Elsevier

American Journal of Ophthalmology

Volume 158, Issue 6, December 2014, Pages 1199-1204.e1
American Journal of Ophthalmology

Original article
Dynamic Vaulting Changes in V4c versus V4 Posterior Chamber Phakic Lenses Under Differing Lighting Conditions

https://doi.org/10.1016/j.ajo.2014.08.020Get rights and content

Purpose

To compare vaulting changes in eyes implanted with V4c and V4 implantable collamer lenses (ICLs) under differing lighting conditions.

Design

Noninterventional, cross-sectional comparative observational case series.

Methods

Fifty-six eyes of 38 patients implanted with V4c ICLs, and 54 eyes of 28 patients implanted with V4 ICLs were enrolled and analyzed. Anterior chamber depth, pupil size and postoperative vaulting were evaluated using a Visante optical coherence tomography system under photopic and mesopic conditions 1 month postoperatively. Refractive errors, keratometry values, axial lengths, intraocular pressures, anterior chamber volumes, and central corneal thicknesses were also recorded.

Results

No significant differences were noted in anterior chamber depth between photopic and mesopic conditions in either group. Significant decreases in vaulting and pupil size were detected under photopic conditions in both groups. Moreover, vaulting changes in eyes implanted with V4c ICLs were significantly larger than those in eyes implanted with V4 ICLs.

Conclusions

V4c ICL vaulting decreased more prominently under photopic conditions than did V4 ICL vaulting. Therefore, postoperative vaulting under mesopic and photopic conditions should be considered when interpreting the vaulting of eyes implanted with V4c ICLs.

Section snippets

Design

This retrospective, comparative case series was performed with the approval of the Institutional Review Board of Yonsei University College of Medicine (Seoul, South Korea) and conducted in accordance with the tenets of the Declaration of Helsinki and good clinical practices. All patients provided written informed consent.

Participants

This study comprised 110 eyes of 66 patients who underwent V4c or V4 ICL implantation in a standardized fashion by the same surgeon (SYK) at the Eyereum Eye Clinic, Seoul,

Results

The preoperative and 1-month postoperative patient data are summarized in Table 1. Postoperative vaulting, ACD, and pupil sizes of the eyes implanted with V4c and V4 ICLs under photopic and mesopic conditions are demonstrated in Table 2.

In eyes implanted with V4c and V4 ICLs there were significant differences in vaulting between photopic and mesopic conditions. In eyes implanted with V4c ICLs, the mean results for vaulting under photopic and mesopic conditions were 399.5 ± 151.9 μM and 547.0 ±

Discussion

In this study, we measured postoperative ICL vaulting, ACD, and pupil size of eyes implanted with V4c and V4 ICLs under differing lighting conditions, and we demonstrated significant decreases in vaulting and pupil size under photopic conditions. More important, decreases in vaulting after photopic light exposure were more remarkable in eyes implanted with V4c ICLs.

The observed vaulting changes from posterior movement of the ICL under photopic conditions are assumed to be associated with pupil

Hun Lee, MD, is currently pursuing his first year of corneal fellowship in Yonsei University College of Medicine, Severance hospital, Seoul, South Korea. He graduated from Yonsei University College of Medicine in 2006, where he completed his ophthalmology residency in 2011. His research interests are dry eye and refractive surgery.

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  • Cited by (0)

    Hun Lee, MD, is currently pursuing his first year of corneal fellowship in Yonsei University College of Medicine, Severance hospital, Seoul, South Korea. He graduated from Yonsei University College of Medicine in 2006, where he completed his ophthalmology residency in 2011. His research interests are dry eye and refractive surgery.

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