Safety of pure implantable collamer lens implantation without viscoelastic agent in the early period after surgery

Abstract Backgroud: To investigate the safety of pure implantable collamer lens implantation without an ophthalmic viscosurgical device (OVD). Methods: A total of 181 eyes that underwent nontoric ICL were enrolled. Preoperative and postoperative intraocular pressure (IOP) measurements were collected and analyzed at 2 h and 24 h. Visual acuity, corneal endothelial cell density (ECD) and anteriorchamber parameters were evaluated at 24 h postoperatively. Vault was evaluated at 24 h and 7 days. The number of haptics implanted into the posterior chamber was analyzed. Results: The efficacy and safety indices were 1.30 ± 0.32 and 1.31 ± 0.32, respectively. Of 181 eyes, 99 eyes received 4 haptics on the first attempt without any adjustment, and 72 eyes received an adjusted lens without an OVD. The success rate of the OVD-free procedure was 94.5%.Two hours postoperatively, IOP was 17.41±3.77 mmHg, which was significantly higher than the preoperative value (t=8.930, P < 0.000), however there was no significant difference between preoperative IOP and IOP at 1 day and 1 week postoperatively. The ECD changed from 2895.52±253.73 cells/mm2 preoperatively to 2873.66±244.17 cells/mm2 at 1 day postoperatively), and the difference was not statistically significant (t=1.811, P=0.072). The ACA was narrowed by 42% on the first day. Conclusion: The pure OVD-free technique is safe and efficient for ICL implantation. It can be a safer method of ICL implantation because of it reduces the risk of complications associated with ocular hypertension in the short term. Trial registration: Chinese Clinical Trial Registry (ChiCTR2000036335) at August 20, 2020.