Anterior Segment Analysis In The Prediction Of ICL Implantation

Purpose:To analyze the prediction of Anterior segment parameters in ICL implantation and the correlation and agreement of white-to-white(WTW)measured with caliper,IOL Master and Oculyzer anterior segment analysis system.Methods:Totally 41 patients with 80 eyes who underwent ICL V4c implantation in our hospital from July 2018 to January 2019 were enrolled.Preoperative WTW and central anterior chamber depth(ACD)was measured.WTW was measured by caliper,IOL Master and Oculyzer anterior segment analysis system respectively.The postoperative vault(the distance between the posterior surface of the intraocular lens and the anterior surface of lens)was measured using anterior segment OCT,the UCVA,computer optometry,intraocular pressure and vault at postoperative1w,1mo,and 3mo were recorded,and whether there were complications occurred.SPSS22.0 software,MedCalc statistical software and Matlab statistical software were used for statistical analysis.Results:1.The mean WTW value measured with caliper,IOL Master and Oculyzer anterior segment analysis system were:11.73±0.40,12.03±0.46,11.54±0.39mm respectively,and the 95%LoA of Bland-Altman analysis were(-0.84,0.22),(-0.27,0.64),(-0.07,1.05)mm respectively.the value of caliper and IOL Master,caliper and Oculyzer,IOL Master and Oculyzer were highly correlated(r=0.809,0.826,0.785,all P<0.01).2.The average postoperative vault was 622.12±185.01?m(220~1160?m),including 4 eyes(5%)with vault?1000?m and 2 eyes(2%)with vault<250?m.No increase in intraocular pressure during follow-up and hadn't form turbidity under the anterior capsule.Vault was positively correlated with preoperative WTW(r=0.371,P<0.01)and ACD(r=0.297,P=0.003),and negatively correlated with age(r=-0.245,P=0.013).Multiple linear regression was performed between vault and WTW,ACD and age.The analysis showed that the vault was the only linearly related to WTW(R~2 was 0.171,t=2.471,p=0.015),there was no linear relationship between ACD and age(p>0.05).3.The preoperative BCVA was 0.93±0.13,and the postoperative UCVA was 1.09±0.11,which was a significant difference between the two groups(t=-10.484,p<0.01);The preoperative IOP was 14.05±2.01mmHg,and the postoperative IOP was 13.92±2.29 mmHg,there was no significant difference between the two groups(t=0.569,p>0.05),and there was no obvious Complications such as high IOP,pupil block and cataract occurred during follow-ups.Conclusion:1.Among the three measuring instruments,IOL Master has the largest measurement value.The three measurement methods have poor consistency and cannot be replaced in clinical application.Whereas,their measurements are highly correlated.In clinical application,the measurements of IOL Master and Oculyzer can be corrected based on the difference with caliper.2.There is a linear relationship between postoperative vault and WTW,and a wireless relationship between vault and ACD.3.ICL implantation is safe and effective in correcting high myopia.Calculating ICL diameter according to WTW has good predictability for postoperative vault.