Corneal endothelial assessment after ICL implantation

The authors evaluated the long-term effects of the Implantable Contact Lens (ICL) on corneal endothelium. Endothelial cell images were collected in the central region of the cornea before surgery at 12, 24, and 36 months after surgery, with a few at 48 months. The cumulative cell loss was between 8.4% and 8.9% over the first three years and between 8.4% and 9.5% over the first four years depending on the method of calculation. The cell loss between baseline and three months was 2.1%; three months and one year, 0.9%; one year and two years, 2.3%; and three years and four years, −0.1%. The coefficient of variation decreased over the course of the study, and the proportion of cases with hexagonal cells increased slightly. Cell loss between one and three years is most readily explained by prolonged corneal endothelial cell remodeling following the surgical procedure rather than ongoing cell loss. Regardless of the cause of the change in endothelial cell density over the first three years, the available four-year data suggest there was no ongoing chronic loss.—Michael D. Wagoner