Changes In Accommodative Microfluctuations After Icl Surgery

To evaluate postoperative changes in the high-frequency component (HFC) of accommodative microfluctuations following implantable collamer lens (ICL) surgery.

A prospective clinical study conducted at Guangzhou Aier Eye Hospital, China.

A total of 45 patients (88 eyes) with myopia (SE: -8.37 ± 2.91 D) who underwent ICL (V4c) surgery were included. Using the Acomoref 2 accommodative function analyzer, HFC was measured at +0.5D, 0D, -0.5D, -1.0D, -1.5D, -2.0D, -2.5D, and -3.0D, starting from the refractive endpoint. Patients were divided into an accommodative insufficiency group (PRA, positive relative accommodation ≤ 1.75D) and a normal accommodation group (PRA > 1.75D). HFC values were collected preoperatively, 1 week/1 month postoperatively in both groups. Independent sample t-tests and non-parametric tests were used for baseline comparisons, while repeated measures ANOVA was applied for intra- and inter-group analyses. A P ≤ 0.05 was considered statistically significant.

At 0D, HFC values were 56.93 ± 6.52 at the 1 week, and 58.03 ± 6.87 at the 1 month, which were significantly lower than preoperative values (60.89 ± 5.43, P=0.020). In the accommodative insufficiency group, at -0.5D, HFC value was 57.69 ± 6.06 at 1m, which was significantly lower than preoperative value (60.74 ± 5.29, P = 0.013). In the normal accommodation group, at 0D, HFC values were 56.10 ± 4.86 at the 1w, and 57.79 ± 4.45 at the 1 month, which were significantly lower than preoperative values (60.73 ± 4.46, P = 0.036 and 0.032, respectively). At -2.0D, HFC values were 61.80 ± 4.42 at the 1 week, and 61.44 ± 3.95 at the 1 month, which were significantly lower than preoperative values (64.44 ± 5.13, P = 0.025 and 0.012, respectively).

Postoperative HFC reductions suggest potential improvements in accommodative microfluctuation dynamics, indicating that ICL surgery may enhance accommodative capacity in myopic patients.