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Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up

Eye (2024)Cite this article

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Abstract

Background

This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia.

Methods

We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was −11.50 D (interquartile range [IQR]: −13.00 to −9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation.

Results

The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00–1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00–1.25), 1.20 (IQR: 1.00–1.33), and 0.8 (IQR: 0.65–1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery.

Conclusion

In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.

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Fig. 1: Clinical outcomes of 125 eyes with myopia at last follow-up after implantation of V4c implantable collamer lens (ICL).
Fig. 2: Various parameters at different follow-up times after V4c implantable collamer lens (ICL) implantation.
Fig. 3: The association between postoperative vault and variables.
Fig. 4: Multiple linear regression model.

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Data availability

The datasets used in the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Science and Technology Planning Project of Sichuan Province (No.2020YFS0257; No. 2023YFS0179).

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Author notes

  1. These authors contributed equally: Qi Wan, Peiyuan He.

Authors and Affiliations

  1. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China

    Qi Wan, Peiyuan He, Ran Wei, Ke Ma, Hongbo Yin, Jing Tang & Ying-ping Deng

  2. Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China

    Peiyuan He

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Contributions

QW conducted the analysis and drafted the original manuscript, while PYH, RW reviewed the relevant articles. HBY, JT, KM, and YPD developed the idea for the paper. All authors provided feedback and approved the final text.

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Correspondence to Ke Ma or Ying-ping Deng.

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The research adhered to the ethical principles outlined in the Helsinki Declaration and received approval from the Ethics Committee of West China Hospital (No. 20210427).

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Wan, Q., He, P., Wei, R. et al. Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up. Eye (2024). https://doi.org/10.1038/s41433-024-03046-9

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