Analysis Of Early Objective Visual Quality And Vision Related Quality Of Life After Central Hole ICL Implantation For High Myopia

Objective: To evaluate the early objective visual quality and vision related quality of life after posterior chamber phakic implantable collamer lens(ICL)with a central hole implantation for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and the vision quality of life questionnaire.Methods: Totally 26 patients(44 eyes)with high myopia in our hospital were enrolled in this prospective study,including 9 male and 17 female,with an average age of 28.89±9.26 years,the preoperative diopter of-11.44±2.83 D,cylindrical degree of-1.33±1.19 D.Preoperative examinations have exclude surgical contraindications.The patients were all received the central hole ICL implantation by the same experienced surgeon in our hospital,including 15 eyes of ICL and 29 eyes of TICL.All the operations were successful and no postoperative complications occurred.The evaluation items included uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE),diopter of cylindrical power(DC),the location of the ICL,intraocular pressure,corneal endothelial cell density(ECD),vault,and OQASⅡ values,including object scatter index(OSI),modulation transfer function cut off frequency(MTF cut off),Strehl ratio(SR),OQAS values(OV100%,OV20%,OV9%)at contrasts of 100%,20%and 9%.All measurements were performed preoperative and 1wk,1mo,3mo postoperatively.At the same time,observed the occurrence of related surgical complications.Vision related quality of life questionnaire was performed at postoperative 3mo.SPSS20.0 statistical software was used for statistical analysis,and the follow-up data at different time points are compared with analysis of variance for repeated measurement data or generalized estimation equations.Results: 1.Postoperative UCVA and BCVA,at all follow-up time,were better than that in preoperative(P<0.001).Compared with preoperative SE and DC,the situation improved at postoperative 1wk,1mo and 3mo.At the postoperative 1wk,1mo,and 3mo,the safety indices were: 1.46±0.55,1.47±0.49,1.49±0.53,and the effectiveness indices were 1.29±0.53,1.44±0.50,1.46±0.53.Postoperative 1wk intraocular pressure was higher than that in preoperative and postoperative 1mo and 3mo(P<0.05),and there was no significant difference between the preoperative and postoperative 1mo and 3mo(P>0.05).Postoperative corneal endothelial cell counts at all time points have different degree reduced which compared with the preoperative(P<0.05),and there are statistically significant in pairwise comparison at any time of postoperative,but all within the normal range.No significant difference was found in vault at follow-up point(P=0.790),among which 1 case had a monocular vault than 1000μm.But the long-term follow-up showed good visual acuity and no complications occurred.2.Compared with preoperative OSI value,the OSI values at postoperative 1wk,1mo,and 3mo were lower(P<0.001).There was significant difference compared with 1wk,1mo and 3mo after operation(P<0.05).Compared with preoperative MTF cut off,SR,OV100%,OV20% and OV9%,the situation improved at postoperative 1wk,1mo and 3mo,with statistical significance(P<0.001).At the same time,the postoperative 1wk was larger than the preoperative and smaller than the postoperative 1mo and 3mo(P<0.05).There was no statistical difference between the postoperative 1mo and 3mo(P> 0.05).3.The vision related quality of life questionnaire at postoperative 3mo showed that all patients had high satisfaction in the good subjective visual acuity after operation,which generally improved the postoperative vision related quality of life and the patients were willing to recommend the operation to their family members and friends.Conclusion: 1.ICL with the central hole implantation is safe and effective in correcting high myopia,and it can significantly improve the objective visual quality and vision related quality of life of patients with high myopia in the early stage.And all patients had high satisfaction after operation.2.The double-pass optical quality analysis system Ⅱ and life quality questionnaire laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.