Anterior Segment OCT Angle and Vault Analysis After Implantable Collamer Lens  Implantation in

Patients With High Myopia

Arturo Ramirez-Miranda M.D.Alejandro Navas M.D., M.Sc.Arturo Gómez-Bastar M.D.

Enrique O. Graue-Hernandez M.D., M.Sc.

Department of Cornea and Refractive Surgery Instituto de Oftalmologia

“Fundacion Conde de Valenciana”Mexico City, Mexico

Dr. Ramirez-Miranda and Dr. Navas are consultants for Carl Zeiss Meditec. Dr. Ramirez-Miranda is a speaker of Thea Laboratoires.The remaining authors have no financial or proprietary interest in the materials presented herein.

PURPOSETo compare angle measurements before

and after ICL V4c Implantation and vault changes during progress and under different light conditions, in patients with high myopia.

Visante optical coherence tomography (OCT SA/ Carl Zeiss Meditec)

METHODS

• Prospective, longitudinal, case series. • Implantation of ICL4c. • High myopia.• 75 eyes (52 patients).• AS-OCT VISANTE– (photopic, mesopic and escotopic light

conditions)

METHODSMain Outcome Measures

Uncorrected visual acuity (UCVA)Best corrected visual acuity

(BCVA)Slit lamp examination

Optical coherence tomography (OCT)

Angle and Vault were evaluated using an OCT Visante.

RESULTS

• 75 eyes, 52 patients• 32 females (69.5 %)• Follow-up 13 +/- 3 months • Mean age 26.9 +/- 4.8 years

Light Condition

s

Preoperative

Angle (°)

Postoperative Angle

(°)

Angle Change(

°)

p

Mesopic 54.2 37.7 -16.5 <0.05

Photopic 53.5 34.6 -18.6 <0.05

Escotopic 58.4 39.7 -18.7 <0.05

RESULTS

RESULTS

RESULTS

Light conditions

Postoperative Angle

Achieved Vault

(microns)

Mesopic 37.7 552

Photopic 34.6 507

Escotopic 39.7 374

Light conditions

Preoperative ACD

Postoperative ACD

p

Mesopic 3.26 3.24 p>0.05

Photopic 3.22 2.85 p<0.05

Escotopic 3.24 2.90 p<0.05

DISCUSSION

• ICL V4c implantation is secure, stable, predictible and effective for correction of high myopia in a 6 month follow up.

• Greater influence on the vault: ICL size, the anterior chamber depth and a positive correlation with the keratometric mean power

• Few studies report the changes presented in iridocorneal angle and vault after ICL V4 implantation measured by OCT-SA Visante and during its follow up.

• There are no studies that analyzed these changes with ICL V4c model.

DISCUSSION

CONCLUSION

• ICL V4c is a secure, efficient, predictable and stable procedure.

• There is a significant reduction in the iridocorneal angle after implantation.

• Inverse relationship between the iridocorneal angle and the achieved vault, accentuated under different light conditions.