Comparison of optical quality and intraocular scattering after posterior chamber phakic intraocular lens with and without a central hole (Hole ICL and Conventional ICL) implantation using the double-pass instrument

To objectively compare the optical quality and the intraocular scattering after implantation of the posterior chamber phakic implantable collamer lens (Visian ICL™, STAAR Surgical) with and without a central artificial hole for moderate to high ametropia. This retrospective study comprised 28 eyes of 28 consecutive patients undergoing Hole ICL implantation (mean age ± standard deviation, 30.3±5.8 years), and 24 age-matched eyes of 24 patients undergoing conventional ICL implantation (age, 30.4±6.1 years). We quantitatively assessed the postoperative values of MTF cutoff frequency, Strehl ratio, objective scattering index (OSI), and OQAS values (OVs), using an Optical Quality Analysis System™. We compared these postoperative variables between the two groups. The mean MTF cutoff frequency, Strehl ratio, OSI, OV100%, OV 20%, and OV9%, were 26.21±8.32 cycles/degree, 0.16±0.04, 1.16±0.57, 0.87±0.28, 0.80±0.35, and 0.80±0.33, respectively, 3 months after Hole ICL implantation. We found no significant differences in the MTF cutoff frequency (Mann Whitney U test, p = 0.59), the Strehl ratio (p = 0.82), the OSI (p = 0.63), or the OVs at contrasts of 100% (p = 0.58), 20% (p = 0.40), and 9% (p = 0.87), between the two groups. Both Hole ICL and conventional ICL implantation provides an excellent optical performance including intraocular scattering. Newly developed Hole ICL implantation appears to be essentially equivalent in the optical quality variables to conventional ICL implantation, suggesting that the presence of the central artificial hole does not significantly affect the optical quality and the intraocular scattering after surgery.