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E. Feldman, L. Affel, M. Maderin, B. Ayres; A Clinical Analysis of the STAAR Visian Phakic ICL® (Implantable Collamer Lens) Using the Ultrasound Biomicroscope (UBM). Invest. Ophthalmol. Vis. Sci. 2008;49(13):2815. doi: https://doi.org/.
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To determine whether the UBM is an effective imaging tool to evaluate patients who received the STAAR Phakic ICL both pre and post operatively.
A prospective case series was conducted on six eyes of three patients who received the ICL at Wills Eye Institute. Anterior segment evaluation was performed using the 35Mhz OTI UBM both pre and post operatively. A comparison of pre-operative manually measured white-to-white limbal diameters was made to UBM measured sulcus diameters. Post-operative UBM images were used to verify ICL position and to measure vault within the ciliary sulcus.
Six eyes were included in this study. For all six eyes, the average manual "white to white" diameter was measured to be 12.17mm. The average UBM measured sulcus diameter was found to be 12.28mm. This difference was not found to be statistically significant (p=0.70). The post-operative UBM images revealed all six ICL’s to be well centered within the ciliary sulcus, with an average central vault over the anterior capsule measured to be 0.58mm centrally. No contact with the crystalline lens was noted on the UBM images.
In attempting to choose the appropriate size ICL preoperatively, one must accurately measure the cililary sulcus diameter. Traditionally this has been done using calipers to measure the "white to white" diameter of the corneal limbus. We believe that this small series demonstrates that both manual and UBM methods can obtain accurate measurements of the sulcus diameter to help ensure accurate ICL calculations. Furthermore we believe that the UBM can be used post operatively to accurately determine ICL position, centration, lenticular contact, and vault within the ciliary sulcus. As the UBM is a dynamic imaging modality, further study may evaluate pupil size on ICL position with examination in both light and dark conditions, as well as any potential change in ICL position during accommodation.
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