Assessment of Central Vault Changes induced By Cyclopentolate In Myopic Patients Implanted with the Implantable Phakic Contact Lens®

Abstract

Background A safe alternative to excimer laser in fixing high myopia is the implantable phakic contact lens (IPCL). Cycloplegics have been found to produce vault changes in the implantable collamer lens but not tested yet for the IPCL. Purpose To analyze central vault changes linked with instillation of cyclopentolate in myopic IPCL implanted patients and its association with anterior chamber depth (ACD), pupillary diameter, and white-to-white (WTW) diameter. Patients and methods This prospective study assessed the left eyes of 37 patients. Patients were followed up for 3 months postoperatively. The basic outcome measures were the safety and efficacy indices, while the main outcome was the vault measurements before and after cyclopentolate. Results Twenty (54.1%) females and 17 (45.9%) males, with a mean age of 24±4 years (18–32) were recruited. The safety index was 1.08±0.07 and the efficacy index was 0.99±0.1. There was a significant increase in central vault ‘V(C)’ after cyclopentolate [83.7±86.7 μm (−48 to 303); P<0.001). A good positive correlation existed between V(C) and ACD (r=0.7, P<0.001), and a fair correlation with pupil diameter (r=0.4, P=0.014), WTW (r=0.39, P=0.017), and the original vault ‘V(B)’ (r=0.34, P=004) was demonstrated. Conclusion Cyclopentolate induces an increase in central vault in most IPCL implanted myopic eyes, which is typically associated with ACD, pupillary diameter, WTW, and the original vault. Care should be advised to avoid angle narrowing.