Incidence of implantable Collamer lens–induced cataract

Objective: Although the literature on the implantable Collamer lens (ICL) suggests an increasing rate of anterior subcapsular cataract (ASC) development with increasing age and decreasing anterior chamber depth (ACD), the exact correlation is not known. We performed a retrospective observation study of 1653 eyes and calculated the incidence of ICL removal with cataract extraction and intraocular lens placement (CE-IOL) as a result of ASC, in correlation to patient's age and ACD. Design: Retrospective observation study. Setting: The Gimbel Eye Centre, Calgary, Alberta, Canada. Methods: We analyzed ICL V4 model (Visian ICL; STAAR Surgical, Monrovia, CA) implanted in 1653 eyes with myopia from 2000 to 2012 at the Gimbel Eye Centre, Calgary. Myopic patients aged 19 years and older with no history of cataracts were included. The rate of ICL removal with cataract extraction was calculated. Parameters such as age, sex, refractive sphere, refractive cylinder, length of follow-up, and ACD were collected. Cataract-free survival with comparison of FDA and non-FDA cohorts was conducted using Kaplan–Meier survival curves with the log-rank test. In addition, covariates adjusted hazards ratios and 95% confidence intervals were calculated using Cox regression. Results: Of the 1653 eyes included in this study, a total of 46 eyes underwent ICL removal with CE-IOL. The length of follow-up varied between 2 and 14 years. Conclusions: This retrospective study demonstrated that the rate of developing ASCs positively correlated with age and negatively correlated with ACD.