Predictive factors for postoperative visual acuity improvement with ICL-V4c for ultrahigh myopia above - 10 D.

Abstract

Purpose: The purpose of this study is to evaluate the predictive factors for postoperative visual acuity improvement (PVAI) in subjects who underwent phakic intraocular lens implantation with a central hole (ICL-V4c) for ultrahigh myopia above - 10 D.

Methods: This was a retrospective study. Eyes with ultrahigh myopia above - 10 D undergoing ICL-V4c implantation were studied. Univariable linear regression models were used to assess the association between PVAI and preoperative parameters. Myopic maculopathy was classified into 5 categories by fundus photography. After the 1-month follow-up, the PVAI was compared within different age and preoperative spherical degree groups.

Results: This study included 726 eyes from 419 patients (111 men and 308 women), and the mean age, spherical refraction, and axial length were 28.67 ± 7.93 years, - 13.61 ± 3.44 D, and 28.59 ± 1.50 mm, respectively. At baseline, myopic maculopathy was classified (grades C0-C4) as follows: C0 was observed in 200 eyes (27.5%), C1 in 297 eyes (40.9%), C2 in 147 eyes (20.2%), C3 in 22 eyes (3.0%), and C4 in 60 eyes (8.3%). The PVAI was significantly negatively associated with age and positively associated with SD-pre(-Sph), but no significant association between myopic maculopathy classification and axial length was found. After 1 month, 417 eyes (57.4%) gained more than 1 line at BCVA, 250 eyes (34.4%) remained the same, and 59 eyes (8.13%) lost 1 line. The postoperative visual acuity of 52 eyes was improved by more than 3 lines, and 42.3% were grade C4.

Conclusions: The ICL performed well for the correction of ultrahigh myopia above - 10 D. Younger patients and those with a higher preoperative spherical degree had greater postoperative satisfaction.

Trial registration: Chinese Clinical Trial Registry (ChiCTR2000036335). Date of registration: 2020/8/22.