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The following is a summary of “Comprehensive assessment of corneal microstructural changes following V4c implantable collamer lens surgery using in vivo confocal microscopy,” published in the September 2024 issue of Ophthalmology by Wei et al.
Implantable Collamer Lenses (ICL) offer a promising option compared to traditional refractive surgeries, but their effects on the corneal microstructure are not well understood.
Researchers conducted a prospective study and used in vivo confocal microscopy (IVCM) to explore changes in stromal and endothelial cells after inserting V4c ICLs, aiming to improve post-surgical care and outcomes.
They performed a longitudinal study involving 103 eyes from 53 participants, conducting thorough preoperative assessments. Follow-ups occurred on day 1, 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, using IVCM to analyze stromal and endothelial cell changes. A mixed-effects model assessed pre- and post-surgery differences and correlations. With age, axial length (AL), and spherical equivalent refraction (SER).
The result showed that no vision-threatening complications were reported after surgery. Significant stromal cell density (SCD) reductions occurred postoperatively, with anterior and mid-SCD hitting their lowest at 3 months and posterior SCD at 1 month, remaining below baseline at 12 months. Endothelial cell density (ECD) and hexagonal cell percentage (PHC) initially decreased but recovered by 12 months. In contrast, endothelial cellular area (ECA) and coefficient of variation (CoV) increased post-surgery, peaking at 1 week. Endothelial deposits appeared in 49 of 101 eyes on day 1, half absorbed within 3months. Changes in posterior SCD were negatively related to AL.
Investigators concluded that V4c ICL implantation causes notable early drops in corneal cell densities. They recommend managing viscoelastic carefully during surgery and enhancing early postoperative monitoring to improve recovery and overall patient outcomes.
Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03677-2
