Vault changes after cyclopentolate instillation in eyes with posterior chamber phakic intraocular lens

Beatriz Gargallo-Martinez,Jose Javier Garcia-Medina,José M Gonzalez-Meijome,Ramón Gutierrez-Ortega,Elena Rubio-Velazquez,Paulo Fernandes,César Villa-Collar,César Villa-Collar

doi:10.1038/s41598-020-66146-y

Beatriz Gargallo-Martinez, Jose Javier Garcia-Medina + Show 6 more

Open Access

https://doi.org/10.1038/s41598-020-66146-y

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Abstract

Posterior chamber phakic intraocular lens (pIOL) implantation is a common option for correcting moderate-to-high ocular refractive defects. Because this pIOL is implanted on ciliary sulcus, the distance between the back surface of the pIOL and the anterior surface of the crystalline lens, that it is known as vault, should be measured in different conditions to ensure the technique’s safety. Cyclopentolate is a drug that dilates the pupil and relaxes accommodation (cycloplegia). It is often used for different ocular examinations and for other medical purposes. However, there is no evidence of the effect of this drug on vault. This study quantified central vault changes associated with cyclopentolate instillation. We measured the vault under normal conditions (pre-cycloplegic instillation) and after instilling cyclopentolate on 39 eyes of 39 patients with implanted pIOL. Our results suggest that cyclopentolate instillation may induce changes to vault in eyes with implanted pIOL. These changes seem safe and are mainly associated with vault under normal conditions, but also with anterior chamber depth, pupillary diameter and pIOL size.

Highlights

Posterior chamber phakic intraocular lens implantation is a common option for correcting moderate-to-high ocular refractive defects
The central vault is defined as the distance between the back surface of the ICL and the anterior surface of the crystalline lens
Changes in anterior segment structures appear during accommodation, such as reduced anterior chamber depth (ACD), inducing proximity between the anterior surface of the crystalline lens and the cornea with appearance of synkinetic myosis[12]

Summary

Introduction

Posterior chamber phakic intraocular lens (pIOL) implantation is a common option for correcting moderate-to-high ocular refractive defects. Because this pIOL is implanted on ciliary sulcus, the distance between the back surface of the pIOL and the anterior surface of the crystalline lens, that it is known as vault, should be measured in different conditions to ensure the technique’s safety. Our results suggest that cyclopentolate instillation may induce changes to vault in eyes with implanted pIOL. These changes seem safe and are mainly associated with vault under normal conditions, and with anterior chamber depth, pupillary diameter and pIOL size. Cyclopentolate instillation might be needed after pIOL implantation when other concurrent ocular diseases appear (uveitis, keratitis, retinal detachment and so)

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