Evaluation of Higher Order Aberrations and Anterior Segment Parameters Changes After Implantable Collamer Lens Implantation for High Myopia

PURPOSE: To evaluate changes in higher order aberrations (HOAs) induced by implantable collamer lens (ICL) implantation in correction of high myopia and to compare the anterior segment parameters before and after surgery. Also, to correlate these parameters with HOAs, the best corrected visual acuity (BCVA) and intraocular pressure (IOP). METHODS: This prospective interventional cohort case series study included 40 eyes with high myopia that underwent ICL V4c implantation. They were evaluated pre-operatively and post-operatively at 1(st) and 3(rd) month HOAs using Scheimpflug Sirius Camera. The anterior segment parameters were evaluated by optical biometry. Correlations between HOAs, BCVA and anterior segment parameters were evaluated. RESULTS: The mean pre-operative BCVA was 0.67 ± 0.17, while post-operative BCVA was 0.74 ± 0.16 (p-value < 0.001). The spherical equivalent was −13.66 ± 2.23 pre-operatively, while post-operatively it was −0.77 ± 0.65 (p-value < 0.001). The mean pre-operative root mean square (RMS) of HOAs was 0.62 ± 0.11 µm, while mean post-operative RMS in the 1st month was 0.82 ± 0.29 µm (p-value < 0.001). At 3rd month, it was 0.63 ± 0.17 µm (p-value = 0.685). The mean pre-operative anterior chamber depth (ACD) was 3.66 ± 0.26 mm. It decreased in the post-operative 1(st) month to 3.46 ± 0.30 mm, while in 3(rd) month 3.45 ± 0.24 mm (p-value < 0.001, < 0.001) respectively. The mean pre-operative anterior chamber angle (ACA) 45.98 ± 8.39 (o) while, the mean ACA was 31.65 ± 4.14, 31.03 ± 3.74 post-operatively (p-value < 0.001, < 0.001) respectively. There was significant increase in IOP (p-value < 0.001). CONCLUSION: ICL implantation is safe and effective in correction of high myopia, as HOAs increase at first month post-operatively then, return to the pre-operative level by 3(rd) month. However, anterior segment parameters show significant changes which may need longer follow up.