA, and 66% eyes gained ≥1 line. Furthermore, refractive error in 90% eyes was within ±0.50 D and that of 100% was within ±1.0 D of the attempted refraction. Anterior average lens density (a-ALD) in the 0.5-, 1.0- and 1.5-mm depth zones increased by 10.41 ± 11.51%, 17.1 ± 11.09% and 16.76 ± 10.4%, respectively, compared to preoperative values (all p < 0.05). The change in a-ALD between two different age groups was not significant. Moreover, there were no significant correlations between the change in a-ALD and age, preoperative spherical equivalent, ACD, ACA, ACV or vault.

Conclusions

Implantable Collamer Lens (ICL) V4c implantation demonstrates safety and efficacy for myopia correction. Although a-ALD increased slightly at 4 years postoperatively, no cataract developed during the follow-up. Further studies should investigate the reason for the postoperative increase in a-ALD.