title: Effect of Accommodation on Vaulting and Movement of Posterior Chamber Phakic Lenses in Eyes With Implantable Collamer Lenses.
abstract: OBJECTIVE
  To investigate and compare vaulting and movement changes during accommodation in eyes with the V4c and V4 implantable collamer lenses (ICL).
  
  
  METHODS
  Comparative, observational case series.
  
  
  METHODS
  The medical records of 35 eyes (18 patients) with the V4 ICL and 51 eyes (26 patients) with the V4c ICL were retrospectively examined and included in analyses. Anterior chamber depth (ACD), posterior corneal surface-to-ICL distance (endo-ICL distance), pupil size, and postoperative vaulting were evaluated using the Visante anterior chamber optical coherence tomography system. Images were taken during the nonaccommodative and accommodative states 3 months after ICL implantation. Refractive error, keratometry values, axial length, intraocular pressure, and central corneal thickness were evaluated at 3 months postoperatively.
  
  
  RESULTS
  ICL vaulting did not significantly change during accommodation in eyes with either the V4 or V4c ICL (P = .532 for V4 ICL and P = .415 for V4c ICL). However, significant reductions in ACD, endo-ICL distance, and pupil size were observed during accommodation in both groups. In eyes with a V4 ICL, the change in [Δ] ACD was 0.2 ± 0.1 mm (P < .001), Δendo-ICL distance was 0.2 ± 0.1 mm (P < .001), and Δpupil size was 0.5 ± 0.9 mm (P = .021). For eyes with the V4c ICL, ΔACD was 0.2 ± 0.2 mm (P < .001), Δendo-ICL distance was 0.2 ± 0.2 mm (P < .001), and Δpupil size was 0.8 ± 1.2 mm (P < .001). The mean reductions of each parameter were not statistically different between eyes with the V4 ICL and the V4c ICL.
  
  
  CONCLUSIONS
  Contrary to the light stimulation response, accommodation does not significantly affect ICL vaulting differently in eyes with either the V4 or V4C ICLs.
authors.affiliation: Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea; The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hun
authors.initials: H
authors.lastname: Lee
authors.affiliation: Eyereum Eye Clinic, Seoul, South Korea.
authors.forename: David Sung Yong
authors.initials: DS
authors.lastname: Kang
authors.affiliation: Eyereum Eye Clinic, Seoul, South Korea.
authors.forename: Byoung Jin
authors.initials: BJ
authors.lastname: Ha
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Moonjung
authors.initials: M
authors.lastname: Choi
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea; Corneal Dystrophy Research Institute, Severance Biomedical Science Institute, and Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eung Kweon
authors.initials: EK
authors.lastname: Kim
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyoung Yul
authors.initials: KY
authors.lastname: Seo
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: tikim@yuhs.ac.
authors.forename: Tae-Im
authors.initials: TI
authors.lastname: Kim
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D060437:Artificial Lens Implant Migration / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery; D054120:Phakic Intraocular Lenses; D011680:Pupil / Q000502:physiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult