Comparison of Accommodation and Accommodative Micro-Fluctuation After Implantable Collamer Lens and LASIK Surgery for Myopia

Abstract Background: To longitudinally analyze and compare the accommodative micro-fluctuation (MFs) and accommodative function between myopic patients after implantable collamer lens (ICL) implantation and laser in situ keratomileusis (LASIK).Methods: Patients with good corrected visual acuity (20/20 or better) that underwent ICL (V4c) and LASIK for myopic-correction (ranging from -3.50 to -8.50 D) were recruited. Refraction, amplitude of accommodation (AMP), accommodative lags, high-order aberrations (HOAs), and MFs were recorded before surgery and 1 and 3 months after surgery. The ACOMEREF automatic refractor was used to measure the high-frequency component (HFC) of the MFs, which suggested tension of the ciliary muscle.Results: The study comprised 120 eyes. At 3 months after surgery, the manifest refractive spherical equivalent of the ICL and LASIK groups were -0.11 and -0.09 D, respectively (p = 0.46). HFC values were significantly higher at 1 month (p = 0.03) and 3 months postoperatively (p = 0.03) in the ICL group compared to that in the LASIK group. The ocular HOAs of the ICL group was 1.08 ± 0.43 μm, which was lower than the LASIK group 1.45 ± 0.54 μm (p = 0.01). No significant differences in AMP and accommodative lags between groups were noted at 3 months postoperatively. There was a positive correlation between HFC and vault of the ICL lens (r2 = 0.14, p = 0.005). There were no correlations between HFC and HOAs and postoperative MRSE in the two groups (all p﹥0.05).Conclusions: The HFC increased significantly after ICL implantation compared to laser in situ keratomileusis for myopic correction, which indicated increased tension of the ciliary muscle, and had a positive correlation on the vault of the ICL lens; However, studies with longer follow-up time and more structural evaluation are needed.