Implantable collamer lens for high myopia: assessment of visual quality after implantation

Background: Patients with high myopia have higher risk of eye diseases. Currently, Implantable collamer lens (ICL) implantation is one of the widely used refractive intraocular lens surgical intervention methods. Purpose: To evaluate the effectiveness of implantable collamer lens (ICL) implantation in high myopia patients and the changes in wavefront aberrations after the operation. Methods: Thirty-two eyes with high myopia were enrolled. The spherical equivalent, visual acuity including near vision, uncorrected distant visual acuity (UDVA) and corrected distant visual acuity (CDVA), and the total aberrations root mean square (Total-RMS) were measured before and after ICL operation. Furthermore, Total-RMS fixating on targets at 2 distances (5 m and 30 cm) was compared. Results: One month after ICL implantation, UDVA and CDVA were increased (P<0.05). The average spherical equivalent, entire eye Total-RMS and internal optics Total-RMS were decreased (P<0.05). Furthermore, Total-RMS of entire eye and internal optics were lower with fixating on 5m distance target than with 30cm distance target at three postoperative time points. 6-month after ICL operation, total LOA-RMS and total HOA-RMS fixating on targets at 2 distances were different (P<0.001 and P=0.026, respectively). Moreover, compensation effect of internal optics aberrations on corneal aberrations was better with fixating on 5 m distance target than with 30 cm distance target (P=0.002). Conclusions: After ICL implantation, high myopia patients have significant improvement of visual acuity. Furthermore, wavefront aberrations of distant vision are obviously lower than that of near vision after ICL implantation in high myopia patients.