Purpose This study evaluated the impact of clear corneal incision (CCI) morphology on corneal endothelial cell density (ECD), astigmatism, and higher‐order aberrations (HOAs) following implantable collamer lens (ICL) implantation. Design Prospective study. Methods Sixty‐five patients (65 eyes) undergoing ICL implantation were included. CCI characteristics were assessed with the AS‐OCT CASIA 2, and HOAs were measured using the Pentacam. Corneal astigmatism changes were analyzed using Aplin’s vector analysis. Results The study divided the eyes into two groups: intact incision (29 eyes, with well‐aligned wound architecture) and defective incision (36 eyes, with misaligned incision planes or endothelial gaps). At 3 months postoperatively, corneal thickness at the incision exit (CT‐Ex) was significantly different between the groups ( p = 0.038). The incision exit angle (Angle‐Ex) also differed significantly at 1 month ( p = 0.023) and 3 months ( p = 0.022). The defective incision group showed increases in incision length (IL) and the distance from the entry incision to the center (Dis‐En) between 1 and 3 months ( p = 0.006 and p = 0.034, respectively). Both groups showed significant reductions in CT‐Ex, CT‐En, and Angle‐Ex at 3 months. In the defective incision group, trefoil, quadrafoil, and spherical aberrations increased significantly ( p < 0.05) while ECD decreased significantly ( p < 0.05). Conclusions Shorter IL and smaller exit angle during ICL surgery increase the risk of forming defective incisions, leading to more HOAs and greater ECD loss within the 3‐month postoperative period.
Lin et al. (Thu,) studied this question.