Official ESCRS | European Society of Cataract & Refractive Surgeons


The impact of angle kappa and pupil size on quality of vision in high myopic patients with implantable collamer lens (ICL) implantation

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Session Details

Session Title: Posterior Chamber Phakic IOLs

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 14:50

Venue: Free Paper Forum: Podium 3

First Author: : E.Pazo CHINA

Co Author(s): :    Z. Liu   H. Huang   C. Zheng   L. Xu   W. He                 

Abstract Details


To assess the quality of vision after implantable collamer lens surgery and factors influencing visual outcome.


He Eye Hospital, Shenyang, China.


Medical charts from 100 eyes of 50 patients who underwent Visian V4c (STAAR, Switzerland) implantable collamer lens implantation (ICL) were assessed. The quality of vision was evaluated using a validated Quality of Vision (QOV) questionnaire and Dry Eye OSDI questionnaires administered preoperatively, 3 and 6 months after surgery. Potential factors included in the analysis were preoperative and postoperative pupil diameter (PD), pupil shift (PS), and angle kappa (AK). keratometric value, anterior chamber depth, postoperative residual refractive error, and higher order aberrations. The power, size, and optic zone diameter of the implantable collamer lens were also included as variables.


Preoperative mean PD was 3.12±0.55mm and postoperatively at 3-months and 6-months it decreased to 2.91±0.46mm (p<0.001) and 2.85±0.52mm (p>0.001) respectively. The coloration between change in postoperative PD and QOV was at 3-months (R=32.01; p<0.001) and 6-months (R=30.05; p<0.001) respectively; Correlation between AK and QOV at 3-months and 6-months postop was: R=44.06; p<0.001 and R=42.19; p<0.001 respectively. Correlation between postoperative QOV and OSDI change at 3-months (R=54.27; p<0.001) and 6-months (R=56.10; p<0.001) were significant. No statistically significant difference was found between best-corrected distance visual acuity and AK or PD at the postoperative 3-months and 6-months.


PD tends to decrease at the 3-months and 6-months stages after ICL implantation and the significant coloration between increase in AK and decrease in QOV suggests that higher AK may be cause possible dysphotopia in such eyes. Correlation between postoperative QOV and OSDI suggests that postoperative dry eye is an important index that should be monitored in ICL patients. An evaluation of angle kappa should be a part of preoperative examination before ICL implantation in high myopes. Patients with a high angle kappa should be excluded because of a higher risk of postoperative photic phenomena.

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