Abstract
Purpose. To assess intraocular pressure (IOP), lens vaulting, and anterior chamber (AC) angle width, following V4C implantable Collamer lens (ICL) procedure for myopic refractive error. Methods. A prospective case series that enrolled 54 eyes of 27 patients that were evaluated before and after V4C phakic posterior chamber Collamer lens implantation for correction of myopic refractive error. Preoperative measurement of IOP was done using Goldmann applanation tonometer and anterior chamber angle width using both Van Herick slit lamp grading system and Scheimpflug tomography imaging (Oculus Pentacam). Follow-up of the aforementioned variables was at 1, 6, and 18 months postoperatively, together with ICL vault measurements. Results. The mean baseline IOP of 11.69 ± 2.15 showed a statistically significant (P = 0.002) increase after 1 month that remained unchanged at 6 and 18 months postoperatively, with mean value of 16.07 ± 4.12, 16.07 ± 4.10, and 16.07 ± 4.13, respectively. Pentacam AC angle width showed a statistically significant decrease at 1 (P = 0.025), 6 (P = 0.016), and 18 (P = 0.010) months postoperatively, with mean preoperative value of 40.14 ± 5.49 that decreased to 25.28 ± 5.33, 25.46 ± 5.44, and 25.49 ± 5.38, at 1, 6, and 18 months, respectively. Mean ICL vault showed moderate correlation with Pentacam AC angle width at 1 (r = −0.435) and 6 (r = −0.424) months. Conclusion. V4C ICL implantation resulted in decrease in AC angle width and increase in IOP, within acceptable physiological values at all time points.
Highlights
Many authors showed that conventional implantable Collamer lens (ICL) insertion with peripheral iridotomy had no significant effect on postoperative intraocular pressure (IOP) and that it resulted in a narrower angle width without increasing trabecular pigmentation [1].The V4C model of ICL has got the KS-AquaPORT introduced to the center of the ICL optic, which improved aqueous humor circulation between posterior and anterior chambers
Many authors showed that conventional ICL insertion with peripheral iridotomy had no significant effect on postoperative IOP and that it resulted in a narrower angle width without increasing trabecular pigmentation [1]
Our study aims to evaluate the correlation between ICL power and vault, with postoperative IOP and anterior chamber angle width
Summary
Many authors showed that conventional ICL insertion with peripheral iridotomy had no significant effect on postoperative IOP and that it resulted in a narrower angle width without increasing trabecular pigmentation (compared with values after laser iridotomy) [1].The V4C model of ICL has got the KS-AquaPORT introduced to the center of the ICL optic, which improved aqueous humor circulation between posterior and anterior chambers. The nonoccludable 0.36 mm CentraFLOW diminished the risk of postoperative pupillary block that may occur following closure of peripheral surgical or laser iridotomy [2]. The distance between the posterior ICL surface and the anterior crystalline lens pole is termed the ICL vault, which is crucial regarding the incidence of anterior subcapsular cataract formation [3]. The ideal postoperative vault must create a space over the entire anterior crystalline lens surface, with 1.00 to 1.50 central corneal thickness (CCT), on slit lamp examination [4]. Whilst poor vault (750 μm) may result in pupillary block-angle closure glaucoma [5]
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