Piggyback Collamer Copolymer Lens: 2-Year Results
Purpose
To assess the efficacy and safety of implanting Visian implantable collamer lens (ICL/TICL) in the ciliary sulcus to correct pseudophakic ametropia in patients not candidate for keratorefractive procedure.
Methods
Retrospective non comparative study included patients who had implantation of a secondary/piggy-back ICL (V4B and V4C) to correct residual refractive error in 9 eyes of 9 patients (age 48-61 y) after phacoemulsification with IOL implantation in the capsular bag (refractive surprise) and in 4 pediatric eyes of 4 patients (age 7-9 y) with myopic shift and anisometropic amblyopia following lensectomy and IOL implantation. Before and after implantation of the ICL in the ciliary sulcus, evaluation of uncorrected and best corrected visual acuity, refraction, IOP, endothelial cell count outcomes were evaluated. The position and rotation of the ICLs/TICLs were documented at all control visits, and Scheimpflug images were taken. Postoperative follow-up was at 1 week and 1, 6, 9, 12, and 18 months.
Results
Thirteen eyes of 13 patients were evaluated. The refractive error range (-4.00 to +3.00) preoperatively corrected with mean SE of -0.65 +/- 0.25 D postoperatively. Uncorrected distance visual acuity improved in all cases and BCVA improved in 4 amblyopic eyes (2-3 lines). No evidence of interlenticular opacification throughout the 2 years follow up. Postoperative IOP elevation and anterior uveitis in 2 pediatric eyes and controlled by topical steroids and beta blocker.
Conclusion
Sulcus implantation of the secondary ICL to correct pseudophakic refractive error was safe, predictable and well tolerated in all eyes not candidate for LASIK surgery.