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M. Lee, S. Park, E.-S. Chung, T. Chung; The Changes of Iridocorneal Angle Structure and Trabecular Pigmentation After STAAR Implantable Collamer Lens (ICL) Implantation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1996. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the changes of iridocorneal angle structure and trabecular pigmentation after STAAR Implantable Collamer Lens (ICL) implantation, as potential risk factors of secondary glaucoma
An ICL was implanted in 49 eyes of 29 patients with moderate to high myopia. Mean (±standard deviation) follow-up period was 21.2 (±7.3) months. Trabecular-iris angle (TIA), angle opening distance (AOD, distance between trabecular meshwork and iris) measured at 500 µm from the scleral spur (AOD500), and trabecular pigmentation were prospectively evaluated preoperatively and early- (1-3 months), mid- (6-12 months), and late- (>18 months) postoperatively, using ultrasound biomicroscopy and gonioscopic photography. The changes of uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent (SE), intraocular pressure (IOP), and corneal endothelium after surgery were also determined.
TIA and AOD500 decreased significantly from preoperative to early-postoperative periods (P<0.001), but no significantly progressive changes were observed thereafter. In at least one quadrant, trabecular pigmentation increased in 41.7% of patients from preoperative to early-postoperative periods and in 16.7% from early- to late-postoperative periods. UCVA and BCVA improved significantly after surgery (P<0.001), and 83.3% of patients were within 0.5 D and 94.4% were within 1.0 D of predicted refraction. IOP remained stable in all eyes after surgery except in one eye, which showed increased IOP and consistently increased trabecular pigmentation. Antiglaucoma medications were needed to keep the IOP within normal limits. Corneal endothelial cell density decreased significantly from preoperative to early-postoperative periods (P=0.026), but no ongoing chronic loss of corneal endothelial cells was detected.
Significant narrowing of iridocorneal angle and seemingly ongoing increase of trabecular pigmentation were observed after ICL implantation, with one eye (2%) that showed clinically significant increase of IOP. Close follow-up with careful monitoring of iridocorneal angle status and IOP may be needed for early detection of secondary glaucoma after ICL implantation.
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