Study: Cataract a long-term complication after ICL implantation

Visual impairment due to cataract formation occurred in about 10% of patients implanted with the STAAR Visian ICL in a long-term study in Austria. Median time to lens opacification was 27 months, the study authors reported.

Birgit Lackner, MD, and colleagues at the University of Vienna prospectively evaluated the long-term results of Visian ICL (formerly the Implantable Contact Lens) implantation in 65 myopic and 10 hyperopic eyes of 45 patients aged 21 to 61 years. Primary outcome measures included uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and intraocular pressure. Slit-lamp exams preoperatively and at 1, 3 and 6 months and yearly postoperatively were used to determine the presence of lens opacification and the distance between the ICL and the crystalline lens.

In the eyes with myopia, mean spherical equivalent improved from –16.23 D preop to –1.77 D postop. In the eyes with hyperopia, mean spherical equivalent improved from +7.88 D preop to +0.44 D postop. Mean UCVA up to the end of individual observation time was Snellen 0.36 in the myopic eyes and Snellen 0.58 in the hyperopic eyes. Mean IOP was 14 mm Hg preoperatively and 13 mm Hg postoperatively.

One-third of the eyes developed anterior subcapsular opacification of the crystalline lens; two of these eyes showed direct contact with the ICL. Eleven eyes (14.7%) had stable opacification, and 14 eyes (18.7%) had progressive opacification. The mean time to opacification was 27 months. Of the eyes that progressed to opacification, eight (10.7%) had subjective visual impairment that required cataract surgery.

Contralateral opacification, old age and female gender were all significant independent risk factors for early formation of opacification after ICL implantation in phakic eyes.

The study is published in the November issue of Ophthalmology.