Abstract:AIM: To observe the changes of the vault height and the correlation analysis of visual quality under different pupil diameters after ICL surgery.
METHODS: Retrospective case study. Selected 43 patients(86 eyes)who implanted V4c ICL surgery successfully at Shanghai Aier Eye Hospital and followed up regularly to meet the measurement requirements from January 2018 to January 2019, Routine parameters and iTrace were checked before and 1wk, 1mo, and 3mo after surgery. Visante-OCT was used to measure the vault height under the pupils of 3mm and 5mm.
RESULTS: The vault height under the 3mm pupil at 1wk, 1mo and 3mo after surgery were(586.06±24.49, 560.16±21.31, 508.19±21.17)μm, the values under the 5mm pupil were(698.13±20.98, 667.69±20.16, 613.28±19.79)μm(FTime=40.160,PTime<0.001; FGroups=56.835,PGroups<0.001). The wave of vaule under the different pupils was(112.06±8.91, 107.53±6.94,101.01±10.64)μm(F=16.875, P>0.05). The total high-order aberration(HOA)and RMS of the whole eye after ICL were significantly reduced(F=29.847, 85.019; P<0.001). The MTF and SR value were significantly higher than before surgery(F=47.653, 33.264; P<0.001), and there was no statistical difference after ICL. At 3mo after surgery, the RMS and MTF values at 3mm and 5mm pupils were compared. The RMS value of the total HOA under the pupil of 5mm is significantly higher than that at 3mm, and the increase of spherical and trefoil aberration is significant(t=21.812, 17.136; P<0.001). No significant difference in coma value(t=2.028, P>0.05). The MTF at 5mm pupils were significantly lower than those at 3mm at spatial frequencies of 5, 10, 15, 20, 25, 30c/d(t=15.138, 9.147, 7.018, 4.693, 3.814 and 3.075, all P<0.05).
CONCLUSION: The impact of pupil movement on vault height fluctuation is about 110μm. It is recommended that the minimum vault height should be above 300μm. It can significantly reduce the root mean square value of total high-order aberration and aberration of the whole eye, and significantly increase the MTF and SR values after ICL surgery. The pupil size has a significant effect on visual quality after ICL. The spherical aberration and trefoil aberration increase under the condition of large pupil, and the MTF value generally decreases.
