Effect of pupil size on posterior chamber phakic intraocular lens vault measurements.

PURPOSE: The aim of this study was to measure the implantable collamer lens (ICL) vault changes with anterior segment optical coherence tomography (AS-OCT) after the implantation of the Visian posterior chamber phakic ICL with a central hole (V4c) in relation to the pupil size. METHODS: This retrospective observational pilot study included 32 eyes of 16 patients, who underwent V4c ICL implantation. ICL vault was measured with AS-OCT in undilated and fully dilate state of the pupil. Primary outcome measure was the change in the vault of V4c ICL at the maximum and minimum pupil size. RESULTS: Median (IQR) undilated and post-dilated vault measurement was 393.00 (335.50-493.50) microns and 421.00 (338.50-503.75) microns, respectively, which was not statistically significant (P = 0.44). CONCLUSION: No statistically significant difference was observed between the undilated and post-dilated ICL vault measurements. Hence, the postoperative vault can be measured either in resting, undilated state or fully dilated state of the pupil and would be similar irrespective of the pupil size.

Management of anisocoria and high vault in an eye with implantable collamer lens.

A young lady presented with very high vault and fixed dilated pupil along with optic capture of the implantable collamer lens (ICL). After thorough evaluation and ruling out the ICL sizing error, the optic capture was relieved and the ICL was rotated into vertical position. Single-pass four throw pupilloplasty was performed for the fixed dilated pupil. Postoperatively the ICL vault and the pupil size decreased and patient was asymptomatic. This case highlights a successful outcome of rotation of a nontoric ICL to reduce the high vaulting and optic capture along with single-pass four throw pupilloplasty.

Comparison of single-step transepithelial photorefractive keratectomy and conventional photorefractive keratectomy in low to high myopic eyes.

Purpose: To compare the visual outcome, safety, safety index, efficacy, efficacy index and corneal transparency between single-step transepithelial photorefractive keratectomy (t-PRK) and conventional photorefractive keratectomy (PRK) with manual debridement of epithelium in eyes with low to high simple myopia and compound myopic astigmatism. Methods: In this retrospective ,case control study, we analysed and compared the postoperative uncorrected visual acuity(UCVA), postoperative best corrected visual acuity (BCVA) , safety, safety index,efficacy,efficacy index and the corneal transparency between t-PRK and PRK with 6th-generation Amaris excimer 500E laser (Schwind eye-tech-solutions) in 115 eyes of 59 patients. Results: Preoperative Mean Refractive Spherical Equivalent (MRSE) was - 3.88 + 0.23 Diopters(D) and -4.73 + 0.23D in PRK and t-PRK group respectively(p=0.09). In both the groups , none of the eyes lost postoperative BCVA at the end of mean follow-up period of 3.5 months . All the eyes achieved post operative UCVA of 20/40 or better in both the groups. Incidence of trace corneal haze was high in t-PRK group at the end of 3.5 months (P = 0.003). Conclusion: Single-step t-PRK and PRK provide similar results at the end of mean follow-up period of 3.5 months postoperatively with regards to post-operative UCVA, post operative BCVA, safety, safety index, efficacy and efficacy index. There was high incidence of trace haze in t- PRK eyes. Both the procedures are predictable, effective, and safe for correction of low to high myopia.