Comparison of higher-order aberrations between implantable collamer lens V4c implantation and simulated spectacle correction in patients with high myopia

Purpose. - To investigate the differences in higher-order aberrations between non-toric or toric implantable collamer lens (ICL or TICL) V4c implantation and simulated spectacle correction. Methods. - Patients with high myopia who underwent ICL/TICL V4c implantation were enrolled. The "total no defocus" pattern of iTrace aberrometry to simulate the condition of spectacle correction was measured before ICL/TICL implantation, and higher-order aberrations in this condition were compared to those 3 months after surgery. Related factors with changes in coma were comprehensively analyzed.Results. - A total of 89 right eyes of 89 patients were included. Compared to simulated spec-tacle correction, total-eye coma (P < 0.0001 ICL, P < 0.0001 TICL) and internal coma (P < 0.0001 ICL, P < 0.001 TICL) decreased in the ICL-and TICL-treated groups after surgery. Total-eye secondary astigmatism (P < 0.0001 ICL, P = 0.007 TICL) and internal secondary astigmatism (P < 0.0001 ICL, P = 0.009 TICL) were also decreased in both groups postoperatively. Spheri-cal error showed positive correlations with variation in total-eye coma (r = 0.37, P = 0.004 ICL; r = 0.56, P = 0.001 TICL) and internal coma (r = 0.30, P = 0.02 ICL and r = 0.45, P = 0.01 TICL). Axial length revealed negative correlations with changes in total-eye coma (r = -0.45, P < 0.001 ICL; r = -0.39, P = 0.03 TICL) and internal coma (r = -0.28, P = 0.03 ICL and r = -0.42, P = 0.02 TICL).Conclusions. - Both ICL-and TICL-treated groups demonstrated a decrease in coma and sec-ondary astigmatism after 3 months, postoperatively. ICL/TICL may confer a compensatory effect on coma aberration and secondary astigmatism. Patients with a higher myopia achieved a greater improvement in coma and may benefit more from ICL/TICL implantation than from spectacle correction implantation than from spectacle correction.& COPY; 2023 Elsevier Masson SAS. All rights reserved.