Using a slit lamp-mounted digital high-speed camera for dynamic observation of phakic lenses during eye movements: a pilot study

Purpose: To evaluate a digital high-speed camera combined with digital morphometry software for dynamic measurements of phakic intraocular lens movements to observe kinetic influences, particularly in fast direction changes and at lateral end points. Materials and methods: A high-speed camera taking 300 frames per second observed movements of eight iris-claw intraocular lenses and two angle-supported intraocular lenses. Standardized saccades were performed by the patients to trigger mass inertia with lens position changes. Freeze images with maximum deviation were used for digital software-based morphometry analysis with ImageJ. Results: Two eyes from each of five patients (median age 32 years, range 28-45 years) without findings other than refractive errors were included. The high-speed images showed sufficient usability for further morphometric processing. In the primary eye position, the median decentrations downward and in a lateral direction were -0.32 mm (range -0.69 to 0.024) and 0.175 mm (range -0.37 to 0.45), respectively. Despite the small sample size of asymptomatic patients, we found a considerable amount of lens dislocation. The median distance amplitude during eye movements was 0.158 mm (range 0.02-0.84). There was a slight positive correlation (r=0.39, P<0.001) between the grade of deviation in the primary position and the distance increase triggered by movements. Conclusion: With the use of a slit lamp-mounted high-speed camera system and morphometry software, observation and objective measurements of iris-claw intraocular lenses and angle-supported intraocular lenses movements seem to be possible. Slight decentration in the primary position might be an indicator of increased lens mobility during kinetic stress during eye movements. Long-term assessment by high-speed analysis with higher case numbers has to clarify the relationship between progressing motility and endothelial cell damage.