Visual Outcomes Early after Implantable Collamer Lens V4c Implantation in Different Preoperative Spectacle Correction: Full Correction vs. Under Correction

Abstract

Purpose To investigate visual outcomes early after implantable collamer lens (ICL) V4c implantation between patients with fully corrected and under-corrected spectacles preoperatively. Methods Patients who implanted ICL V4c were divided into the full correction (46 eyes/23 patients) and under-correction groups (48 eyes/24 patients) based on preoperative differences between the spherical diopter of the spectacles and the actual spherical diopter. Refractive outcomes, scotopic pupil size, higher-order aberrations, and subjective visual outcomes as assessed using a validated questionnaire were compared between the two groups 3 months postoperatively. Moreover, the relationships between the severity of haloes and postoperative ocular or ICL parameters were analyzed. Results At the 3-month follow-up, the efficacy indices in the full correction and under-correction groups were 0.99 ± 0.12 and 1.00 ± 0.10, respectively; the safety indices were 1.15 ± 0.16 and 1.15 ± 0.15, respectively. Total-eye spherical aberration (p < 0.0001) and internal spherical aberration (p = 0.0005) were significantly different pre- and post-operatively in the under-correction group, while no differences were found in the full correction group. Total-eye spherical aberration (p = 0.002) and the severity of haloes (p = 0.03) were postoperatively different between the two groups. The severity of haloes was associated with postoperative spherical aberration (total-eye spherical aberration: r = −0.32, p = 0.002; internal spherical aberration: r = −0.24, p = 0.02). Conclusion Good efficacy, safety, predictability, and stability were obtained early after surgery regardless of preoperative spectacle correction. Patients in the under-correction group possessed a shift to negative spherical aberration and reported greater severity of haloes at the 3-month follow-up. Haloes were the most common visual symptoms after ICL V4c implantation and the severity of them was correlated with postoperative spherical aberration.