Abstract： Objective: To observe the changes in the anterior chamber angle at different times after phakic posterior chamber intraocular lens (EVO ICL V4c) implantation and to analyze the related factors affecting the postoperative anterior chamber angle (ACA). Methods: A prospective, nonrandomized continuous study was conducted. Eighty-one myopic patients (81 eyes) who underwent posterior chamber intraocular lens implantation from September 2018 to February 2019 were recruited in the Refractive Center of the First Affiliated Hospital of Zhengzhou University. Patients underwent Visante anterior segment optical coherence tomography (OCT) before surgery, and 1 day, 1 month and 6 months after surgery to measure the preoperative and postoperative data of the nasal/temporal anterior chamber and vault. Data analysis included the correlation between postoperative ACA and axial length, horizontal corneal diameter (white to white), anterior chamber depth, anterior chamber volume, horizontal keratometry, anterior chamber angle, ICL diameter and postoperative vault. Repeated measures analysis of variance was used to compare the changes in various parameters of the anterior segment at different time points in patients, and the Bonferroni test was used for pairwise comparisons. Correlation analysis was performed using Pearson correlation or Spearman correlation. Results: There was no significant difference in the anterior chamber angle at 1 day, 1 month and 6 months after the operation, while the postoperative nasal ACA was reduced by 45%-50% compared with preoperative ACA (F=268.73, P<0.001). The postoperative temporal ACA decreased by 44%-49% compared with preoperative ACA (F=333.40, P<0.001). The mean vault was 640±180 μm at 1 day, 540±150 μm at 1 month, and 530±160 μm at 6 months after ICL V4c implantation. The differences were statistically significant (F=54.14, P<0.001). The declining trend in vault was obvious within 1 month after the operation, while the declining trend in vault obviously slowed from 1 month to 6 months after the operation. There was a positive correlation between anterior chamber volume, anterior chamber depth and preoperative angle opening after ICL implantation (r=0.426, P=0.003; r=0.377, P=0.008; r=0.525, P<0.001), without significant correlations between anterior chamber angle opening and ICL diameter, arch height, preoperative spherical power, axial length, horizontal keratometry and white to white. There were positive correlations between anterior chamber volume, anterior chamber depth and preoperative angle opening after ICL implantation (r=0.392, P=0.006; r=0.376, P=0.008; r=0.594, P<0.001), without significant correlations between anterior chamber angle opening and ICL diameter, arch height, preoperative spherical power, axial length, horizontal keratometry and white to white. Conclusions: The anterior chamber angle is significantly reduced after posterior chamber intraocular lens implantation in phakic eyes, and the anterior chamber angle is basically stable during the follow-up period without further narrowing.
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