Long-Term Evaluation of Contrast Sensitivity and Vision Quality for High and Extreme High Myopia After EVO ICL Implantation

Purpose: To determine the contrast sensitivity (CS) and vision quality of patients with high and extreme high myopia following long-term evolution implantable collamer lens (EVO ICL) implantation. Patients and Methods: Thirty-five patients (60 eyes) with a myopia range of -7.25 D to -18.50 D were enrolled. Participants were categorized into the high myopia (HM) (spherical equivalent>-12.0 D) and extreme high myopia (EHM) (spherical equivalent≤-12.0 D) groups. Routine examinations, including measurements of endothelial cell density and anterior chamber parameters, were performed. CS and vision quality were assessed over a long-term follow-up period, with an average final follow-up time of 7.29±0.82 years. Results: All surgical procedures were completed without any significant complications. No statistical differences for the CS parameters at the six different spatial frequencies in the corrected and uncorrected conditions were identified between the two groups (P>0.05). The vision quality questionnaire results indicated both groups reported concerns regarding the frequency of halos (HM group 57.6%, EHM group 63%). Driving was identified as the most distressing postoperative daily life activity. Further analysis revealed a negative correlation between driving distress and CS (B=-0.40, P<0.01). The preoperative axial length was found to be correlated with CS (B=-0.39, P<0.01). Conclusion: Patients with HM and EHM maintained good long-term CS and vision quality after EVO ICL implantation. Halos and driving distress were the most common complaints.