Abstract
BackgroundAchieving an appropriate vault is the main concern after the implantation of Implantable Collamer Lens (ICLs) for surgical correction of high myopia. The vault will vary with time and optical parameters, such as accommodation and pupil size. This research is to evaluate the vault change in Myopic and Toric ICLs under different lighting conditions; and to analyze the relationship between vault changes and pupillary responses to light.MethodsWe enrolled and analyzed 68 eyes from 68 patients who were implanted with Myopic EVO ICLs; we also included 60 eyes from 60 patients who were implanted with Toric EVO ICLs. The anterior chamber depth, pupil size and the post-operative vault were evaluated, 1 week after the operation, using a Visante Optical Coherence Tomography (OCT) under different lighting conditions. For each eye that was assessed, we calculated the vault change, which is defined as the difference between vault under mesopic condition and photopic condition; and the rate of vault change, which is defined as the vault change divided by mesopic vault.ResultsNo significant difference was noted with the anterior chamber depth between mesopic and photopic conditions in either group. A significant decrease in vault and pupil size was detected under photopic condition in both groups. We found no difference in vault change between Myopic and Toric EVO ICLs under different lighting conditions. Moreover, the rate of vault change had a significant decrease with increased mesopic vault (baseline value).ConclusionsToo low a mesopic vault has a big rate of vault change, which may cause the contact of ICL with crystalline lens in photopic state; Too high a mesopic vault would constrict the posterior movement of pupil. The findings of the study suggest that, for patients with high or low vault, we should be more careful and must perform checks in different lighting conditions.
Highlights
The Implantable Collamer Lens (ICLs) is often the first choice for surgical correction of high myopia [1, 2]
Postoperative vault, ACD, and pupil sizes of the eyes implanted with myopic and toric EVO ICLs under mesopic and photopic conditions are demonstrated in Table 2 and Fig. 2
The eyes that were implanted with myopic and toric EVO ICLs showed significant differences in vault between mesopic and photopic conditions
Summary
The Implantable Collamer Lens (ICLs) is often the first choice for surgical correction of high myopia [1, 2]. Lee et al [9] believes that the change of vault caused by accommodation mainly lies in the forward movement of the natural lens and the change of its movement. After Sanders et al [10] used pilocarpine to constrict the pupil, the distance from the posterior surface of the ICL to the anterior capsule of the lens was significantly reduced compared to the non-accommodated state, while the distance from the corneal endothelium to the anterior surface of the ICL changed by a very small margin, which indicated that it was mainly the increased iris tension under the drug-induced accommodation that hindered the anterior movement of the ICL. Achieving an appropriate vault is the main concern after the implantation of Implantable Collamer Lens (ICLs) for surgical correction of high myopia. This research is to evaluate the vault change in Myopic and Toric ICLs under different lighting conditions; and to analyze the relationship between vault changes and pupillary responses to light
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