Journal of Cataract and Refractive Surgery, volume 51, issue 3, pages 236-242

Anterior Segment Pharmacological Accommodative Changes and Its Impact on the Circumferential Anterior Chamber Angle after ICL V4c Implantation

Shengtao Liu ^{1, 2, 3}

Mingrui Cheng ^{1, 2, 3}

Fang Liu ^{1, 2, 3}

Lin Feng ^{1, 2, 3}

Yichen Xiao ^{1, 2, 3}

Xiaoying Wang ^{1, 2, 3}

Xingtao Zhou ^{1, 2, 3}

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Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China. |

NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China

Shanghai Research Center of Ophthalmology and Optometry |

Publication type: Journal Article

Publication date: 2025-03-01

Ovid Technologies (Wolters Kluwer Health)

Journal: Journal of Cataract and Refractive Surgery

scimago Q1

SJR: 1.472

CiteScore: 5.6

Impact factor: 2.6

ISSN: 08863350, 18734502

DOI: 10.1097/j.jcrs.0000000000001593

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Abstract

PURPOSE:

To investigate the pharmacological accommodative changes of the anterior segment and its impact on the circumferential anterior chamber angle (ACA) after implantable collamer lens (ICL) implantation using swept-source optical coherence tomography (SS-OCT).

SETTING:

Eye and ENT Hospital, Fudan University, Shanghai, CHINA.

DESIGN:

Prospective randomized contralateral eye study.

METHODS:

Eight men and 24 women (mean age, 28.2 ± 5.8 years; range, 19–42 years); 64 eyes were included at 3 months after ICL implantation. One eye per patient was randomly assigned to undergo tropicamide instillation (mydriasis group), and the contralateral eye underwent pilocarpine instillation (miosis group). SS-OCT examinations were performed before and after instillation to measure angle parameters. Trabecular-iris angle 500 (TIA₅₀₀), angle opening distance 500 (AOD₅₀₀), trabecular-iris space area (TISA₅₀₀), angle opening distance circumference area 500 (AODA₅₀₀), trabecular-iris circumference volume 500 (TICV₅₀₀), and central vault (ICL to crystalline lens [ICL-L]) were evaluated.

RESULTS:

Relative to baseline levels, TIA₅₀₀, AOD₅₀₀, and TISA₅₀₀ values all increased significantly in both groups (all P < 0.01). AODA₅₀₀ and TICV₅₀₀ values increased by 19.7% and 12.1%, respectively, in the mydriasis group (all P < 0.001), and these values similarly increased by 23.4% and 27.7%, respectively, in the miosis group (all P < 0.001). After instillation, the ICL-L decrease in the miosis group was significantly larger than that in the mydriasis group (P = 0.004). Mean AOD₅₀₀, TISA₅₀₀, and TICV₅₀₀ in the miosis group were significantly larger than those in the mydriasis group (all P ≤ 0.036), especially at 8 and 10 o’clock (all P ≤ 0.014). Correlation analyses indicated that the increase in anterior chamber angle parameters was positively correlated with the change in ICL-L for both groups.

CONCLUSIONS:

Pilocarpine induced a more significant increase in ACA than tropicamide, because of different mechanism of anterior segment changes. We recommend circumferential meridian scan to assess angle status.

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Publisher

Ovid Technologies (Wolters Kluwer Health)

Journal

Journal of Cataract and Refractive Surgery

scimago Q1

SJR

1.472

CiteScore

5.6

Impact factor

2.6

ISSN

08863350 (Print)

18734502 (Electronic)

Profiles

Zhou, Xingtao -T