ESCRS - FP30.10 - Comparative Study On The Impact Of Different Limbal Incision Locations On Tear Function And Visual Quality After V4c Icl Implantation

Comparative Study On The Impact Of Different Limbal Incision Locations On Tear Function And Visual Quality After V4c Icl Implantation

Published 2025 - 43rd Congress of the ESCRS

Reference: FP30.10 | Type: Free paper | DOI: 10.82333/map2-xn92

Authors: Catarina Francisco* 1 , Renato Correia Barbosa 2 , Rui Carvalho 2 , Paula Tenedório 2

1Ophthalmology,Unidade Local de Saúde de Matosinhos,Matosinhos,Portugal;Porto University,Faculty of Medicine,Porto,Portugal, 2Ophthalmology,Unidade Local de Saúde de Matosinhos,Matosinhos,Portugal

Purpose

To evaluate the effects of superior and temporal limbal incision locations on tear function and visual quality following V4c ICL implantation

Setting

In refractive surgeries, the incision site directly influences the degree of corneal nerve damage,which affects reflex tear production, blink frequency, and tear dynamics. Alterations in incision location can also influence tear film distribution across the ocular surface.  While these factors are well-established, there remains a paucity of research exploring the impact of different corneal incision sites in ICL implantation on tear film stability.

Methods

A prospective, self-controlled study included 43 patients(86eyes).The right eyes(superior 12 o’clock limbal incision)were assigned to the intervention group,the left eyes(temporal 3 o’clock)served as controls. Measurements were conducted preoperatively and at 1- and 3-month follow-ups, including Tear Meniscus Height(TMH), First Non-Invasive Breakup Time(NI-BUTf), Average Non-Invasive Breakup Time(NI-BUTave), Upper Meibomian Gland Loss Area(UMGL), Lower Meibomian Gland Loss Area(LMGL), Red Eye Index Analysis, Corneal Fluorescein Staining(FCS), Modulation Transfer Function(MTF), and Objective Scatter Index(OSI). Generalized Estimating Equations(GEE) were used to analyze group effects, time effects, and group-time interaction effects.

Results

Preoperative refractive error, ICL/TICL ratio, BCVA, and dry eye indices showed no significant differences between groups (P > 0.05). No significant time or interaction effects were observed for most dry eye metrics. However, mean BUT and lower meibomian gland scores differed significantly between groups (P< 0.001 and = 0.024, respectively). Compared to baseline, NI-BUTf scores increased
by 5.98 at 1 month and 6.96 at 3 months postoperatively (P< 0.001). UMGL, LMGL, and FCS scores decreased postoperatively (P< 0.001, < 0.001, and < 0.001 , respectively). OSI values decreased (P< 0.001), while MTF scores increased (P< 0.001)

 

Conclusions

Superior limbal incisions in V4c ICL implantation yield better tear film function and visual quality compared to temporal limbal incisions