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. 2016 Sep 7;16(1):161.
doi: 10.1186/s12886-016-0336-8.

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)

Xun Chen  1   2 , Huamao Miao  1   2 , Rajeev Krishnan Naidu  3 , Xiaoying Wang  4   5   6 , Xingtao Zhou  1   2
Affiliations

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)

Xun Chen et al. BMC Ophthalmol. .

Abstract

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.

Keywords: Implantable Collamer Lens; Pupil; Vault.

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Figures

Fig. 1
Fig. 1
Time course of the phakic IOL vaults in the two groups following implantation of ICL V4 and ICL V4c. (***P <0.001)
Fig. 2
Fig. 2
Time course of pupil size in the two groups following implantation of ICL V4 and ICL V4c. (***P <0.001)
Fig. 3
Fig. 3
Correlation of vault changes and pupil size changes in the ICL V4 and ICL V4c groups from 1 day postoperatively to 1 month postoperatively. (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001, y = 159.0 x − 51.3; ICL V4c: r = 0.588, P <0.001, y = 118.5 x + 89.8, respectively)
Fig. 4
Fig. 4
Correlation between anterior chamber depth and the central vault in the ICL V4 and ICL V4c groups (r = 0.562, P <0.001; r = 0.524, P = 0.001, respectively)
Fig. 5
Fig. 5
Correlation between white-to-white and the central vault in the ICL V4 and ICL V4c groups (r = 0.440, P = 0.006; r = 0.366, P = 0.022, respectively)
Fig. 6
Fig. 6
Correlation between horizontal sulcus to sulcus and the central vault in the ICL V4 and ICL V4c groups (r = 0.355, P = 0.029; r =0.365, P = 0.022, respectively)
Fig. 7
Fig. 7
Correlation between vertical sulcus to sulcus and the central vault in the ICL V4 and ICL V4c groups (r = 0.345, P = 0.034; r = 0.344, P = 0.032, respectively)
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