To compare the clinical outcomes between AQUA ICL® (V4C) and conventional implantable collamer lens (ICL, V4B) in patients with high myopia.

We compared preoperative and postoperative visual acuities, spherical equivalent, intraocular pressure, postoperative vault and visual quality assessed using optical quality analyzing system (OQAS®) between 20 eyes implanted with ICL (V4B) and 22 eyes implanted with AQUA ICL® (V4C).

Visual acuity (log MAR) and spherical equivalent at postoperative 3 months were 0.06 ± 0.09 and -0.26 ± 0.17 D in the V4B group and 0.03 ± 0.03 and -0.23 ± 0.19 D in the V4C group, respectively. There was no statistical difference in visual acuity and spherical equivalent between the 2 groups ( p > 0.05). Postoperative intraocular pressure (IOP) elevated significantly in both groups until 6 hours after the operation ( p < 0.05) compared with preoperative IOP. No significant IOP elevation was observed from the first postoperative day to postoperative 3 months ( p > 0.05). V4C resulted in lower IOP than V4B 6 hours postoperatively. In ICL (V4B) and AQUA ICL® (V4C) groups, the objective scattering index (OSI) was 1.29 ± 0.90 and 1.36 ± 0.68, modulation transfer function (MTF) cut off value was 29.62 ± 11.31 c/deg and 29.61 ± 9.56 c/deg and Sterhl ratio was 0.18 ± 0.07 and 0.17 ± 0.04, respectively, 3 months postoperatively. None of these values were significantly different between the 2 groups.

AQUA ICL® (V4C) implantation is an effective, convenient and safe surgery for myopia correction and yields better outcome than ICL (V4B) in terms of early postoperative IOP.