Observation And Analysis Of Short-term Subjective And Objective Visual Quality After Phakic Posterior Chamber Intraocular Lens Implantation (ICL V4c) For High Myopia Correction

Objective: The purpose of this paper is to assess the relation between objective and subjective visual quality in high myopic patients after V4 c Implantable Collamer Lens(ICL)implantation in the short term,and to explore the changes of various factors affecting visual quality.Methods: This prospective case studies included a total of 34 eyes of 18 patients that underwent V4 c ICL surgery in our hospital.The age of the patients ranged from 19-33(mean 25.5±3.95)years old,spherical equivalent was-4.75 to-11 dioptres(D)(mean-8.84±1.66),preoperative uncorrected visual acuity was(UCVA)0.82 to 2 Log MAR(mean 1.50±0.32),and the best corrected vision(BCVA)was 0 to 0.1 Log MAR(mean 0.01±0.02).Objective visual quality assessment and subjective visual quality assessment was performed before surgery,1 week and 1 month after surgery.Objective visual quality assessment including refractive status,higher order aberration(Zeiss i.Profiler Plus optometer),dry eye index(Ocular synthesis analyser Keratograph 5M).Subjective visual quality assessment including visual acuity,visual questionnaire assessment(Qo V)and dry eye questionnaire(OSDI).The results were statistically analysed using the IBM SPSS23.0 repeated measure analysis of variance.Results: Objective visual quality assessment: refractive status: spherical was-8.17±1.74 D before surgery,0.45± 0.41 D 1 week after surgery,and 0.47±0.49 D 1 month after surgery.The cylindrical was-1.19±0.96 D before surgery,-0.41±0.84 D 1 week after surgery,and-0.48±0.74 D 1 month after surgery.The difference between the two before surgery was statistically significant(P < 0.05),and the difference between 1 week and 1 month after surgery was not statistically significant(P>0.05).Higher order aberration: spherical aberration was 0.06±0.10?m before surgery,0.00±0.05?m 1 week after surgery,and 0.00±0.05?m 1 month after surgery.Horizontal trefoil was-0.01±0.07?m before surgery,-0.09±0.15 ?m 1 week after surgery,and-0.1±0.13?m 1 month after surgery.Quatrefoil was 0.04±0.12 ?m before the surgery,0.01±0.08?m 1 week after the surgery and 0.01±0.07?m 1 month after the surgery.The difference of the three before and after the operation was statistically significant(P < 0.05),and the difference between 1 week and 1 month after the operation was not statistically significant(P>0.05).The total high order aberration(HOA)was 0.25±0.13?m before surgery,0.29±0.14?m 1 week after surgery,and 0.29±0.13?m 1 month after surgery.The horizontal coma was 0.03±0.08?m before surgery,0.01±0.08?m 1 week after surgery,and 0.01±0.07?m 1 month after surgery.The vertical coma was-0.00±0.16 m before surgery,-0.02± 0.12 m 1 week after surgery,and-0.04±0.15 ?m 1 month after surgery.There was no statistically significant difference between the three before and after surgery(P>0.05).Dry eye index: the first tear break time was 8.94± 6.1s before surgery,7.48± 4.45 s 1 week after surgery,and 6.94± 5.47 s 1 month after surgery;The average tear break time was 12.10±5.81 S before surgery,11.68±6.13 S 1 week after surgery,and 10.82±5.59 S 1 month after surgery.The height of tear was 0.19±0.09 mm before surgery,0.20±0.07 mm 1 week after surgery,and 0.20±0.10 mm 1 month after surgery,respectively.There was no statistically significant difference between the three before and after surgery(P>0.05).Others: Kappa Y was 0.09±0.12 before surgery,0.01±0.13 1 week after surgery,and 0.01±0.14 1 month after surgery,with statistically significant difference before and after surgery(P<0.05).There was no significant difference between preoperative corneal endothelium 2881.59±219.75 and postoperative corneal endothelium 2756.75±373.87(P>0.05).There was no significant difference between preoperative Kappa X-0.06 ±0.17 and postoperative-0.05±0.12(P>0.05).Subjective visual quality assessment: visual acuity: UCVA was 1.50±0.32 before surgery,-0.04±0.04 1 week after surgery,and-0.05±0.05 1 month after surgery.BCVA was 0.01±0.02 before surgery,1 week after surgery-0.05±0.04,1 month after surgery-0.05±0.04.There was a statistically significant difference between the two before and after surgery(P < 0.05),and no statistically significant difference between 1 week and 1 month after surgery(P>0.05).OSDI scores were 14.04±9.62 before surgery,10.55±8.75 1 week after surgery,and 10.92±10.32 1 month after surgery.Qo V scores were 6.00±7.42 before surgery,6.94±5.12 1 week after surgery,and 8.06±7.23 1 month after surgery,respectively.There was no statistically significant difference between the two before and after surgery(P>0.05).Conclusion: One month after implantation of V4 c ICL,the visual acuity improved significantly,which had little impact on the high order aberration and the ocular surface state,did not cause the decline of visual quality,and no serious complications occurred.The efficacy and safety of the operation were worthy of affirmation,and the short-term postoperative effect was stable.