Endothelial cell loss post-ICL V4c: a meta-analysis.

Abstract

Endothelial cell density (ECD) loss is a noted effect of Implantable Collamer Lens (ICL) V4c surgery. Current literature provides a wide range of values for ECD loss post-surgery, which may not be helpful in advising patients and clinicians. A meta-analysis exploring ECD loss in ICL V4c for myopia correction was undertaken. 18 studies were included in this meta-analysis with two subgroup analyses to account for the variability in follow-up lengths. The average ECD loss 3, 12 and 21.25 (mean) months post-surgery were 1.32 ±1.28% (p<0.001, 95%CI = -75.158, -1.19), 1.75± 2.17% (p<0.001, 95%CI = -134.09, 14.52) and 3.84 ± 1.78% (p<0.001, 95%CI = -156.04, -54.26) respectively. ECD loss is most pronounced 3-months post-surgery, suggesting that acute surgical trauma was the primary contributor rather than long-term lens implantation. Overall, ICL V4c is for myopia correction exhibits similar ECD loss as seen in other ICL models, thereby affirming its safety.