Four-year Follow-up of the Changes in Anterior Segment After Phakic Collamer Lens Implantation

The changes in central vaulting, endothelial cell density, and crystalline lens thickness are more prominent during the first year after ICL implantation and then become relatively stable.

In a recent study by Lu et al, published in Am J Ophthalmol 2017; 178:140–149 Q 2017 Published by Elsevier Inc., the changes and relationship in central vaulting, flare intensity, and crystalline lens thickness during a follow-up period of 4 years after implantable collamer lens (ICL) implantation in eyes with high myopia was assessed. It was a retrospective observational study, conducted in Ninety-eight eyes of 50 patients. Measurements of central vaulting, crystalline lens thickness, endothelial cell density, and aqueous flare were recorded postoperatively. The relationship between the annual change in crystal lens thickness after surgery and age was evaluated. This showed that there was a reduction in central vaulting and endothelial cell density with an increase in crystalline lens thickness in ICL eyes from 1 month onward to 5 years postoperatively (P < .001) and this variation was smaller between 12 and 36 months or 60 months postoperatively. Aqueous flare intensity increased significantly after surgery and returned to normal 1 year later.

They concluded that changes in central vaulting, endothelial cell density, and crystalline lens thickness are more prominent during the first year after ICL implantation, tending to be relatively stable afterwards. The anterior inflammation during the early postoperative period synchronizes with the sharp progression of crystalline lens changes within the first year.