BackgroundTo objectively compare the early changes in vault over time following implantation of an Implantable Collamer Lens without (ICL V4) and with (ICL V4c) a central hole and the respective factors affecting vault change in moderate to high myopia.MethodsThis prospective study comprised of 38 eyes of 38 patients implanted with ICL V4 and 39 eyes of 39 patients implanted with ICL V4c intraocular lenses. We quantitatively assessed the postoperative values of vault and pupil size at 1 day, 1 week, and 1 month following implantation using a rotating Scheimpflug camera (Pentacam). We compared these postoperative values within and between the two groups and identified the factors affecting vault change.ResultsThe mean vaults at 1 day, 1 week, and 1 month following ICL V4 implantation were 303.68 ± 185.11, 517.89 ± 160.07 and 521.32 ± 155.72 μm respectively, and those following ICL V4c were 316.67 ± 186.89, 495.13 ± 180.84 and 510.77 ± 175.51 μm, respectively. There was a significant difference in vault between 1 day and 1 week postoperatively. There was a significant association between the vault change and the pupil size change in both groups from 1 day to 1 month postoperatively (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001; ICL V4c: r = 0.588, P <0.001). The vault value 1 month after implantation of ICL V4 and ICL V4c was associated with the preoperative anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus.ConclusionsPupil movement is a critical factor in vault change, with increasing vault observed postoperatively from 1 day to 1 week associated with the declining effects of pharmacological miosis and increasing pupil size. The anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus show some correlation with vault.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0336-8) contains supplementary material, which is available to authorized users.

This study suggests that, although mild decentration occurred in the early learning curve, good visual outcomes were achieved after the SMILE surgery. Special efforts to minimize induced vertical coma are necessary.

Axial elongation in children undergoing ortho-k therapy is negatively correlated with the age of the wearer and summed corneal power change from the central to the mid-peripheral cornea. We speculate that axial elongation is influenced by the extent to which the retinal defocus profile is altered with ortho-k lens wear. (http://www.chictr.org number, ChiCTR-TNRC-11001210.).

Purpose: To compare visual outcomes and aberration outcomes in small incision lenticule extraction (SMILE) versus femtosecond laser LASIK (FS-LASIK). Methods: This prospective, comparative, nonrandomized clinical study included 68 eyes of 37 patients receiving SMILE and 55 eyes of 30 patients receiving FS-LASIK between December 2011 and January 2013 at the Fudan University Eye and ENT Hospital (Shanghai, People's Republic of China). Patients were followed up at 3, 6 months and 5 years after surgery. Main outcome measurements included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, central corneal thickness (CCT), total corneal refractive power (TCRP) and wavefront aberrations. Results: About 98% (49/50) of treated eyes in the SMILE group and 95% (39/41) in the FS-LASIK group had a postoperative logMAR UDVA of 0 or better. Spherical equivalent (SE) after 5 years was À0.01 AE 0.35 D in the SMILE group and À0.23 AE 0.41 D in the FS-LASIK group. A regression of À0.02 AE 0.39 D in the SMILE group and À0.12 AE 0.32 D in the FS-LASIK group was observed between 6 months and 5 years postoperative time-points. TCRP increased by 0.39 AE 0.38 D in the SMILE group and 0.45 AE 0.49 D in the FS-LASIK group between 6-month and 5-year time-points. However, no statistically significant difference was found between the SMILE and FS-LASIK groups in terms of ΔSE, ΔCCT and ΔTCRP between 6 months and 5 years postoperative time-points. Conclusion: Myopic regression was observed in terms of TCRP but not in subjective refraction. No statistically significant difference in stability was found between SMILE and FS-LASIK.

Purpose To investigate differences in the objective and subjective visual quality of patients with high myopia following implantable collamer lens V4c (ICL V4c) versus small incision lenticule extraction (SMILE) early postoperatively. Methods This prospective analysis included 94 eyes of 57 patients (8 males) in the ICL V4c group (mean spherical equivalent (SE), −8.07 ± 1.03 dioptres (D)) and 103 eyes of 57 patients (13 males) in the SMILE group (mean SE, −7.85 ± 0.78 D). Refractive parameters and wavefront aberrations were recorded preoperatively and 6 months postoperatively. Subjective visual quality was scored with the Quality of Vision questionnaire, and operation satisfaction was evaluated 6 months postoperatively. Results At 6 months postoperatively, the efficacy index was 1.17 ± 0.16 in the ICL and 1.09 ± 0.20 in the SMILE group; the safety index was 1.21 ± 0.18 in the ICL and 1.12 ± 0.16 in the SMILE group. A significant increase in total higher‐order aberrations (HOAs) in both the ICL and SMILE groups was observed, but to a lesser degree in ICL (p < 0.05). In the ICL group, trefoil significantly increased (p < 0.05), whereas in the SMILE group, coma, trefoil and spherical aberration significantly increased (p < 0.05). Glare, haloes and blurred vision had the highest incidences after both types of surgery, and postoperative haloes were significantly more common following ICL; 96.1% of ICL‐treated and 94.9% of SMILE‐treated patients were satisfied with their visual outcomes. Conclusion ICL V4c caused lower HOAs induction than SMILE. Despite the postoperative visual disturbances, both ICL and SMILE provided good efficacy, safety, predictability and high satisfaction in correcting high myopia.

PurposeTo compare one‐year visual outcomes and optical quality after femtosecond laser small incision lenticule extraction (SMILE) and Visian Implantable Collamer Lens with a central hole (ICL V4c) implantation for high myopia.MethodsThis prospective non‐randomized study included 37 eyes of 20 patients who underwent SMILE (G‐S) and 39 eyes of 20 patients who underwent ICL V4c implantation (G‐V). Spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity, retinal image quality and intraocular scattering were evaluated at one year after surgery. Each model was adjusted for age, gender, eye and preoperative SE during treatment.ResultsAt the one‐year follow‐up, G‐S and G‐V showed similar safety index (1.13 ± 0.13 and 1.11 ± 0.15, respectively) and efficacy index (1.05 ± 0.14 and 1.06 ± 0.15, respectively). All 21 eyes with Toric ICL (TICL) had a postoperative astigmatism of ≤0.5 dioptres (D), while the astigmatism was ≤0.5 D in all G‐S eyes. Thirty‐six G‐S eyes (97%) and 35 G‐V eyes (90%) were within ± 0.5 D of the target SE. The changes in the modulation transfer function cut‐off frequency (MTFcut‐off) and the objective scatter index from before operation to one year following the operation were not significantly different between the groups (p = 0.523 and 0.826, respectively).ConclusionBoth SMILE and ICL V4c implantation provide good safety, efficacy, predictability, and stability in correcting high myopia. Optical quality including intraocular scattering was great and relatively stable in both groups during the one‐year observation period.

Background High myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare. This observational study aims to evaluate visual outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. Methods A prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for at least 12 months (average 15.35 ± 4.90 months, rangers from 12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after surgery. Results All surgeries were performed safely and no complication was observed during the follow-ups. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ±1.0 D and 35 eyes (69%) were within ±0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 μm (90 to 700 μm). The ECD was reduced by 8.38 ± 0.06% as compared to the preoperative value ( p < 0.001). No significant change was observed in IOP ( p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed. Conclusions In this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation. Trial registration This trial was retrospectively registered on 05/08/2018 under the number ( ChiCTR1800017594 ).

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