Literature Review to Better Determine Risk for Cataract With Collagen Copolymer IOLs
Narrative Responses:
Purpose
The literature has frequently reported the incidence of cataract occurring following ICL implantation ranges from 2.5%–33%, which is too wide to be a useful gauge of risk. The purpose of this paper was to analyze the literature to better define the risk of clinically significant cataract following ICL implantation.
Methods
A literature search was conducted to find articles reporting the incidence of cataract following ICL implantation. All studies, including review articles, were included in the search so that we could examine all possible variables and trace the origins of data referenced. We isolated clinically significant cataract (cataract resulting in ICL explanation and IOL implantation) from all other reported opacities. Where a range of cataract was cited, we cross checked it in the original article. We also examined the basis of calculations.
Results
A number of variables in reporting were found that materially affected the range of cataract reported from study to study. These variables included the way the author defined cataract; articles the author referenced to support claims; the inclusion or exclusion of cataract induced by surgical trauma; and misleading or imprecise presentation of calculations. Risk factors contributing to the rate of cataract were the older age of the cohort, higher refractive error, and obsolete models of ICL. An extensive 2011 review of the literature found that only 1.4% (38) of 2592 eyes developed clinically significant cataract.
Conclusion
Despite discrepancies in cataract reporting, ICLs have consistently been documented to have low risk of complications when manufacturer age recommendations are followed. Caution should be employed and variables should be examined when interpreting published percentages of ICL-associated cataract.