Long-term Comparison of Vault and Complications of Implantable Collamer Lens with and without a Central Hole for High Myopia Correction: 5 Years

Purpose To investigate the long-term safety, efficacy, stability, vault, and complications of implantable collamer lens with (ICL V4c) and without (ICL V4) a central hole for correcting high myopia. Methods 78 eyes (40 patients) underwent ICL V4c implantation and 78 eyes (48 patients) underwent ICL V4 implantation were enrolled. They were followed up for 5 years of the uncorrected and corrected distance visual acuity, spherical equivalent (SE), axial length, intraocular pressure, endothelial cell density and vault. ResuIts The safety indices of the ICL V4c and V4 groups at 5 years were 1.25 +/- 0.40 and 1.31 +/- 0.40, respectively (P = .353). The efficacy indices were 0.90 +/- 0.29 and 1.00 +/- 0.44, respectively (P = .098). The preoperative, 1 month and 5 year postoperative logMAR UDVAs were respectively 1.54 +/- 0.48, 0.11 +/- 0.17, and 0.20 +/- 0.26 in the V4c group and 1.56 +/- 0.44, 0.14 +/- 0.19, and 0.22 +/- 0.26 in the V4 group (P = .703, 0.329, 0.585). The logMAR CDVAs were resepectively 0.13 +/- 0.18, 0.02 +/- 0.11, and 0.05 +/- 0.16 in the V4c group and 0.18 +/- 0.22, 0.05 +/- 0.14, and 0.09 +/- 0.21 in the V4 group (P = .128, 0.169, 0.229). The SE were resepectively -15.10 +/- 4.32 D, -0.71 +/- 1.31 D and -1.65 +/- 1.30 D in the V4c group and -15.44 +/- 3.51 D, -0.61 +/- 1.12 D and -1.40 +/- 1.30 D in the V4 group (P = .585, 0.637, 0.296). The mean vault reduced by 97.31 +/- 136.61 mu m in the V4c group and by 99.74 +/- 245.83 mu m in the V4 group. Three eyes (3.85%) with mid-periphery anterior subcapsular opacification in the V4c group and two (2.56%) with cataract, one (1.28%) with central anterior subcapsular opacification in the V4 group were observed. The CDVA of 20/40 was obtained in the two cataract eyes after phacoemulcification and intraocular lens implantation. Conclusion Long-term ICL V4c and ICL V4 implantations are safe, effective, and stable for high myopia correction. ICL V4c can potentially reduce the risk of lens opacification and may be more tolerant to low vault than ICL V4.