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First Author: R.Montés-Micó SPAIN
Co Author(s): C. Pérez-Vives T. Ferrer-Blasco L. Belda-Salmerón D. Monsálvez-Romín
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To compare the visual quality of myopic Implantable Collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering. The V4c model introduces a central hole (diameter 0.36 mm) to improve the aqueous humor perfusion and reduce the risk of secondary cataract formation. We used an adaptive optics system to simulate vision from the ICLs aberration patterns themselves.
University of Valencia
The ICLs studied were -3, -6 and -12 diopter (D) V4b (conventional ICL) and -3, -6 and -12D V4c ICLs (Hole-ICL), in three conditions, centered and decentered 0.3 and 0.6 mm. The adaptive optics visual simulation (crx1) was used to simulate the vision post- ICL implantation surgery in each individual and in each condition of decentering. First, the crx1 was programmed to compensate the eyes wavefront error and then the aberration pattern of ICLs was induced adding the wavefront pattern of the myopic eye. High (100%)-, medium (50%)- and low (10%)-contrast visual acuity (VA) was measured. The contrast sensitivity (CS) was measured for 3 spatial frequencies: 10, 20 and 25 cycles/degree (cpd). Oriented sinusoidal gratings (0o, 45o, 90o and 135o) were randomly generated and displayed on the micro-display using a 4-alternative, forced-choice method. All measures were taken for 3- and 4.5-mm pupil. Differences were considered statistically significant when P value was less than .05.
VA values were better than 20/20 at high and medium contrast with both models of ICLs and for all ICL powers evaluated. No statistically significant differences were found in VA and CS between conventional ICL and Hole ICL for any ICL power, VA contrast and spatial frequencies evaluated at 3- and 4.5-mm pupil (p>0.05). Regarding to the effect of the ICL decentration, it was affected in the same manner on the conventional and Hole ICLs. We only found statistical significant differences in VA between centered and decentered 0.6 mm for -12D conventional and -12D Hole ICLs at low contrast and 4.5-mm pupil (p<0.05). Statistically significant differences were found in CS between centered and decentered 0.6 mm for -12D conventional and -12D Hole ICLs at 25 cpd spatial frequency for 4.5-mm pupil (p<0.05).
The outcomes showed that both models of ICLs provide good and comparable VA and CS values. Therefore, the central hole did not affect on the VA and CS for any ICL power evaluated. On the other hand, it have been studied that both models of ICLs have negative spherical aberration, which increases whit the ICL power, in addition a displacement of a lens with spherical aberration generates coma aberration. In this study, this coma increment affects to -12D conventional and Hole ICLs with the major decentration and at low VA contrast and the highest spatial frequency evaluated. This is due to the -12D conventional and Hole ICLs have more spherical aberration and therefore it generates more coma when the ICL is decentered.