Identification of subclinical spherophakia in EVO-ICL candidates
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First Author: Z.Yang CHINA
Co Author(s): Y. Luo
Subclinical spherophakia is a condition in which the crystalline lens exhibits a relatively more spherical shape but no obvious pathologic changes of zonules. It is likely to cause low vault after ICL implantation. The study is to report the clinical characteristics of subclinical spherophakia.
Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
This is a retrospective, observational, comparative case series. A total of 92 highly myopic eyes with lens thickness greater than 4.0mm that underwent ICL implantation between October 2017 and October 2019 were reviewed. ICL size was chosen based on white-to-white and ange-to-angle. 8 eyes of 4 patients (Group A) had low vault (less than 250um) while 12 eyes of 6 patients (Group B) had high vault (greater than 750um) after the surgery. Preoperative myopic diopters, keratometry, axial length, ACD, lens thickness, angle recess to angle recess lens rise, iris contour in anterior segment OCT were analyzed.
Among all the factors we analyzed, the preoperative keratometry and the iris contour differed significantly between the two groups. The average keratometry number of group A was 46.35 while the number of group B was 42.97 (P=0.003). All the eyes in Group A had concave iris while all the eyes in Group B had iris bombe. Based on the result, a greater size of ICL was chosen for two patients thereafter, and the vaults were within the normal range.
Besides increased lens thickness, high keratometry and concave iris were the main characteristics of subclinical spherophakia. A greater size of ICL should be chosen for this group of patients.