Comparative analysis of the biomechanical properties of adult patients with high myopia after implantable collamer lens (ICL, V4) implantation

Comparative analysis of the biomechanical properties of adult patients with high myopia after implantable collamer lens (ICL, V4) implantation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparative analysis of the biomechanical properties of adult patients with high myopia after implantable collamer lens (ICL, V4) implantation Ye Lin, Shuke Luo, Qiang Lu, Xueke Pang, Zhihui Liu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6567891/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background To evaluate the effects of ICL implantation on the corneal biomechanical parameters of patients with high myopia Methods Corneal biomechanical parameters were measured preoperatively and postoperatively in 110 eyes of 55 high myopia patients who underwent ICL implantation by the same surgeon between January 2021 and December 2022. Measurements were obtained using Pentacam, and Corvis ST. Results Comparative analysis of Pentacam parameters before and after ICL surgery revealed significant differences in Astig F and ISV at one week, one month, and three months postoperatively (P < 0.05). IVA showed significant differences only at the three-month mark compare to preoperative measure (P 0.05). In Corvis ST parameters, A1T, A1V, A2T, PD, HCDfmA, HCDflA, and DA Ratio showed significant changes at one week, one month, and three months postoperatively compare to preoperative measures (P < 0.05). Additionally, there were significant differences observed between one month and three months postoperative for A1T, A1V, A2T, A2V, PD, HCR, HCDfmA, HCDflA, SP-A1, IR, and DA Ratio (P 0.05). Conclusions ICL implantation significantly affects certain corneal biomechanical parameters, with both immediate and persistent changes observed following surgery Implantable Collamer Lens Myopia Corneal Biomechanics Corvis ST Pentacam Background The implantable collamer lenses (ICL), a type of intraocular lens (IOL) implanted in the posterior chamber and fixed in the ciliary, offer a minimally invasive solution to correct refractive errors such as myopia, hyperopia, and astigmatism [ 1 – 2 ]. Compared to LASIK, ICL (EVO Visian V4c) provides better visual acuity and contrast sensitivity at night [ 3 ]. This approach involves inserting a biocompatible lens into the eye's posterior chamber, markedly improving visual acuity. With its advantages of small incisions, a broad correction range, high predictability, stability, and reversibility, ICL implantation effectively prevents the rebound of refractive errors associated with corneal cell proliferation, thereby significantly enhancing patients' quality of life [ 4 – 6 ]. The study of corneal biomechanics plays an important role in the field of refractive surgery, as these parameters are critical to understand corneal response and stability [ 7 ]. The Corvis ST, known for its corneal visualization Scheimpflug technology, excels in providing precise measurements of corneal pressure profiles and quantifying mechanical deformation of the cornea [ 8 ]. Concurrently, the Pentacam complements these measurements with its detailed corneal mapping capabilities, offering a comprehensive three-dimensional analysis of the anterior segment for characterizing corneal structure and morphology [ 9 ]. While there is extensive literature on the biomechanical impacts of various refractive surgeries, studies focusing specifically on the biomechanical effects of ICL surgery are less prevalent. However, comprehending these biomechanical alterations is crucial for the sustained success and stability of ICL procedures. The use of Pentacam and Corvis ST for pre- and post-surgery assessments is integral, as these tools provide in-depth insights into the anterior segment of the eye and document the biomechanical changes following ICL implantation. The purpose of this study is to compare and evaluate the tomographic and biomechanical indexes of ICL surgery provided by the Pentacam and Corvis ST system preoperatively and postoperatively. Methods Subjects A total of 110 eyes of 55 patients (n = 55) underwent ICL implantation surgery performed by the same experienced surgeon at the Second People's Hospital of Foshan between year 2021 and 2022. 16 were males (29.1%) and 39 were females (70.9%). The mean age of the patients was 25.36 ± 4.81 years old, with a range of 18 to 39 years old. The inclusion criteria for this study were as follows: (1) Patients who provided informed consent; (2) Patients with an anterior chamber depth of at least 2.8mm, normal intraocular pressure (10–21 mmHg), an open anterior chamber angle, and a corneal endothelial cell count exceeding 2000 cells/mm²; (3) Patients with clear lenses, no active ocular inflammation, and no other eye disorders; (4) Patients with no prior history of eye surgery; (5) Patients without progressive keratoconus; (6) Patients with no history of retinal tears, uveitis, glaucoma, or retinal detachment, no family history of these conditions, and stable refractive status for at least one year; (7) Patients without severe systemic diseases such as malignant tumors, mental health disorders, immune system diseases, blood disorders, heart disease, or liver and kidney dysfunction; (8) Patients in special conditions such as pregnancy, lactation, or the postpartum period were excluded. The study was conducted in accordance with the principles of the Helsinki Declaration. Surgical procedure The pupil was dilated to at least 8mm before the procedure. Subsequently, the horizontal white-to-white (WTW) measurement was rechecked under a microscope using a caliper. Next, a clear corneal incision was made at the twelve o'clock position, followed by the injection of a viscoelastic substance into the anterior chamber. The ICL (ICL Model EVO; STAAR Surgical, Monrovia, CA, USA) was then implanted, with its four haptics positioned behind the iris. Thereafter, after pupil dilation with a mydriatic agent, a 3mm temporal incision was created at the peripheral cornea. Finally, the viscoelastic substance was flushed out from the anterior chamber using a single cannula, and the incision was sealed. Observations The Pentacam (Pentacam HR, Oculus, Wetzlar, Germany) is widely used for corneal tomography image analysis. It utilized a Scheimpflug camera to capture detailed scans from the anterior surface of the cornea to the posterior surface of the lens, allowing for the calculation and analysis of various morphological parameters of the anterior segment. The Corvis ST (Corvis ST, Oculus, Wetzlar, Germany) measures corneal deformation in response to an air pulse using a high-speed Scheimpflug camera. It monitors and analyzes the bidirectional applanation and maximum compression during deformation, thereby providing valuable parameters that reflect the corneal biomechanical properties. The same experienced clinician operated both the Pentacam and Corvis ST. Each measurement was verified with an "OK" display to confirm quality before being recorded and saved. The parameters of Pentacam and Corvis ST that were included in this study shown in Table 1 . Table 1 Corneal morphological and biomechanical parameters obtained with Pentacam and Corvis ST Parameters PENTACAM K1 F (D) Steepest keratometry reading from the anterior corneal surface K2 F (D) Flattest keratometry reading from the anterior corneal surface Astig F (D) Central astigmatism from the anterior corneal surface CCT Central corneal thickness TP Pachymetry at the thinnest point ISV Index of surface variance IVA Index of vertical asymmetry KI Keratoconus index CKI Central keratoconus index IHA Index of height asymmetry IHD Index of height decentration Corvis ST A1T (ms) First applanation time A1V (m/s) First velocity of applanation A2T (ms) Second applanation time A2V (m/s) The second velocity of applanation PD (mm) Peak distance HCR (mm) Highest concavity Radius HCDfmA (mm) Deformation amplitude of the highest concavity HCDflA (mm) Deflection amplitude of the highest concavity SP-A1 Stiffness parameter at the first applanation IR (mm^-1) Integrated Radius ARTh Ambro´sio relational thickness to the horizontal profile DA ratio (2mm) Deformation amplitude ratio Results Diagnostic Tests The results of the eye diagnostic tests indicated a significant improvement in visual acuity following ICL implantation. Objective measurements including subjective refraction, axial length, corneal thickness, corneal endothelium, intraocular pressure, and anterior chamber depth were collected and analyzed. Postoperative indicators for all patients were within normal range, as presented in Table 2 . Table 2 Clinical Characteristics and Refractive Parameters of Patients Undergoing ICL Implantation Mean ± SD Range [min, max] Age (years) 25.36 ± 4.81 [18, 39] Sphere (D) -9.38 ± 3.36 [-20, 9.25] Cylinder (D) -1.44 ± 0.92 [-3.75, 1] Axis (degrees) 122.91 ± 71.25 [2, 180] BCVA 1 ± 0.11 [0.6, 1.2] Axial Length 27.49 ± 1.42 [24.92, 32.68] Corneal Thickness (um) 539.88 ± 33.52 [472, 626] Corneal Endothelium 2852.2 ± 216.37 [2085.1, 3286.5] Intraocular Pressure (mmHg) 15.39 ± 2.82 [10.3, 22] PENTACAM Anterior Chamber Depth (mm) 3.21 ± 0.26 [2.66, 3.98] Length of wearing spectacle (year) 13.21 ± 5.13 [5, 29] Length of wearing contact lens (year) 3.06 ± 4.46 [0, 20] Notes : Visual acuity of 1.0 is equivalent to 20/20 on Snellen chart Overall Results Comparing the PENTACAM parameters before and one week after the operation, there were statistically significant in Astig F and ISV (t=-3.25, -3.05; P 0.05). Comparing the Pentacam parameters before and one month after the operation, there were statistically significant in Astig F and ISV (t=-3.53, -3.24; P 0.05). Comparing the Pentacam parameters before and three months after the operation, there were statistically significant in Astig F, ISV and IVA (t=-2.91, -2.97, 2.02; P 0.05). Comparing the Pentacam parameters one week and one month after the operation, there were no statistically significant in any parameters (P > 0.05). Comparing the Pentacam parameters one month and three months after the operation, there were no statistically significant in any parameters (P > 0.05). (Table 3 – 4 ) Comparing the Corvis ST parameters before and one week after the operation, there were statistically significant in A1T, A1V, A2T, PD, HCDfmA, HCDflA, and DA Ratio (t=-3.54, 2.00, 2.25, 2.63, 2.09, 2.65, 3.02; P 0.05). Comparing the Corvis ST parameters before and one month after the operation, there were statistically significant in A1T, A1V, A2T, PD, HCDfmA, HCDflA, IR, and DA Ratio (t=-4.14, 2.58, 3.27, 2.64, 2.01, 2.94, 2.86, 3.69; P 0.05). Comparing the Corvis ST parameters before and three months after the operation, there were statistically significant in A1V, A2T, A2V, PD, HCDfmA, and HCDflA (t=-2.21, -2.21, 3.97, -4.37, -4.42, -3.50; P 0.05). Comparing the Corvis ST parameters one week and one month after the operation, there were no statistically significant in any parameters (P > 0.05) Comparing the Corvis ST parameters one month and three months after the operation, there were statistically significant in A1T, A1V, A2T, A2V, PD, HCR, HCDfmA, HCDflA, SP-A1, IR, and DA Ratio (t = 4.57, -4.68, -6.26, 4.20, -5.60, -2.14, -5.30, -5.55, 2.53, -3.13, -3.59; P 0.05) [ 10 ]. (Table 3 – 4 ) Table 3 Pentacam and Corvis ST Parameters of Patients Undergoing ICL Implantation Pre 1 Week Post 1 Month Post 3 Months Post Pentacam K1 F 42.98 ± 1.22 42.73 ± 1.14 42.86 ± 1.42 42.88 ± 1.26 K2 F 44.44 ± 1.35 44.58 ± 1.32 44.76 ± 1.52 44.74 ± 1.48 Astig F 1.46 ± 0.91 1.85 ± 0.73 1.91 ± 0.81 1.87 ± 0.87 CCT 541.72 ± 33.29 539.81 ± 32.47 535.61 ± 34.2 538.67 ± 38.18 PD 539.69 ± 33.3 537.95 ± 32.5 533.57 ± 33.97 536.67 ± 38.16 ISV 20.18 ± 6.04 22.53 ± 4.54 22.93 ± 5.45 22.83 ± 5.35 IVA 0.12 ± 0.05 0.13 ± 0.04 0.13 ± 0.05 0.14 ± 0.05 KI 1.03 ± 0.02 1.03 ± 0.02 1.04 ± 0.02 1.04 ± 0.02 CKI 1.01 ± 0.01 1.01 ± 0.01 1.01 ± 0.01 1.01 ± 0.01 IHA 7.44 ± 5.66 8.05 ± 5.48 7.85 ± 6.24 8.23 ± 6.23 IHD 0.014 ± 0.006 0.014 ± 0.006 0.014 ± 0.007 0.015 ± 0.006 Corvis ST A1T 7.85 ± 0.42 8.15 ± 0.69 8.25 ± 0.79 7.79 ± 0.28 A1V 0.14 ± 0.02 0.14 ± 0.02 0.13 ± 0.03 0.15 ± 0.02 A2T 22.22 ± 0.71 22 ± 0.58 21.87 ± 0.64 22.43 ± 0.37 A2V -0.27 ± 0.05 -0.26 ± 0.06 -0.27 ± 0.05 -0.3 ± 0.04 PD 5.01 ± 0.33 4.84 ± 0.51 4.83 ± 0.52 5.22 ± 0.24 HCR 6.79 ± 0.77 6.68 ± 0.78 6.77 ± 0.74 7.03 ± 0.72 HCDfmA 1.04 ± 0.11 1 ± 0.16 1 ± 0.16 1.12 ± 0.11 HCDflA 0.91 ± 0.12 0.85 ± 0.16 0.84 ± 0.17 0.98 ± 0.11 SP-A1 114.62 ± 21.77 118.68 ± 17.33 120.68 ± 19.74 112.02 ± 21.30 IR 8.81 ± 1.06 8.55 ± 1.18 8.3 ± 1.23 8.9 ± 1.04 ARTh 495.54 ± 102.38 493.65 ± 119.8 522.89 ± 125.03 522.21 ± 158.01 DA Ratio 4.25 ± 0.43 4.06 ± 0.4 3.98 ± 0.5 4.27 ± 0.46 Table 4 Changes of Pentacam and Corvis ST Parameters Pre and Post ICL Implantation Pre 1 week Post Pre 1 month Post Pre 3 months Post 1 week Post 1 month Post 1 month Post 3 months Post t/Z p value* t/Z p value* t/Z p value* t/Z p value* t/Z p value* Pentacam K1 F 1.49 0.14 0.64 0.52 0.50 0.62 -0.66 0.51 -0.13 0.90 K2 F -0.71 0.48 -1.53 0.13 -1.36 0.17 -0.85 0.39 0.11 0.92 Astig F -3.25 < 0.05 -3.53 < 0.05 -2.91 < 0.05 -0.56 0.58 0.35 0.73 CCT 0.41 0.68 1.24 0.22 0.56 0.58 0.83 0.41 -0.52 0.60 PD 0.37 0.71 1.24 0.21 0.56 0.58 0.86 0.39 -0.53 0.60 ISV -3.05 < 0.05 -3.23 < 0.05 -2.97 < 0.05 -0.53 0.60 0.11 0.91 IVA -1.89 0.06 -1.59 0.11 -2.02 < 0.05 0.07 0.94 -0.45 0.65 KI -0.60 0.55 -0.79 0.43 -0.77 0.44 -0.23 0.82 0.01 0.99 CKI -0.61 0.54 -0.01 0.99 -1.90 0.06 0.51 0.61 -1.62 0.11 IHA -0.77 0.44 -0.47 0.64 -0.87 0.38 0.23 0.82 -0.38 0.70 IHD -0.03 0.98 -0.12 0.90 -1.43 0.15 -0.09 0.92 -1.18 0.24 Corvis ST A1T -3.54 < 0.05 -4.14 < 0.05 1.09 0.28 -0.88 0.38 4.57 < 0.05 A1V 2.00 < 0.05 2.58 < 0.05 -2.21 < 0.05 0.81 0.42 -4.68 < 0.05 A2T 2.25 < 0.05 3.27 < 0.05 -2.21 < 0.05 1.39 0.16 -6.26 < 0.05 A2V -1.27 0.2 -0.27 0.79 3.97 < 0.05 0.99 0.32 4.20 < 0.05 PD 2.63 < 0.05 2.64 < 0.05 -4.37 < 0.05 0.09 0.93 -5.60 < 0.05 HCR 0.96 0.34 0.24 0.81 -1.92 0.05 -0.70 0.48 -2.14 < 0.05 HCDfmA 2.09 < 0.05 2.01 < 0.05 -4.42 < 0.05 0.02 0.98 -5.30 < 0.05 HCDflA 2.65 < 0.05 2.94 < 0.05 -3.50 < 0.05 0.37 0.71 -5.55 < 0.05 SP-A1 -1.39 0.17 -1.86 0.06 0.74 0.46 -0.70 0.48 2.53 < 0.05 IR 1.56 0.12 2.86 < 0.05 -0.52 0.60 1.34 0.18 -3.13 < 0.05 ARTh 0.11 0.91 -1.54 0.12 -1.27 0.20 -1.55 0.12 0.03 0.98 DA Ratio 3.02 < 0.05 3.69 < 0.05 -0.28 0.78 1.15 0.25 -3.59 < 0.05 Discussion Implantable Collamer Lens (ICL) surgery, a popular refractive procedure for correcting high myopia, has significant implications for corneal biomechanics which shown by this study. We also aim to analyze these biomechanical changes using Pentacam and Corvis ST measurements. Understanding these changes is essential for predicting surgical outcomes and ensuring long-term stability of visual acuity [ 11 , 12 ]. Our results indicate significant changes in several corneal parameters post-ICL surgery. Specifically, the Pentacam parameters such as Astig F, which measures the degree of astigmatism in the cornea, and ISV (Index of Surface Variance), an indicator of the corneal surface's overall irregularity, showed significant differences pre- and postoperatively. The changes in these parameters persisted across all postoperative time points, indicating a stable alteration in the corneal structure following ICL implantation. These findings align with previous studies highlighting the impact of ICL implantation on corneal, while certain corneal alterations post-ICL implantation stabilize, some may persist [ 13 ]​. Notably, IVA (Index of Vertical Asymmetry), which assesses the asymmetry between the superior and inferior corneal halves, did not show significant differences until three months after surgery. This delayed response suggests that IVA may be indicative of longer-term biomechanical changes in the cornea post-ICL surgery, reflecting ongoing adaptation and remodeling processes. The lack of immediate changes in IVA aligns with the understanding that some biomechanical parameters may take longer to manifest significant alterations [ 14 ]. In terms of Corvis ST measurements, Parameters such as A1V (first applanation velocity), A2T (second applanation time), PD (peak distance), HCDfmA (highest concavity deformation amplitude), and HCDflA (highest concavity deflection amplitude) exhibited significant and persistent changes post-surgery similar to Astig F. These differences were still evident at the 3-month follow-up, and there were significant differences even between the 1-month and 3-month postoperative measurements. This suggests that these biomechanical properties of the cornea continue to evolve and adapt over an extended period following ICL implantation, underscoring the need for long-term monitoring, which align with many previous studies [ 13 – 17 ]. A1T (first applanation time) and DA Ratio (deformation amplitude ratio) showed significant changes immediately after surgery but normalized by the 3-month mark. The normalization of these parameters by the 3-month mark can be attributed to the cornea's natural healing process, where initial inflammation is temporary and mechanical stress is reducing, and the tissue gradually stabilizes. This process reflects the cornea's ability to adapt, to stabilize and to reduce back to pre-surgery stage following the ICL surgical intervention [ 15 – 17 ]. Lastly, A2V (second applanation velocity) demonstrated a delayed response similar to IVA, with significant differences becoming apparent only at later postoperative stages. This delayed response indicates that this parameter is more sensitive to long-term biomechanical remodeling of the cornea, potentially reflecting deeper structural changes that occur as the eye adapts to the implanted lens [ 13 , 14 , 18 ]. These biomechanical changes have several clinical implications. The persistent changes in parameters such as Astig F, ISV, A1V, A2T, PD, HCDfmA, and HCDflA suggest a need for careful and prolonged monitoring post-ICL surgery to ensure the long-term stability of the corneal structure. Furthermore, the significant differences observed between 1 month and 3 months postoperatively highlight the importance of extended follow-up beyond the 3 month mark to capture the full extent of biomechanical adaptation after ICL implanation [ 19 , 20 ]. Additionally, the delayed response in parameters such as A2V, and IVA suggest ongoing biomechanical changes that take longer to manifest and become significant at a later stage potentially affecting the overall stability post-surgery [ 13 , 14 ]. Understanding these responses is crucial for optimizing surgical techniques and ensuring a sustained visual acuity. In light of this, further research is needed to explore the long-term stability of these biomechanical changes and their correlation with visual outcomes. Longitudinal studies with larger sample sizes could provide more comprehensive insights into the biomechanical effects of ICL surgery. Additionally, advancements in imaging and measurement technologies could offer more precise assessments of corneal biomechanics, enhancing our understanding of the impacts of ICL implantation. Conclusions In conclusion, ICL implantation significantly affects corneal biomechanical parameters, with both immediate and persistent changes observed post-surgery. These findings highlight the importance of continuous monitoring and a thorough understanding of corneal biomechanics to ensure not only successful surgical outcomes but also sustainable visual acuity over the long term. Abbreviations ICL, implantable collamer lens; IOL, intraocular lens; Covis ST, Corneal Visualization Scheimpflug Technology ; LASIK, Laser-Assisted in Situ Keratomileusis; WTW, white-to-white; K1 F, Steepest Keratometry Reading from the Anterior Corneal Surface; K2 F, Flattest Keratometry Reading from the Anterior Corneal Surface; Astig F, Central Astigmatism from the Anterior Corneal Surface; CCT, Central Corneal Thickness; TP, Pachymetry at the Thinnest Point; ISV, Index of Surface Variance; IVA, Index of Vertical Asymmetry; KI, Keratoconus Index; CKI, Central Keratoconus Index; IHA, Index of Height Asymmetry; IHD, Index of Height Decentration; A1T, First Applanation Time; A1V, First Velocity of Applanation; A2T, Second Applanation Time; A2V, Second Velocity of Applanation; PD, Peak Distance; HCR, Highest Concavity Radius; HCDfmA, Deformation Amplitude of the Highest Concavity; HCDflA, Deflection Amplitude of the Highest Concavity; SP-A1, Stiffness Parameter at the First Applanation; IR, Integrated Radius; ARTh, Ambrosio Relational Thickness to the Horizontal Profile; DA Ratio, Deformation Amplitude Ratio; D, Diopters; um, Micrometer; mmHg, Millimeters of mercury; mm, Millimeter; SD, standard deviation; BCVA, best corrective visual acuity; Declarations Funding Research and analysis of corneal biomechanical characteristics before and after phakic posterior chamber intraocular lens (ICL) implantation (20230333); Foshan City '14th Five-Year Plan' Medical Key Specialty Construction Project (FSGSP145064) Competing interests The authors have no conflict of interest to declare Authors' contributions X. P. and Q. L. collected preoperative eye diagnostic tests data. S. L. is the surgeon of all patients, Y. L. coordinated all other data collections, analyzed the data and drafted the paper with comments from all other authors. All authors have read and approved the final manuscript. Ye Lin is the guarantor for the study. Ethics approval and consent to participate The research has received approval from the Second People's Hospital of Foshan ethics committee (2022)-0091 and has been conducted in compliance with ethical guidelines established in the 1964 Declaration of Helsinki, as well as subsequent amendments, or equivalent ethical standards. Informed consent to participate was obtained from all participants prior to their inclusion in the study. Consent for publication This article is distributed under the terms of the Creative Commons Attribution License allows for unrestricted utilization, distribution, and reproduction in any medium, as long as proper attribution to the original author(s) and the source is given. Availability of data and materials Data supporting the results reported in the manuscript can be found: https://data.mendeley.com/drafts/yry4r9y9v5 References Sanders DR. Anterior subcapsular opacities and cataracts 5 years after surgery in the visian implantable collamer lens FDA trial. J Refract Surg. 2008;24:566-70. Sanders DR, Doney K, Poco M. ICL in Treatment of Myopia Study Group. United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up. Ophthalmology. 2004;111:1683-92. Parkhurst G. A prospective comparison of phakic Collamer lenses and wavefront-optimized laser-assisted in situ keratomileusis for correction of myopia. 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Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 22 Nov, 2025 Reviewers agreed at journal 10 Nov, 2025 Reviewers agreed at journal 04 Nov, 2025 Reviewers invited by journal 13 Oct, 2025 Editor assigned by journal 02 May, 2025 Submission checks completed at journal 02 May, 2025 First submitted to journal 30 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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Luo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYBAC+4bDhx///WcjJ8/eQKQWA8ZjaQY8bGnGhj0HiNXCfMZAgoftcGLDjQQitZizHTAA6jmc2Djz8cYbDDU20QS1WPYcSHhgIJFu3C6dVmzBcCwtt4GgnhsHDhgkGFjLNs7OMZNgbDhMhJb7DxskDiQwMzbcPEOkFoMDhxkkGw44Kzbc4CFSi2TDMTZjxgZQIAP9kkCMX/gZzn9+zNgAisrDG298qLEhwi/IjpRIIEU5RAupOkbBKBgFo2BkAAA3V0QoskjAeAAAAABJRU5ErkJggg==","orcid":"","institution":"The Second People's Hospital of Foshan","correspondingAuthor":true,"prefix":"","firstName":"Shuke","middleName":"","lastName":"Luo","suffix":""},{"id":534049338,"identity":"629d2c9f-ec0c-40a6-a787-05ccff05ba7f","order_by":2,"name":"Qiang Lu","email":"","orcid":"","institution":"The Second People's Hospital of Foshan","correspondingAuthor":false,"prefix":"","firstName":"Qiang","middleName":"","lastName":"Lu","suffix":""},{"id":534049339,"identity":"f58848f7-4f95-4a78-8df3-21da645503e2","order_by":3,"name":"Xueke Pang","email":"","orcid":"","institution":"The Second People's Hospital of Foshan","correspondingAuthor":false,"prefix":"","firstName":"Xueke","middleName":"","lastName":"Pang","suffix":""},{"id":534049340,"identity":"6f37fdae-fc2d-4c64-80e1-9861bea8e411","order_by":4,"name":"Zhihui Liu","email":"","orcid":"","institution":"The Second People's Hospital of Foshan","correspondingAuthor":false,"prefix":"","firstName":"Zhihui","middleName":"","lastName":"Liu","suffix":""}],"badges":[],"createdAt":"2025-04-30 21:23:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6567891/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6567891/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":94456152,"identity":"030badb2-feda-4092-88ae-dc27c04b8ef2","added_by":"auto","created_at":"2025-10-27 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14:43:35","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":102068,"visible":true,"origin":"","legend":"","description":"","filename":"2e12eceea0c74e06a84cb1cad6a579be1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-6567891/v1/759f5cdd7d680417d201ce4a.xml"},{"id":94455366,"identity":"d3685c61-d4cf-450f-a15a-a6cb4d073a98","added_by":"auto","created_at":"2025-10-27 14:43:37","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":100463,"visible":true,"origin":"","legend":"","description":"","filename":"2e12eceea0c74e06a84cb1cad6a579be1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-6567891/v1/734f1575cb6f4a3ce87cdbb5.xml"},{"id":94456129,"identity":"0d7c6883-2274-4c2f-adc0-b6882707b89c","added_by":"auto","created_at":"2025-10-27 14:44:12","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":105311,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-6567891/v1/dd87301b35a9ca95c744f3ad.html"},{"id":94468634,"identity":"37a77523-a9ec-4ee7-b40a-df5efc577bba","added_by":"auto","created_at":"2025-10-27 15:25:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":878579,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6567891/v1/16712b71-0cf9-4d2e-adbf-fa88982a36b9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparative analysis of the biomechanical properties of adult patients with high myopia after implantable collamer lens (ICL, V4) implantation","fulltext":[{"header":"Background","content":"\u003cp\u003eThe implantable collamer lenses (ICL), a type of intraocular lens (IOL) implanted in the posterior chamber and fixed in the ciliary, offer a minimally invasive solution to correct refractive errors such as myopia, hyperopia, and astigmatism [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Compared to LASIK, ICL (EVO Visian V4c) provides better visual acuity and contrast sensitivity at night [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This approach involves inserting a biocompatible lens into the eye's posterior chamber, markedly improving visual acuity. With its advantages of small incisions, a broad correction range, high predictability, stability, and reversibility, ICL implantation effectively prevents the rebound of refractive errors associated with corneal cell proliferation, thereby significantly enhancing patients' quality of life [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe study of corneal biomechanics plays an important role in the field of refractive surgery, as these parameters are critical to understand corneal response and stability [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The Corvis ST, known for its corneal visualization Scheimpflug technology, excels in providing precise measurements of corneal pressure profiles and quantifying mechanical deformation of the cornea [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Concurrently, the Pentacam complements these measurements with its detailed corneal mapping capabilities, offering a comprehensive three-dimensional analysis of the anterior segment for characterizing corneal structure and morphology [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile there is extensive literature on the biomechanical impacts of various refractive surgeries, studies focusing specifically on the biomechanical effects of ICL surgery are less prevalent. However, comprehending these biomechanical alterations is crucial for the sustained success and stability of ICL procedures. The use of Pentacam and Corvis ST for pre- and post-surgery assessments is integral, as these tools provide in-depth insights into the anterior segment of the eye and document the biomechanical changes following ICL implantation.\u003c/p\u003e\u003cp\u003eThe purpose of this study is to compare and evaluate the tomographic and biomechanical indexes of ICL surgery provided by the Pentacam and Corvis ST system preoperatively and postoperatively.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eSubjects\u003c/h2\u003e\u003cp\u003eA total of 110 eyes of 55 patients (n\u0026thinsp;=\u0026thinsp;55) underwent ICL implantation surgery performed by the same experienced surgeon at the Second People's Hospital of Foshan between year 2021 and 2022. 16 were males (29.1%) and 39 were females (70.9%). The mean age of the patients was 25.36\u0026thinsp;\u0026plusmn;\u0026thinsp;4.81 years old, with a range of 18 to 39 years old.\u003c/p\u003e\u003cp\u003eThe inclusion criteria for this study were as follows: (1) Patients who provided informed consent; (2) Patients with an anterior chamber depth of at least 2.8mm, normal intraocular pressure (10\u0026ndash;21 mmHg), an open anterior chamber angle, and a corneal endothelial cell count exceeding 2000 cells/mm\u0026sup2;; (3) Patients with clear lenses, no active ocular inflammation, and no other eye disorders; (4) Patients with no prior history of eye surgery; (5) Patients without progressive keratoconus; (6) Patients with no history of retinal tears, uveitis, glaucoma, or retinal detachment, no family history of these conditions, and stable refractive status for at least one year; (7) Patients without severe systemic diseases such as malignant tumors, mental health disorders, immune system diseases, blood disorders, heart disease, or liver and kidney dysfunction; (8) Patients in special conditions such as pregnancy, lactation, or the postpartum period were excluded. The study was conducted in accordance with the principles of the Helsinki Declaration.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSurgical procedure\u003c/h3\u003e\n\u003cp\u003eThe pupil was dilated to at least 8mm before the procedure. Subsequently, the horizontal white-to-white (WTW) measurement was rechecked under a microscope using a caliper. Next, a clear corneal incision was made at the twelve o'clock position, followed by the injection of a viscoelastic substance into the anterior chamber. The ICL (ICL Model EVO; STAAR Surgical, Monrovia, CA, USA) was then implanted, with its four haptics positioned behind the iris. Thereafter, after pupil dilation with a mydriatic agent, a 3mm temporal incision was created at the peripheral cornea. Finally, the viscoelastic substance was flushed out from the anterior chamber using a single cannula, and the incision was sealed.\u003c/p\u003e\n\u003ch3\u003eObservations\u003c/h3\u003e\n\u003cp\u003eThe Pentacam (Pentacam HR, Oculus, Wetzlar, Germany) is widely used for corneal tomography image analysis. It utilized a Scheimpflug camera to capture detailed scans from the anterior surface of the cornea to the posterior surface of the lens, allowing for the calculation and analysis of various morphological parameters of the anterior segment.\u003c/p\u003e\u003cp\u003eThe Corvis ST (Corvis ST, Oculus, Wetzlar, Germany) measures corneal deformation in response to an air pulse using a high-speed Scheimpflug camera. It monitors and analyzes the bidirectional applanation and maximum compression during deformation, thereby providing valuable parameters that reflect the corneal biomechanical properties.\u003c/p\u003e\u003cp\u003eThe same experienced clinician operated both the Pentacam and Corvis ST. Each measurement was verified with an \"OK\" display to confirm quality before being recorded and saved. The parameters of Pentacam and Corvis ST that were included in this study shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorneal morphological and biomechanical parameters obtained with Pentacam and Corvis ST\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameters\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003ePENTACAM\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK1 F (D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSteepest keratometry reading from the anterior corneal surface\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK2 F (D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlattest keratometry reading from the anterior corneal surface\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAstig F (D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCentral astigmatism from the anterior corneal surface\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCCT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCentral corneal thickness\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePachymetry at the thinnest point\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eISV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndex of surface variance\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIVA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndex of vertical asymmetry\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKeratoconus index\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCKI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCentral keratoconus index\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIHA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndex of height asymmetry\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIHD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndex of height decentration\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eCorvis ST\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA1T (ms)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFirst applanation time\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA1V (m/s)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFirst velocity of applanation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA2T (ms)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSecond applanation time\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA2V (m/s)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe second velocity of applanation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePD (mm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeak distance\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCR (mm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHighest concavity Radius\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCDfmA (mm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDeformation amplitude of the highest concavity\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCDflA (mm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDeflection amplitude of the highest concavity\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSP-A1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStiffness parameter at the first applanation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIR (mm^-1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntegrated Radius\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eARTh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmbro\u0026acute;sio relational thickness to the horizontal profile\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDA ratio (2mm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDeformation amplitude ratio\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eDiagnostic Tests\u003c/h2\u003e\u003cp\u003eThe results of the eye diagnostic tests indicated a significant improvement in visual acuity following ICL implantation. Objective measurements including subjective refraction, axial length, corneal thickness, corneal endothelium, intraocular pressure, and anterior chamber depth were collected and analyzed. Postoperative indicators for all patients were within normal range, as presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eClinical Characteristics and Refractive Parameters of Patients Undergoing ICL Implantation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRange [min, max]\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e25.36\u0026thinsp;\u0026plusmn;\u0026thinsp;4.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[18, 39]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSphere (D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e-9.38\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[-20, 9.25]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCylinder (D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e-1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[-3.75, 1]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAxis (degrees)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e122.91\u0026thinsp;\u0026plusmn;\u0026thinsp;71.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[2, 180]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBCVA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[0.6, 1.2]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAxial Length\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e27.49\u0026thinsp;\u0026plusmn;\u0026thinsp;1.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[24.92, 32.68]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCorneal Thickness (um)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e539.88\u0026thinsp;\u0026plusmn;\u0026thinsp;33.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[472, 626]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCorneal Endothelium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2852.2\u0026thinsp;\u0026plusmn;\u0026thinsp;216.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[2085.1, 3286.5]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntraocular Pressure (mmHg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e15.39\u0026thinsp;\u0026plusmn;\u0026thinsp;2.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[10.3, 22]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePENTACAM Anterior Chamber Depth (mm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[2.66, 3.98]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLength of wearing spectacle (year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e13.21\u0026thinsp;\u0026plusmn;\u0026thinsp;5.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[5, 29]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLength of wearing contact lens (year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.06\u0026thinsp;\u0026plusmn;\u0026thinsp;4.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[0, 20]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003cb\u003eNotes\u003c/b\u003e: Visual acuity of 1.0 is equivalent to 20/20 on Snellen chart\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eOverall Results\u003c/h2\u003e\u003cp\u003eComparing the PENTACAM parameters before and one week after the operation, there were statistically significant in Astig F and ISV (t=-3.25, -3.05; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, respectively) and no statistically significant in K1 F, K2 F, CCT, TP, KI, CKI, IHA, IHD, and IVA (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Pentacam parameters before and one month after the operation, there were statistically significant in Astig F and ISV (t=-3.53, -3.24; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and no statistically significant in K1 F, K2 F, CCT, TP, KI, CKI, IHA, IHD, and IVA (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Pentacam parameters before and three months after the operation, there were statistically significant in Astig F, ISV and IVA (t=-2.91, -2.97, 2.02; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and no statistically significant in K1 F, K2 F, CCT, TP, KI, CKI, IHA, and IHD (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Pentacam parameters one week and one month after the operation, there were no statistically significant in any parameters (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Pentacam parameters one month and three months after the operation, there were no statistically significant in any parameters (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) Comparing the Corvis ST parameters before and one week after the operation, there were statistically significant in A1T, A1V, A2T, PD, HCDfmA, HCDflA, and DA Ratio (t=-3.54, 2.00, 2.25, 2.63, 2.09, 2.65, 3.02; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, respectively) and no statistically significant in A2V, HCR, SP-A1, IR, and ARTh (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Corvis ST parameters before and one month after the operation, there were statistically significant in A1T, A1V, A2T, PD, HCDfmA, HCDflA, IR, and DA Ratio (t=-4.14, 2.58, 3.27, 2.64, 2.01, 2.94, 2.86, 3.69; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and no statistically significant in A2V, HCR, SP-A1, and ARTh (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Corvis ST parameters before and three months after the operation, there were statistically significant in A1V, A2T, A2V, PD, HCDfmA, and HCDflA (t=-2.21, -2.21, 3.97, -4.37, -4.42, -3.50; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and no statistically significant in A1T, HCR, SP-A1, IR, ARTh, and DA Ratio (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Comparing the Corvis ST parameters one week and one month after the operation, there were no statistically significant in any parameters (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) Comparing the Corvis ST parameters one month and three months after the operation, there were statistically significant in A1T, A1V, A2T, A2V, PD, HCR, HCDfmA, HCDflA, SP-A1, IR, and DA Ratio (t\u0026thinsp;=\u0026thinsp;4.57, -4.68, -6.26, 4.20, -5.60, -2.14, -5.30, -5.55, 2.53, -3.13, -3.59; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and no statistically significant in ARTh (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePentacam and Corvis ST Parameters of Patients Undergoing ICL Implantation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePre\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 Week Post\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 Month Post\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3 Months Post\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePentacam\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK1 F\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e42.98\u0026thinsp;\u0026plusmn;\u0026thinsp;1.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e42.73\u0026thinsp;\u0026plusmn;\u0026thinsp;1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e42.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e42.88\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK2 F\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e44.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e44.58\u0026thinsp;\u0026plusmn;\u0026thinsp;1.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e44.76\u0026thinsp;\u0026plusmn;\u0026thinsp;1.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e44.74\u0026thinsp;\u0026plusmn;\u0026thinsp;1.48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAstig F\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e1.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e1.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCCT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e541.72\u0026thinsp;\u0026plusmn;\u0026thinsp;33.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e539.81\u0026thinsp;\u0026plusmn;\u0026thinsp;32.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e535.61\u0026thinsp;\u0026plusmn;\u0026thinsp;34.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e538.67\u0026thinsp;\u0026plusmn;\u0026thinsp;38.18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e539.69\u0026thinsp;\u0026plusmn;\u0026thinsp;33.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e537.95\u0026thinsp;\u0026plusmn;\u0026thinsp;32.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e533.57\u0026thinsp;\u0026plusmn;\u0026thinsp;33.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e536.67\u0026thinsp;\u0026plusmn;\u0026thinsp;38.16\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eISV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e20.18\u0026thinsp;\u0026plusmn;\u0026thinsp;6.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e22.53\u0026thinsp;\u0026plusmn;\u0026thinsp;4.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.93\u0026thinsp;\u0026plusmn;\u0026thinsp;5.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e22.83\u0026thinsp;\u0026plusmn;\u0026thinsp;5.35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIVA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e0.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e0.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCKI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIHA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7.44\u0026thinsp;\u0026plusmn;\u0026thinsp;5.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e8.05\u0026thinsp;\u0026plusmn;\u0026thinsp;5.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;6.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e8.23\u0026thinsp;\u0026plusmn;\u0026thinsp;6.23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIHD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e0.014\u0026thinsp;\u0026plusmn;\u0026thinsp;0.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e0.014\u0026thinsp;\u0026plusmn;\u0026thinsp;0.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e0.014\u0026thinsp;\u0026plusmn;\u0026thinsp;0.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e0.015\u0026thinsp;\u0026plusmn;\u0026thinsp;0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCorvis ST\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA1T\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e8.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e7.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA1V\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e0.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e0.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e0.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA2T\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e22.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e22.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA2V\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e-0.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e-0.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e-0.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e-0.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e5.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.24\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e6.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e7.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCDfmA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e1.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCDflA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e0.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e0.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSP-A1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e114.62\u0026thinsp;\u0026plusmn;\u0026thinsp;21.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e118.68\u0026thinsp;\u0026plusmn;\u0026thinsp;17.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e120.68\u0026thinsp;\u0026plusmn;\u0026thinsp;19.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e112.02\u0026thinsp;\u0026plusmn;\u0026thinsp;21.30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e8.55\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e8.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.04\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eARTh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e495.54\u0026thinsp;\u0026plusmn;\u0026thinsp;102.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e493.65\u0026thinsp;\u0026plusmn;\u0026thinsp;119.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e522.89\u0026thinsp;\u0026plusmn;\u0026thinsp;125.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e522.21\u0026thinsp;\u0026plusmn;\u0026thinsp;158.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDA Ratio\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4.06\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e3.98\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e4.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eChanges of Pentacam and Corvis ST Parameters Pre and Post ICL Implantation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"11\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePre\u0026thinsp;\u0026lt;\u0026thinsp;\u0026gt;\u0026thinsp;1 week Post\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ePre\u0026thinsp;\u0026lt;\u0026thinsp;\u0026gt;\u0026thinsp;1 month Post\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003ePre\u0026thinsp;\u0026lt;\u0026thinsp;\u0026gt;\u0026thinsp;3 months Post\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003e1 week Post\u0026thinsp;\u0026lt;\u0026thinsp;\u0026gt;\u0026thinsp;1 month Post\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003e1 month Post\u0026thinsp;\u0026lt;\u0026thinsp;\u0026gt;\u0026thinsp;3 months Post\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003et/Z\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et/Z\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et/Z\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et/Z\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003et/Z\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePentacam\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK1 F\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.90\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK2 F\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-1.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.92\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAstig F\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-3.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-3.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-2.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCCT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-0.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eISV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-3.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-3.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-2.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.91\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIVA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-1.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-2.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" 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colname=\"c3\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-3.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eARTh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-1.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-1.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.98\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDA Ratio\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-3.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eImplantable Collamer Lens (ICL) surgery, a popular refractive procedure for correcting high myopia, has significant implications for corneal biomechanics which shown by this study. We also aim to analyze these biomechanical changes using Pentacam and Corvis ST measurements. Understanding these changes is essential for predicting surgical outcomes and ensuring long-term stability of visual acuity [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOur results indicate significant changes in several corneal parameters post-ICL surgery. Specifically, the Pentacam parameters such as Astig F, which measures the degree of astigmatism in the cornea, and ISV (Index of Surface Variance), an indicator of the corneal surface's overall irregularity, showed significant differences pre- and postoperatively. The changes in these parameters persisted across all postoperative time points, indicating a stable alteration in the corneal structure following ICL implantation. These findings align with previous studies highlighting the impact of ICL implantation on corneal, while certain corneal alterations post-ICL implantation stabilize, some may persist [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]​.\u003c/p\u003e\u003cp\u003eNotably, IVA (Index of Vertical Asymmetry), which assesses the asymmetry between the superior and inferior corneal halves, did not show significant differences until three months after surgery. This delayed response suggests that IVA may be indicative of longer-term biomechanical changes in the cornea post-ICL surgery, reflecting ongoing adaptation and remodeling processes. The lack of immediate changes in IVA aligns with the understanding that some biomechanical parameters may take longer to manifest significant alterations [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn terms of Corvis ST measurements, Parameters such as A1V (first applanation velocity), A2T (second applanation time), PD (peak distance), HCDfmA (highest concavity deformation amplitude), and HCDflA (highest concavity deflection amplitude) exhibited significant and persistent changes post-surgery similar to Astig F. These differences were still evident at the 3-month follow-up, and there were significant differences even between the 1-month and 3-month postoperative measurements. This suggests that these biomechanical properties of the cornea continue to evolve and adapt over an extended period following ICL implantation, underscoring the need for long-term monitoring, which align with many previous studies [\u003cspan additionalcitationids=\"CR14 CR15 CR16\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A1T (first applanation time) and DA Ratio (deformation amplitude ratio) showed significant changes immediately after surgery but normalized by the 3-month mark. The normalization of these parameters by the 3-month mark can be attributed to the cornea's natural healing process, where initial inflammation is temporary and mechanical stress is reducing, and the tissue gradually stabilizes. This process reflects the cornea's ability to adapt, to stabilize and to reduce back to pre-surgery stage following the ICL surgical intervention [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eLastly, A2V (second applanation velocity) demonstrated a delayed response similar to IVA, with significant differences becoming apparent only at later postoperative stages. This delayed response indicates that this parameter is more sensitive to long-term biomechanical remodeling of the cornea, potentially reflecting deeper structural changes that occur as the eye adapts to the implanted lens [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThese biomechanical changes have several clinical implications. The persistent changes in parameters such as Astig F, ISV, A1V, A2T, PD, HCDfmA, and HCDflA suggest a need for careful and prolonged monitoring post-ICL surgery to ensure the long-term stability of the corneal structure. Furthermore, the significant differences observed between 1 month and 3 months postoperatively highlight the importance of extended follow-up beyond the 3 month mark to capture the full extent of biomechanical adaptation after ICL implanation [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAdditionally, the delayed response in parameters such as A2V, and IVA suggest ongoing biomechanical changes that take longer to manifest and become significant at a later stage potentially affecting the overall stability post-surgery [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Understanding these responses is crucial for optimizing surgical techniques and ensuring a sustained visual acuity.\u003c/p\u003e\u003cp\u003eIn light of this, further research is needed to explore the long-term stability of these biomechanical changes and their correlation with visual outcomes. Longitudinal studies with larger sample sizes could provide more comprehensive insights into the biomechanical effects of ICL surgery. Additionally, advancements in imaging and measurement technologies could offer more precise assessments of corneal biomechanics, enhancing our understanding of the impacts of ICL implantation.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, ICL implantation significantly affects corneal biomechanical parameters, with both immediate and persistent changes observed post-surgery. These findings highlight the importance of continuous monitoring and a thorough understanding of corneal biomechanics to ensure not only successful surgical outcomes but also sustainable visual acuity over the long term.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eICL, implantable collamer lens;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIOL,\u0026nbsp;intraocular lens;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCovis ST, Corneal Visualization Scheimpflug Technology ;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLASIK, Laser-Assisted in Situ Keratomileusis;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWTW,\u0026nbsp;white-to-white;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eK1 F, Steepest Keratometry Reading from the Anterior Corneal Surface;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;K2 F, Flattest Keratometry Reading from the Anterior Corneal Surface;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAstig F, Central Astigmatism from the Anterior Corneal Surface;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCCT, Central Corneal Thickness;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTP, Pachymetry at the Thinnest Point;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eISV, Index of Surface Variance;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;IVA, Index of Vertical Asymmetry;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKI, Keratoconus Index;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCKI, Central Keratoconus Index;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIHA, Index of Height Asymmetry;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIHD, Index of Height Decentration;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA1T, First Applanation Time;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA1V, First Velocity of Applanation;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA2T, Second Applanation Time;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA2V, Second Velocity of Applanation;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePD, Peak Distance;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHCR, Highest Concavity Radius;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHCDfmA, Deformation Amplitude of the Highest Concavity;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHCDflA, Deflection Amplitude of the Highest Concavity;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSP-A1, Stiffness Parameter at the First Applanation;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIR, Integrated Radius;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eARTh, Ambrosio Relational Thickness to the Horizontal Profile;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDA Ratio, Deformation Amplitude Ratio;\u003c/p\u003e\n\u003cp\u003eD, Diopters;\u003c/p\u003e\n\u003cp\u003eum, Micrometer;\u003c/p\u003e\n\u003cp\u003emmHg, Millimeters of mercury;\u003c/p\u003e\n\u003cp\u003emm, Millimeter;\u003c/p\u003e\n\u003cp\u003eSD, standard deviation;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBCVA, best corrective visual acuity;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch and analysis of corneal biomechanical characteristics before and after phakic posterior chamber intraocular lens (ICL) implantation (20230333); Foshan City '14th Five-Year Plan' Medical Key Specialty Construction Project (FSGSP145064)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflict of interest to declare\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eX. P. and Q. L. collected preoperative eye diagnostic tests data. S. L. is the surgeon of all patients, Y. L. coordinated all other data collections, analyzed the data and drafted the paper with comments from all other authors. All authors have read and approved the final manuscript. Ye Lin is the guarantor for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research has received approval from the Second People's Hospital of Foshan ethics committee (2022)-0091 and has been conducted in compliance with ethical guidelines established in the 1964 Declaration of Helsinki, as well as subsequent amendments, or equivalent ethical standards. Informed consent to participate was obtained from all participants prior to their inclusion in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis article is distributed under the terms of the Creative Commons Attribution License allows for unrestricted utilization, distribution, and reproduction in any medium, as long as proper attribution to the original author(s) and the source is given.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData supporting the results reported in the manuscript can be found:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ehttps://data.mendeley.com/drafts/yry4r9y9v5\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSanders DR. Anterior subcapsular opacities and cataracts 5 years after surgery in the visian implantable collamer lens FDA trial. J Refract Surg. 2008;24:566-70.\u003c/li\u003e\n\u003cli\u003eSanders DR, Doney K, Poco M. ICL in Treatment of Myopia Study Group. United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up. Ophthalmology. 2004;111:1683-92.\u003c/li\u003e\n\u003cli\u003eParkhurst G. A prospective comparison of phakic Collamer lenses and wavefront-optimized laser-assisted in situ keratomileusis for correction of myopia. Clinical Ophthalmology. 2016;10:1209-1215.\u003c/li\u003e\n\u003cli\u003eDougherty PJ, Priver T. Refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes. Clin Ophthalmol. 2017;11:273-277.\u003c/li\u003e\n\u003cli\u003eZeng QY, Xie XL, Chen Q. Prevention and management of collagen copolymer phakic intraocular lens exchange: causes and surgical techniques. J Cataract Refract Surg. 2015;41:576-84.\u003c/li\u003e\n\u003cli\u003eLin Y, Luo S, Lu Q, Pan X. 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Med Hypothesis Discov Innov Ophthalmol 8:177\u0026ndash;203\u003c/li\u003e\n\u003cli\u003eLin, Ye (2024), \u0026ldquo;Biomechanical properties of adult patients with high myopia after implantable collamer lens (ICL, V4) implantation\u0026rdquo;, Mendeley Data, V1, doi: 10.17632/yry4r9y9v5.1\u003c/li\u003e\n\u003cli\u003eEsporcatte LPG, Salom\u0026atilde;o MQ, Lopes BT, et al. Biomechanical diagnostics of the cornea. Eye Vis (Lond). 2020;7:9.\u003c/li\u003e\n\u003cli\u003eZhang H, Tian L, Guo L, et al. Comprehensive evaluation of corneas from normal, forme fruste keratoconus and clinical keratoconus patients using morphological and biomechanical properties. Int Ophthalmol. 2021;41(4):1247-1259. \u003c/li\u003e\n\u003cli\u003eWei Q, Chang W, Jiang R, Zhou X, Yu Z. Comprehensive assessment of corneal microstructural changes following V4c implantable collamer lens surgery using in vivo confocal microscopy. BMC Ophthalmol. 2024;24:408.\u003c/li\u003e\n\u003cli\u003eDu, G.-P., Gong, Y.-B., Wang, D.-J., Huang, Y.-F., Song, J., Guo, H.-L., Wang, L.-Q., Yu, J.-F., \u0026amp; Huang, H.-B. (2011). Changes in Objective Vault and Effect on Vision Outcomes after Implantable Collamer Lens Implantation: 1-Year Follow-up. European Journal of Ophthalmology, 22(2), 153\u0026ndash;160. \u003c/li\u003e\n\u003cli\u003eLiu Y-C, Teo EPW, Lwin NC, Yam GHF, Mehta JS. Early Corneal Wound Healing and Inflammatory Responses After SMILE: Comparison of the Effects of Different Refractive Corrections and Surgical Experiences. Journal of Refractive Surgery. 2016;32(5):346-353.\u003c/li\u003e\n\u003cli\u003eDupps WJ Jr, Wilson SE. Biomechanics and wound healing in the cornea. Exp Eye Res. 2006 Oct;83(4):709-20.. \u003c/li\u003e\n\u003cli\u003eLi, K., Wang, M. X., Zhang, D., Song, X., Li, Y., Wang, S., \u0026amp; Wang, Z. (2020). Visual outcomes and corneal biomechanics after V4c implantable collamer lens implantation in subclinical keratoconus. \u003cem\u003eJournal of Cataract and Refractive Surgery\u003c/em\u003e, \u003cem\u003e46\u003c/em\u003e(10), 1339\u0026ndash;1345. \u003c/li\u003e\n\u003cli\u003eKomninou MA, Seiler TG, Enzmann V. Corneal biomechanics and diagnostics: a review. Int Ophthalmol. 2024;44:132. doi:10.1007/s10792-024-03057-1.\u003c/li\u003e\n\u003cli\u003ePacker, K. T., Vlasov, A., Weightman, J. W., Berry-Cab\u0026aacute;n, C. S., Greenburg, D. L., Beltran, T., Coggin, A., \u0026amp; Carroll, R. B. (2022). U.S. military implantable collamer lens surgical outcomes: 11-year retrospective review. \u003cem\u003eJournal of Cataract and Refractive Surgery\u003c/em\u003e, \u003cem\u003e48\u003c/em\u003e(6), 649\u0026ndash;656.\u003c/li\u003e\n\u003cli\u003eGrover, I. G., Reddy, J. C., Murthy, S., \u0026amp; Senthil, S. (2017). A Rare Case of Pupillary Block Glaucoma Following CentraFLOW Implantable Collamer Lens Surgery. \u003cem\u003eJournal of Glaucoma\u003c/em\u003e, \u003cem\u003e26\u003c/em\u003e(8), 694\u0026ndash;696.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Implantable Collamer Lens, Myopia, Corneal Biomechanics, Corvis ST, Pentacam","lastPublishedDoi":"10.21203/rs.3.rs-6567891/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6567891/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eTo evaluate the effects of ICL implantation on the corneal biomechanical parameters of patients with high myopia\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eCorneal biomechanical parameters were measured preoperatively and postoperatively in 110 eyes of 55 high myopia patients who underwent ICL implantation by the same surgeon between January 2021 and December 2022. Measurements were obtained using Pentacam, and Corvis ST.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eComparative analysis of Pentacam parameters before and after ICL surgery revealed significant differences in Astig F and ISV at one week, one month, and three months postoperatively (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). IVA showed significant differences only at the three-month mark compare to preoperative measure (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No significant changes were detected in other parameters (K1 F, K2 F, CCT, TP, KI, CKI, IHA, and IHD) across all time points (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). In Corvis ST parameters, A1T, A1V, A2T, PD, HCDfmA, HCDflA, and DA Ratio showed significant changes at one week, one month, and three months postoperatively compare to preoperative measures (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Additionally, there were significant differences observed between one month and three months postoperative for A1T, A1V, A2T, A2V, PD, HCR, HCDfmA, HCDflA, SP-A1, IR, and DA Ratio (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). A2V demonstrated a delayed response, showing significant changes only at later postoperative stages. Other parameters did not show significant changes postoperatively (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eICL implantation significantly affects certain corneal biomechanical parameters, with both immediate and persistent changes observed following surgery\u003c/p\u003e","manuscriptTitle":"Comparative analysis of the biomechanical properties of adult patients with high myopia after implantable collamer lens (ICL, V4) implantation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-27 11:38:49","doi":"10.21203/rs.3.rs-6567891/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-11-22T23:34:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"318891525589554615666490447691725968101","date":"2025-11-10T22:49:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"148958464221499126215179245579671706282","date":"2025-11-04T07:40:57+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-13T14:56:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-02T10:21:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-02T10:21:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Ophthalmology","date":"2025-04-30T21:09:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"ea41bed3-2b37-44fc-add4-9163690a009c","owner":[],"postedDate":"October 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-27T11:38:49+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-27 11:38:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6567891","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6567891","identity":"rs-6567891","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}