Phakic IOL comparison
Two different posterior capsule IOLs show comparable performance.
Suphi Taneri MD, FEBOS-CR
The implantable phakic contact lens (IPCL, Care Group) and the implantable collamer lens (ICL, Staar Surgical) provide similar visual outcomes with similar refractive predictability and safety in the correction of moderate-to-high myopia with or without astigmatism, according to a study presented by Suphi Taneri MD, FEBOS-CR, Ruhr-University Bochum, Germany.
The observational consecutive case series study included 111 eyes that underwent implantation of the IPCL and 115 eyes that underwent implantation of the ICL. Eyes with an internal anterior chamber depth of less than 2.8mm and a central endothelial cell count of less than 2000/cm2were excluded from the study, Dr Taneri told the 25th ESCRS Winter Meeting.
He noted that the lenses have similar designs with regard to their dimensions, haptic design and the inclusion of a central hole to allow flow of the aqueous. They differ slightly in their lens material and in the available power range (IPCL: +15 to -30D, Cylinder up to 12D; ICL: +10 to -20D, Cylinder up to 6D) and sizes (IPCL: 13 sizes from 11.0 to 14.0mm; ICL: four sizes from 12.1 to 13.7mm).
At three months’ follow-up, uncorrected distance visual acuity among eyes targeted for plano was the same or better than preoperative corrected distance visual acuity in 86% of eyes in the IPCL group and 91% of the ICL group. Furthermore, 35% and 38%, respectively, gained one or more lines in corrected distance acuity, Dr Taneri said.
In eyes undergoing correction of up to -20D of myopia, the spherical equivalent was within 1.0D of target refraction in 92% of the IPCL group and 94% of the ICL group. Furthermore, postoperative cylinder was less than 1.0D in 97% and 95% of the IPCL and ICL group, respectively. Moreover, refraction was stable throughout one year of follow-up with both lenses.
Dr Taneri noted that a review of all ICLs and IPCLs implanted over the past 10 years at his centre indicates that postoperative re-rotation was necessary in five of 58 toric IPCL implanted from 2017 to February 2021, compared to two eyes of 64 toric ICLs implanted from 2011 to 2019. However, he pointed out that vaulting was perfect in all cases where rotation occurred and he speculated that iris factors may be at fault.
He also reported that there was no significant endothelial cell loss with either lens at two years’ follow-up. Intraocular pressure returned to preoperative levels after a spike in the first hours after implantation, while cataracts occurred in one eye in the IPCL group and two eyes in the ICL group.