Long-term follow-up for monovision surgery by Implantable Collamer Lens V4c implantation for myopia correction in early presbyopia

Purpose To investigate the long-term safety and efficacy of monovision surgery using implantable collamer lens V4c (ICL V4c) implantation in myopic patients with early presbyopia. Setting Eye and ENT Hospital of Fudan University, Shanghai, China. Design Prospective case series study. Methods This study included 64 eyes of 32 patients with early presbyopia, who underwent bilateral ICL V4c implantation for myopia correction. Parameters, including mean spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity, intraocular pressure, endothelial cell density, presbyopic add power, visual acuity (logMAR) of dominant eyes (D-eye), nondominant (nD-eye) eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m were recorded at the last follow-up. Results All surgeries were uneventful. At the last follow-up, the safety indices were 1.23 +/- 0.18 (D-eyes) and 1.21 +/- 0.18 (nD-eyes) (p > 0.05); the efficacy indices were 0.95 +/- 0.27 (D-eyes) and 0.92 +/- 0.28 (nD-eyes) (p < 0.05), the SE was -0.62 +/- 0.47 D (D-eyes); and - 1.21 +/- 0.78D (nD-eyes) (p < 0.05), presbyopic add power was 1.31 +/- 0.58 D. The visual acuity (logMAR) of D-eyes, nD-eyes, and binocular (Bi) at 5.0 m were: 0.06 +/- 0.15 (D-eye), 0.21 +/- 0.18 (nD-eye), (p < 0.01), and 0.04 +/- 0.13 (Bi); 0.8 m: 0.03 +/- 0.18 (D-eye), 0.08 +/- 0.16 (nD-eye), (p > 0.05), and - 0.02 +/- 0.11 (Bi); 0.4 m: 0.08 +/- 0.09 (D-eye), - 0.02 +/- 0.08 (nD-eye), (p < 0.001), and - 0.03 +/- 0.09 (Bi). Subjects were very satisfied or felt excellent with their visual acuity at near (81.25%) and far distances (87.50%), respectively (versus preoperative, p < 0.001). Conclusion Monovision surgery using ICL V4c implantation is safe and practicable for correction of myopes with presbyopia, with long-term efficacy at near and far distances and patient satisfaction.