Abstract
BackgroundHigh myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare. This observational study aims to evaluate visual outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients.MethodsA prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for at least 12 months (average 15.35 ± 4.90 months, rangers from 12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after surgery.ResultsAll surgeries were performed safely and no complication was observed during the follow-ups. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ±1.0 D and 35 eyes (69%) were within ±0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 μm (90 to 700 μm). The ECD was reduced by 8.38 ± 0.06% as compared to the preoperative value (p < 0.001). No significant change was observed in IOP (p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed.ConclusionsIn this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation.Trial registrationThis trial was retrospectively registered on 05/08/2018 under the number (ChiCTR1800017594).
Highlights
High myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare
* Correspondence: doctzhouxingtao@163.com 1Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai 200031, China 2Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai 200031, China Full list of author information is available at the end of the article (ACD) no less than 2.80 mm is usually recommended [6] and patients with shallow ACD may be at a higher risk of implantation failure [7]
The CentraFLOW technology applied in the Visian Implantable Collamer Lens (ICL) (ICL V4c), which is characterized by a 360 μm central hole that promotes natural circulation of the aqueous humor, can reduce the influence of metabolism on its own crystal, and alleviates the pain and discomfort caused by preoperative laser iridotomy [8, 9], resulting in decreased risks of cataracts, high intraocular pressure (IOP) and endothelial cell loss after ICL implantation [8,9,10]
Summary
High myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare. This observational study aims to evaluate visual outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. The CentraFLOW technology applied in the Visian ICL (ICL V4c), which is characterized by a 360 μm central hole that promotes natural circulation of the aqueous humor, can reduce the influence of metabolism on its own crystal, and alleviates the pain and discomfort caused by preoperative laser iridotomy [8, 9], resulting in decreased risks of cataracts, high intraocular pressure (IOP) and endothelial cell loss after ICL implantation [8,9,10]. In this study we aimed to investigate the efficacy, safety, predictability and stability of ICL V4c implantation in patients with shallow ACD
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