Incidence & Factors Responsible for Implantable Collamer Lens ( ICL ) Explantation & Outcomes of Further Management - 5 Year Retrospective Study

Purpose: To investigate the causes of Implantable Collamer Lens (ICL) explantation and study the visual outcomes after further management in a retrospective case series. Methods: Retrospective chart review was performed for all the eyes that underwent bilateral or unilateral ICL explantation between March 2010 and April 2015. Incidence & causes of explantation, time between primary & secondary surgery and methods of visual rehabilitation were analysed. Results: Out of the 957 ICLs implanted, 19 (1.98%) ICLs were explanted from 14 patients with mean age of 32.7 ± 8.8 yrs during the study period. Causes of explantation were-cataract 8 eyes (42.1%), excessive vault 6 eyes (31.6%) & frequently rotated TICL 5 eyes (26.3%). Average time from ICL surgery to explantation due to cataract was 65.4 ± 24.1 months. Excessive vault and frequently rotated TICLs were exchanged with appropriate size ICL based on STS measurement. Outcomes of lensectomy with IOL implantation in cataract patients were satisfactory with CDVA equal or better than immediate post ICL visual acuity in all eyes. No eye lost lines of CDVA and no adverse effects due to ICL explantation and subsequent secondary procedures were observed. Conclusion: The Results of this retrospective review suggests that ICLs are safe and effective in patients not suitable for keratorefractive procedures and provide stable results. However, a small percentage of patients may encounter some complications, necessitating their explantation. Issues related to ICL sizing should be addressed to minimize the chances of explantation in future.