ICL Exchanges or Explants Due to Sizing in a United States High Volume Center

Purpose: To report the incidence, reasons, and outcomes for Implantable Collamer Lens (ICL) exchanges at a high-volume center in the United States. Patients and Methods: A retrospective chart review was performed on 961 eyes of 484 patients who underwent ICL surgery in a commercial setting at Parkhurst NuVision from 04/06/2022 to 10/21/2024. Results: 11 eyes of 8 patients out of the 961 commercial cases (1.1%) underwent ICL exchange at our institution due to sizing issues. Of these, only 5 cases (0.5%) were exchanged due to initial vault concerns with 6 cases (0.6%) exchanged due to rotated toric ICLs. Upon repeat review of these cases, we would have chosen a different size in 3 of them. Conclusion: ICL implantation is remarkably safe, with an incredibly low exchange rate due to inappropriate sizing. The majority of these cases also involved clinically safe vault and the exchange only occurred due to rotation of a toric ICL.