To evaluate the visual outcomes and complications after Visian Implantable Collamer Lens (ICL) implantation V4c (with centraflow technology) and V4 for correction of high myopia and myopic astigmatism.

A retrospective, comparative interventional case series of V4c and V4 ICL implantation done for correction of high myopia and astigmatism. The outcome measures that were evaluated included preoperative and postoperative uncorrected and corrected distant visual acuity (UDVA), (CDVA), endothelial cell count (ECC), presence of lens opacification, intraocular pressure (IOP) and lens rotation. A follow-up of upto 1 year was done.

46 eyes underwent V4c ICL with centraflow implantation and 40 eyes had implantation of V4 ICL with intraoperative peripheral iridectomy (PI). The mean preoperative manifest spherical equivalent (MSE) was -8.65±2.8 D and -8.51±3.6 D in the V4c and V4 groups respectively which reduced to postoperative values of -0.16± .34 D and -0.33±.41 D respectively. The mean preoperative astigmatism was -1.38±1.3 D and -1.65±1.14 D that respectively reduced to -0.51±0.48 D and -0.46±0.37 D. At the end of 1 year follow up, mean ECC loss was 2.41% and 3.17%, respectively in the V4c and V4 groups. No anterior subcapsular opacities were seen in both groups. One eye of V4c (2.2%) and three eyes of V4 (7.5%) groups required re-rotation surgery. The safety indices were 1.21 and 1.32 and efficacy indices were 1.15 and 1.21 in the V4c and V4 groups respectively at the end of 1 year.

Both V4c and V4 Visian ICL implantations are comparable in terms of visual outcome and safety profile for correction of high myopia and astigmatism. However, V4c ICL offers these advantages without the requirement of an additional PI.