FACT: Complications are Rare with ICL’s. Fewer than 1% of Patients Develop a Cataract, and These are Easily Fixed.
https://www.youtube.com/watch?v=RPe6B3JGTHM
The Implantable Collamer Lens (ICL) has been used for the correction of higher myopia and (more recently) myopia with astigmatism internationally for nearly two decades; in the USA, ICL implantation has had FDA approval for approximately a decade. It is estimated that more than 500,000 ICL procedures have been performed worldwide. Several studies have shown that the ICL is safer and more effective than other refractive surgical modalities (including LASIK and PRK) for the correction of higher myopia and myopic astigmatism.
One of the concerns associated with ICL implantation has been the creation of cataracts. Cataract formation after ICL implantation has been documented in a multitude of clinical studies, including the FDA’s approval and post-approval studies. While an important consideration, clinical experience has taught us that the incidence of cataract formation can be directly related to 3 main factors that are now well established with ICL surgeons. These include (1) patient age, (2) the choice of ICL implant style, and (3) degree of myopia.
Cataract incidence even without any eye surgery is known to increase in patients over 45 years old (as part of the natural aging of the crystalline lens). Thus, it is not surprising that ICL implantation after 45, and especially after 50 years old, is associated with an increased cataract formation risk. Similarly, patients with extremely high myopia (more than -12D) do have a slightly increased risk of cataract formation even without any eye surgery; again, it is not surprising that this is a slight increased risk factor in this patient group undergoing ICL implantation. Finally, the specific parameters of the ICL implant, particularly the vault (or spacing) above the crystalline lens has been strongly associated with cataract formation risk. One of the important decisions for the ICL surgeon is to determine the proper ICL implant vault for each patient’s eyes and there are sophisticated technologies to help in this assessment.
If patient age, ICL implant vault measurements and – to a lesser extent – degree of myopia are taken into account, it is now well accepted that the incidence of visually meaningful cataract formation resulting from ICL implantation is far less than 1% (in some studies even as low as 0.2-0.3%).
Given its safety record and the significant improvement in vision and quality of life the ICL makes possible…
the benefits of ICL implantation outweigh the risks.
The incidence of developing a cataract after ICL implantation is low…
and the rate of developing ASCs positively correlated with age and negatively correlated with ACD.
Title: Complications related to vault are very low
Authors: Packer MD
Précis: The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the Implantable Collamer Lens (ICL). The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault. The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/27354760
Full reference: Packer M. Meta-analysis and review: effectiveness, safety and central port design of the intraocular collamer lens. Clin Ophthalmol 10:1059-1077, 2016
Keywords: ICL, Implantable Collamer Lens, Cataract, Prevalence, Refractive Surgery
Title: Rate of developing Anterior Subcapsular Cataract (ASC) wile low, is positively correlated with age and negatively correlated with Anterior Chamber Depth (ACD)
Article: “Incidence of implantable Collamer lens-induced cataract.”
Authors: Gimbel HV, LeClair BM, Jabo B, Marzouk H.
Précis: While exact
correlation is not known, a retrospective observation study of 1653
eyes totaled the incidence of ICL removal with cataract extraction and
intraocular lens placement (CE-IOL) as a result of anterior subcapsular cataract ASC), in correlation to
patient’s age and anterior chamber depth is low.
Full reference: Can J Ophthalmol. 2018 Oct;53(5):518-522. doi: 10.1016/j.jcjo.2017.11.018. Epub
2018 Mar 28.
Keywords: ICL, Implantable Collamer Lens, Cataract, Prevalence, Refractive Surgery
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