Meta-Analysis Compares Vertical and Horizontal ICL Implantation
A study of over 5,000 eyes reveals differences in postoperative vault between vertical and horizontal EVO ICL implantation.
Updated on Oct. 30, 2026 in Nutrition
A new systematic review and meta-analysis of 16 comparative studies evaluated the outcomes of vertical versus horizontal EVO ICL implantation. The research, covering 5,316 eyes, aimed to determine if orientation affects lens compression and patient safety.
Why it matters
Understanding the impact of lens orientation is essential for surgeons aiming to reduce complications like endothelial cell loss and cataract formation. Researchers investigated these placement methods to determine if one orientation offers superior safety and stability.
The meta-analysis included 5,316 eyes with baseline spherical equivalents ranging from -10.5 D to -6.64 D. Results showed a mean postoperative vault reduction of -77 µm in vertical implantations compared to horizontal orientations.
The details
While vertical implantation was associated with lower postoperative vault values, rotational stability and refractive outcomes remained comparable across both groups. Researchers noted that vault differences lacked statistical significance when orientation was individualized based on anatomical considerations.
Timeline
12 months was the maximum follow-up duration recorded across the analyzed studies.
The Big Picture
This research contributes to the ongoing evolution of EVO ICL (Implantable Collamer Lens) surgical protocols by refining how surgeons approach lens orientation. The study provides data that may eventually move the field toward more standardized anatomical placement strategies.
Patients considering ICL surgery can feel confident that both horizontal and vertical implantation methods offer comparable safety and refractive results. Individual anatomical factors remain the most important consideration for surgeons when determining the best placement for each patient.
The takeaway
Patients should consult with their surgeons to discuss how their specific posterior chamber anatomy influences surgical planning. Surgeons are increasingly tailoring orientation choices based on anatomical measurements rather than adhering to a single default approach.
Further reading
Learn more about the latest advancements in eye health and Nutrition.
Source note: This article includes information reported by Healio.
