Comparison of early changes in and factors affecting vault following posterior chamber phakic Implantable Collamer Lens implantation without and with a central hole (ICL V4 and ICL V4c).
BACKGROUND
To objectively compare the early changes in vault over time following implantation of an Implantable Collamer Lens without (ICL V4) and with (ICL V4c) a central hole and the respective factors affecting vault change in moderate to high myopia.


METHODS
This prospective study comprised of 38 eyes of 38 patients implanted with ICL V4 and 39 eyes of 39 patients implanted with ICL V4c intraocular lenses. We quantitatively assessed the postoperative values of vault and pupil size at 1 day, 1 week, and 1 month following implantation using a rotating Scheimpflug camera (Pentacam). We compared these postoperative values within and between the two groups and identified the factors affecting vault change.


RESULTS
The mean vaults at 1 day, 1 week, and 1 month following ICL V4 implantation were 303.68 ± 185.11, 517.89 ± 160.07 and 521.32 ± 155.72 μm respectively, and those following ICL V4c were 316.67 ± 186.89, 495.13 ± 180.84 and 510.77 ± 175.51 μm, respectively. There was a significant difference in vault between 1 day and 1 week postoperatively. There was a significant association between the vault change and the pupil size change in both groups from 1 day to 1 month postoperatively (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001; ICL V4c: r = 0.588, P <0.001). The vault value 1 month after implantation of ICL V4 and ICL V4c was associated with the preoperative anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus.


CONCLUSIONS
Pupil movement is a critical factor in vault change, with increasing vault observed postoperatively from 1 day to 1 week associated with the declining effects of pharmacological miosis and increasing pupil size. The anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus show some correlation with vault.
Key Lab of Myopia, Ministry of Health, Shanghai, China.|EYE & ENT Hospital of Fudan University, Shanghai, China.
Xun
X
Chen
Key Lab of Myopia, Ministry of Health, Shanghai, China.|EYE & ENT Hospital of Fudan University, Shanghai, China.
Huamao
H
Miao
School of Medicine, The University of Sydney, Camperdown, NSW, Australia.
Rajeev Krishnan
RK
Naidu
Key Lab of Myopia, Ministry of Health, Shanghai, China. doctxiaoyingwang@163.com.|EYE & ENT Hospital of Fudan University, Shanghai, China. doctxiaoyingwang@163.com.|Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Eye and ENT Hospital of Fudan University, No. 19 BaoQing Road, Shanghai, 200031, China. doctxiaoyingwang@163.com.
Xiaoying
X
Wang
Key Lab of Myopia, Ministry of Health, Shanghai, China.|EYE & ENT Hospital of Fudan University, Shanghai, China.
Xingtao
X
Zhou
D000328:Adult; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011446:Prospective Studies; D019591:Pseudophakia / Q000601:surgery; D011680:Pupil / Q000502:physiology*; D012029:Refraction, Ocular; D012044:Regression Analysis; D014792:Visual Acuity; D055815:Young Adult
Implantable Collamer Lens; Pupil; Vault