The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation

Abstract

Purpose. To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods. Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result. Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP ≥ 21 mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (χ2 = 7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher p<0.001 in the right eyes, and TIA and AOD were significantly lower p<0.05 in the right eyes than in the left eyes. There was no significant difference at 24 h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (β = −23.707 and 1.731, respectively; p = 0.013 and 0.002, respectively). Conclusion. The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes.

Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation

“…High intraocular pressure and secondary glaucoma High intraocular pressure and secondary glaucoma account for 4.4% of postoperative complications after ICL implantation [136], and the causes include steroid response, viscoelastic agent residue, aqueous misdirection, pupillary block, Iris pigmentation, narrow ACA, etc. [137][138][139]. The increase in IOP mostly reached its peak at the end of the first postoperative month, and the vast majority of patients can resume normal IOP [137].…”

Intraocular Implantable Collamer Lens with a Central Hole Implantation: Safety, Efficacy, and Patient Outcomes

“…Hu et al found that early increase in IOP after V4c model implantation was associated with a narrowed anterior chamber angle and higher pupil diameter. 68 They recommended the use of intracameral miotics immediately after the operation to reduce the incidence of early postoperative increase in IOP. Persistent IOP elevation after ICL implantation in hole-ICL models is rare.…”

Prediction model of the horizontal trabecular iris angle after phakic posterior chamber implantable intraocular lens surgery

“…15,23,24 Other studies enrolling different ethnical groups, particularly Chinese and Japanese individuals, have reported preoperative TIA values ranging from 40.0 to 58.4 degrees. 17,25–28 Lim et al reported a mean preoperative TIA of 31.9 degrees, which reflects the association between the ACA and the ACD, in patients with ACD lower than 2.8 mm (the minimum ACD recommended by the manufacturer). 29 In the present study, the TIA 750 correlated positively with the corneal sagittal height ( R = 0.534) and the ACD ( R = 0.503) and negatively with the CLR ( R = −0.433).…”