Long-Term Clinical Outcomes Of Evo+ Visian Icl Implantation Using Swept-Source Anterior Segment Optical Coherence Tomography For Pre-Operative Internal Measurement

To assess 6-month visual, refractive and vaulting outcomes of EVO+ Visian ICL implantation based on angle to angle(ATA) measurement by swept-source anterior segment optical coherence tomography(AS-OCT). Also, to compare ATA distance with white to white(WTW) distance measured by other devices.

Single center(Nunemiso Eye Clinic), retrospective study.

Patients who underwent ICL implantation from July, 2019 to August, 2020 in Nunemiso Eye Clinic were reviewed retrospectively. Data from 435 eyes of 240 subjects who completed 6-month follow-up exam were collected and analyzed. ICL size determination was based on pre-operative ATA measurement using swept source AS-OCT(CASIA2). Pre and post-operative manifest refraction(MR), uncorrected distant visual acuity(UDVA), vault height were measured and other complications were recorded.

Mean age, pre-op myopic error, astigmatism and axial length was 26.9±5.6yr, -7.20±2.70D, -1.61±1.24D and 26.58±1.17mm, respectively. UDVA under 20/20 at 6-month was found in 8 cases and were due to amblyopia or toric rotation. Reposition of ICL due to rotation were done in 4 cases. Mean post-op vault height was 520.7±191.0um, and the percentage of low vault(<250um) was 7.1% and high vault(>750um) was 5.9%. Exchange of ICL due to excessively high(>1000um) or low(<150um) vaulat were done in 2 cases. ATA distance measured by CASIA2(11.7±0.4mm) was not significantly different from the WTW distance by Pentacam HR(11.9±0.4mm), however, it showed significant difference(p<0.05) compared with Gallilei G4(12.1±0.4mm) or IOL mater 500(12.1±0.4mm).

ICL implantation based on ATA measurement would provide stable and fine outcomes. High resolution anterior chamber image by CASIA2 could be useful in selecting ICL size and reducing post-operative complications.