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Long-term outcomes of ICL with central hole show stability, safety

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Kimiya Shimizu

ROME — The Visian ICL with KS-AquaPORT is a safe and reversible option that produces better visual outcomes than corneal refractive surgery, according to developer Kimiya Shimizu, MD, PhD.

Shimizu said the ICL with KS-AquaPORT (KS-AP, STAAR Surgical) should be the first-line option for all eligible patients who wish to undergo refractive surgery.

“LASIK causes problems such as a decrease in contrast sensitivity, dry eye and regression. SMILE, on the other hand, has drawbacks such as delayed visual function recovery and complications such as interface fluid syndrome,” Shimizu said at the OSN Italy meeting.

The first ICL was implanted in 1997, and visual results were immediately outstanding. Nevertheless, it was not widely adopted due to induced cataract, difficult sizing and the need to perform peripheral iridotomy to avoid pupillary block.

A small hole in the center of the optic, allowing the flow of aqueous humor, was able to solve major problems.

“In 2007, I implanted the ICL KS-AquaPORT into the eyes of seven human subjects for the first time. Since then, I have not encountered a single complication,” Shimizu said.

In 2016, a 5-year study comparing the ICL with and without the central hole in the two eyes of 32 patients showed that cataract developed in the eyes in which the ICL without the hole had been implanted and not in the eyes in which the ICL with KS-AP had been implanted. In a more recent study evaluating the KS-AP in 512 eyes between 2007 and 2018, stable vision was maintained over 11 years, with no regression, no IOP elevation, no reduction in endothelial cell density and no cataract.

However, four subjects had their lenses exchanged due to inappropriate sizing.

“We have since then improved sizing by the use of ultra-high-speed anterior segment OCT for angle-to-angle distance. With this technology, over 90% of the subjects fall within the ‘ideal vault’ range,” Shimizu said.

Now that that major problems have been overcome, he uses the ICL with KS-AP as the first-line option rather than any other type of refractive surgery. – by Michela Cimberle

Reference:

Shimizu K. 10 years follow-up of KS-AquaPORT ICL. Presented at: OSN Italy meeting; May 24-25, 2019; Rome.

Disclosure: Shimizu reports he is a consultant to Charmant, Kowa and STAAR.