Efficacy and safety of implantable phakic contact lens vs implantable collamer lens in myopic eyes: systematic review and meta-analysis.
Nuno Rodrigues Alves, Catarina Barão, Matheus Pedrotti Chavez et al.
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In 30 seconds
This systematic review and meta-analysis compared implantable phakic contact lenses (IPCLs) with EVO implantable collamer lenses (ICLs) for myopia correction. It included 9 studies—3 randomized and 6 observational—with 1187 eyes. Uncorrected and corrected distance visual acuity, refractive accuracy, and most safety outcomes were similar. A small spherical-equivalent difference favored IPCL (mean difference -0.06 diopters [D]; 95% CI -0.11 to -0.00; P = .03), but this finding was not robust to sensitivity analysis. Toric ICLs had greater rotational stability.
Key findings
- Visual acuity outcomes were similar between lenses; 83% vs 88% were within ±0.50 D of the refractive target (RR 0.96; P = .21).
- Cataract formation was 0.7% vs 0.8%, and endothelial cell loss was 2.2% in both groups.
- Toric ICLs showed greater rotational stability than IPCLs (7.1% vs 1.8%; RR 3.49; P = .03).
- Acute glaucoma was rare (0.17%) and occurred only with IPCL V1.0.
Why it matters
The pooled comparison suggests broadly similar visual and safety outcomes for IPCL and ICL implantation, helping frame the evidence when considering these options for myopia correction. The small spherical-equivalent difference favoring IPCL was not robust, while the rotational-stability finding for toric ICLs may be relevant to lens-specific outcomes. The evidence base remains limited, particularly for long-term comparisons.
What to keep in mind
The review combined only 9 studies, including observational studies, and the authors state that further long-term studies are warranted.