Abstract
Purpose :
To investigate clinical outcomes of immediate sequential bilateral phakic intraocular lens implantation and vaulting height in eyes implanted with V4c implantable collamer lens (ICL) stored in new solution.
Methods :
Ninety four eyes of 47 patients underwent bilateral immediate sequential ICL implantation were investigated for safety and efficacy retrospectively. Among them, eighteen eyes of 10 patients implanted with V4c 12.6 mm size ICLs (group 1), and 12 eyes of 6 patients implanted with V4c 13.2 mm size ICLs (group 2) were evaluated for vaulting. Anterior chamber depth and white to white diameter were measured by using ORBb scan. Vaulting measured using anterior segment optical coherence tomography was compared between two groups at 1 month and 3 months postoperatively. Postoperative uncorrected distant visual acuity(UDVA), refractive errors, intraocular pressures (IOP), and complications were also evaluated.
Results :
Postoperative mean UDVA was 0.032 ± 0.078 LogMAR and mean spherical equivalent was -0.47 ±0.62 diopter at 6month. Preoperative corrected distance visual acuity divide postoperative uncorrected distance visual acuity (efficacy) was 1.19 to 1.23 during follow-up period. ICLs were exchanged in four eyes as low or high vaulting. There was no case of complication such as traumatic or metabolic cataract, endothelial cell loss, severe inflammatory reaction, macular edema. IOP spikes were developed postoperatively in 3 cases and controlled with short term topical intraocular pressure lowering eye drops.
Postoperative mean vaulting were significantly higher in group 2 at 1 month (723.8 ± 127.2 µm vs. 588.3 ± 179.5 µm, p=0.035) and 3 months (726.6 ± 181.9 µm vs. 540.8 ± 174.5 µm, p=0.024). High vaulting cases above 750 µm were 3 (16%) and 2 (11%) in group 1 and 7 (63%) and 5 (45%) in group 2 at 1 month and 3 month, respectively (p=0.015 at 1 month, p=0.051 at 3 month).
Conclusions :
Immediate sequential bilateral phakic intraocular lens implantation is not accompanied by serious complications and showed comparable in safety and efficacy with pervious study. It is considered to be one of the surgical methods which can effectively correct refractive error for a patient in need thereof.
Size adjustment of ICL stored in new solution, V4c model, seems to be necessary especially in V4c 13.2 mm size model.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.