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First Author: J.Kim SOUTH KOREA
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To evaluate the efficacy of the rotating Scheimpflug imaging system (Pentacam®; Oculus, Wetzlar, Germany) method in estimating the white-to-white horizontal diameter for Visian Implantable Collamer Lens(ICL) length determination to obtain optimal ICL vault.
The results of postoperative ICL vaults in 319 eyes of 172 patients were retrospectively analyzed.
Visian Implantable Collamer Lens(ICL) length was determined by the conventional method in 174 eyes(by caliper, group 1), and by the rotating Scheimpflug imaging system(rSIS) method in 145 eyes(group 2). The rotating Scheimpflug imaging system(rSIS) method is a way to calculate the white-to-white distance by measuring the distance between both white edges of wedge shape in cornea stroma after the gamma correction and slope filter at cross-sectional image in the direction of 3 to 9 o"clock. The ICL vaults were measured using slit-lamp microscopy(magnification of 10x) at 1,7 and 30 days postoperatively and the results were compared between the two groups. Ideal ICL vault was defined as vault between 0.8 and 1.2 corneal thickness(CT).
The mean postoperative vault was 1.09ḟ0.32 (SD) CT at 1 day, 1.09ḟ0.29 CT at 7,30 days in group 2 and 1.18ḟ0.33 CT at 1,7 days, 1.19ḟ0.35 CT at 30 days in group 1. There was roughly no change of vault in group 2. In rSIS method group, ICL vault was within the ideal range in 121(83.4%) eyes at 1,7 and 30 days postoperatively, whereas in the conventional method group, 119 (68.3%) eyes showed ideal vault at 1,7 days postoperatively (P=0.03) and 107 (61.4%) eyes showed ideal vault at 30 days postoperatively (P<0.01). Three eyes with excessive vault(?2.5CT) was found in only the conventional method group. Implantable Collamer Lens(ICL) length determined by rSIS method achieved statistically significant more ideal ICL vault than that by the conventional method.
To expectation the proper ICL vault, accurate estimation of white-to-white horizontal diameter is crucial. Our rSIS method achieved more desirable ICL vault than the conventional method. Hence, The rotating Scheimpflug imaging system(rSIS) method is superior to the conventional method in terms of predicting the white-to-white horizontal diameter for ICL length determination.