One-Year Clinical Outcomes Of Evo+ Visian Icl Implantation Using Swept-Source Anterior Segment Optical Coherence Tomography (Casia2)

To assess 1-year 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 measurements with conventional white-to-white(WTW) measurements by other devices.

Nunimiso Eye Clinic, Seoul, South Korea

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 1-year 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 1-year was found only in 8 cases and were due to amblyopia or toric rotation. Reposition of ICL due to rotation were done in 6 cases. Mean post-op. vault was 520.7±191.0um, and the percentage of low vault(<250um) was 7.6%(33 eyes) and high vault(>750um) was 5.3%(23 eyes). Exchange of ICL due to excessively high vault(>1000um) or low vault(<150um) were done in 2 cases(0.45%). ATA measured by CASIA2(11.7±0.4mm) was not significantly different from the WTW measured by Pentacam HR(11.9±0.4mm), however, it showed significant difference(p<0.05) compared with Gallilei G4(12.1±0.4mm).

Long-term post-operative vaulting of ICL based on ATA measurement provided stable outcomes. High resolution anterior chamber imaging by CASIA2 would be very useful in selecting optimal ICL size to avoid post-operative complications.