Evaluation of accommodation effect on central and peripheral vault of posterior phakic IOL (Implantable Collamer Lens)

Purpose: The aim of this study was to determine whether the peripheral vault of implantable collamer lens (ICL) to correct myopia is matter in accommodative and dilated state. Methods: Patients underwent V4c ICL implantation and had the follow-up period of at least 6 months. Anterior chamber depth (ACD), postoperative posterior corneal surface-to-ICL distance (endo-ICL distance), postoperative central, peripheral vault, and pupil size were evaluated using the Casia anterior segment optical coherence tomography system. Measurements were performed during the nonaccommodative, accommodative, and dilated states 3 months after ICL implantation. Results: A total of 60 eyes of 32 high myopic patients who were unsuitable for corneal based refractive surgery (27.31 ± 4.77 years, 17 men) were included in the study. No statistically significant change in central and peripheral vaulting was seen during accommodation (P = 0.184 and P = 0.449 respectively). However, the reduction in ACD, endo-ICL distance measurements was noticeable during accommodation (P = 0.013 and P = 0.025 respectively). Peripheral vault during dilation of pupil was measured (127.07 ± 13.10 μm, range: 102 to 155 μm). Conclusion: Central and peripheral ICL vault were not affected by accommodation. Minimal but noticeable distance between periphery of ICL and crystalline lens during dilation of pupil is seen if central vaulting were within normal limit and proper ICL sizing were chosen.