Evaluation of Eye Alignment Before and After Refractive Surgery Using an Implantable Collamer Lens in Phakic Patients with Myopia

PURPOSE: To investigate changes in eye alignment before and after ICL implantation in patients with myopia having corrected distance visual acuity (CDVA) of ≥0.0 logMAR. SUBJECTS AND METHODS: The medical records of 1012 patients without eye movement limitation who underwent bilateral ICL implantation were retrospectively reviewed a at the Eye Center of Sanno Hospital in Japan. RESULTS: Preoperatively, of 1012 patients, 30 (3.0%), 211 (20.8%), 771 (76.2%), and 126 (12.5%) demonstrated constant strabismus, intermittent strabismus, phoria, and binocular diplopia, respectively. Regarding horizontal strabismus without a vertical component, of 30 patients, 9 (30.0%) demonstrated exotropia and 2 (6.7%) exhibited esotropia. Vertical strabismus without a horizontal component was not observed. A combination of horizontal and vertical strabismus was observed in 19 (63.3%) patients. The rate of eye alignment classification agreement preoperatively and postoperatively was 98.7%, including 100%, 93.8%, and 100% in the constant strabismus, intermittent strabismus, and phoria groups, respectively. Of 1012 patients, 1.3% converted from intermittent strabismus to phoria (6.2% in the intermittent strabismus group). CONCLUSIONS: Uncomplicated ICL implantation under topical anesthesia was not associated with eye alignment in 98.7% of patients with myopia, and 0% transitioned to constant strabismus after ICL implantation.