ArticleClinical ophthalmology (Auckland, N.Z.)2026
Comparative Study of ICL V4c Decentration in Vertical vs Horizontal Implantation: Association with Angle Alpha and Validation of Equivalent Visual Quality.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To compare the decentration of the Implantable Collamer Lens (ICL) V4c and its impact on visual quality between vertical and horizontal implantation techniques. Methods: 50 patients (80 eyes) were assigned to horizontal (40 eyes) or vertical (40 eyes) implantation groups. Preoperative and 6-month postoperative evaluations included uncorrected (UDVA) and corrected distance visual acuity (CDVA), refractive status, corneal topography, and wavefront aberration analysis. Decentration was measured using the OPD-Scan III aberrometer, compared between implantation methods, and analyzed for associations with preoperative angles α and κ. Results: At 6 months, 100% of horizontal and 97.5% of vertical implantation eyes achieved UDVA ≥ 20/20, with all eyes maintaining or improving CDVA. Mean decentration was similar between groups (horizontal: 0.42 ± 0.18 mm; vertical: 0.42 ± 0.19 mm; p = 0.915), with temporal displacement predominating. Angle α significantly correlated with decentration in both groups (p = 0.016; p = 0.017), while angle κ showed no association (p > 0.05). The change of higher-order aberrations did not differ between groups (p > 0.05), and decentration magnitude did not clinically affect optical quality (p > 0.05 for all aberration parameters). Conclusion: Vertical and horizontal ICL V4c implantation demonstrated comparable centration and visual outcomes. Decentration was significantly associated with preoperative angle α, underscoring the clinical importance of angle α assessment for optimal ICL positioning.
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