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Akbas YB, Yildiz BK, Sucu ME, Agca A, Tunc U, Yildirim Y. Three-year outcomes of a novel toric intraocular lens implantation for moderate-high myopic astigmatism in phakic eyes. BMC Ophthalmol 2024; 24:362. [PMID: 39174922 PMCID: PMC11340137 DOI: 10.1186/s12886-024-03633-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/13/2024] [Indexed: 08/24/2024] Open
Abstract
PURPOSE To investigate the three-year visual, refractive outcomes and adverse events of the Eyecryl toric phakic IOL (pIOL) for moderate-to-high myopic astigmatism. METHODS This retrospective study included eligible patients who underwent refractive surgery in one or both eyes with Eyecryl toric pIOL for myopic astigmatism. The efficacy, safety, predictability, rotational stability, vector analysis, and adverse events were evaluated in patients with spherical refraction from - 4.50 to -17.00 diopters (D) and cylindrical refraction from - 0.75 to -5.50 D. RESULTS Fifty-two eyes of 28 patients were included in the study. The mean efficacy and safety index were 1.12 ± 0.35 and 1.38 ± 0.42, respectively. The mean manifest refraction spherical equivalent was - 10.06 ± 2.69 D and - 0.64 ± 0.61 D preoperatively and postoperatively at 36 months, respectively. The mean manifest astigmatism was - 2.06 ± 1.16 D and - 0.44 ± 0.48 D preoperatively and 36 months postoperative, respectively. During the final examination, 70% of the eyes showed an increase in CDVA of one or more lines compared to their preoperative state. There was a cumulative endothelial cell loss of 3.1% at 36 months postoperatively. One eye developed visually significant anterior subcapsular opacity, whereas another eye experienced pIOL opacification. CONCLUSION The Eyecryl toric pIOL demonstrated satisfactory visual acuity and refractive outcomes, as assessed by efficacy, safety and stability over a three-year period.
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Affiliation(s)
- Yusuf Berk Akbas
- University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Olimpiyat Bulvari Yolu, Basaksehir, Istanbul, 34480, Turkey.
| | - Burcin Kepez Yildiz
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | | | - Alper Agca
- Dunya Goz Hospital, Atakoy, Istanbul, Turkey
| | - Ugur Tunc
- Johns Hopkins University, The Wilmer Eye Institute, Maryland, USA
| | - Yusuf Yildirim
- University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Olimpiyat Bulvari Yolu, Basaksehir, Istanbul, 34480, Turkey
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Zhang Q, Gong D, Li K, Dang K, Wang Y, Pan C, Yan Z, Yang W. From inception to innovation: bibliometric analysis of the evolution, hotspots, and trends in implantable collamer lens surgery research. Front Med (Lausanne) 2024; 11:1432780. [PMID: 39224608 PMCID: PMC11366652 DOI: 10.3389/fmed.2024.1432780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Background As one of several refractive surgeries, Implant Collamer Lens (ICL) surgery offers stable biocompatibility and consistent, high-quality visual outcomes. ICL has become an effective complement to corneal refractive surgery, gradually becoming one of the mainstream methods for correcting refractive errors. This study employs bibliometric methods to analyze research on ICL surgery to understand the progress, hotspots, and potential future trends in this field. Methods This study performed a bibliometric analysis of all ICL-related articles collected from the Web of Science Core Collection database between January 1st, 1996, and December 31st, 2023. The CiteSpace 6.2.R4 tool, Excel and the Web of Science website were used to analyze data by country, institution, keywords, and clusters of keywords. Additionally, an in-depth interpretation and analysis were conducted on the field's high-impact articles. Results Since the first clinical application report of ICL, there have been a total of 875 studies. The number of papers published annually has shown an overall increasing trend. Studies published from China are the most numerous, accounting for 29.14% (n = 255) of the total. Among the institutions, Fudan University and Kitasato University both have published more than 50 papers, with Kitasato University having the highest H-index of 26. The journals with the top 10 publication volumes are all specialized in ophthalmology. The burst keywords since the introduction of ICL surgery have been "intraocular lens," "refractive surgery," and "cataract surgery." The current burst keywords include "visual quality," "vector analysis," "axial length," etc. The results of keyword clustering included ICL, pIOL, high myopia, axial length, optical quality, refractive surgery, ICL implantation, and pupil size. In the High-impact Articles, it was found that the high-impact articles predominantly focus on the safety, efficacy, and predictability of ICL surgery. Conclusion Research on ICL has grown since its clinical introduction, with the advent of the central hole ICL sparking a surge in recent hotspots, particularly in China. Current hotpots in the field of ICL surgery are "visual quality," "ICL implantation," "vector analysis," "axial length," "evo ICL," "ICL v4c," and "ICL." ICL surgery research trends have evolved from implantation techniques to biological parameters associated with ICL surgery and the benefits of new ICL designs.
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Affiliation(s)
- Qing Zhang
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang Medical University, Xinxiang, China
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Di Gong
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kunke Li
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Yun Wang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Changfeng Pan
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Zonghui Yan
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
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Ye Y, Wan L, Hou X, Chen P, Yu N, Yu K. Rotational Stability, Footplate Position, and Visual Outcomes of Toric Implantable Collamer Lenses in Eyes With Low Vault. J Refract Surg 2024; 40:e460-e467. [PMID: 39007814 DOI: 10.3928/1081597x-20240517-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
PURPOSE To evaluate the clinical outcomes, rotational stability, and footplate position of the toric Implantable Collamer Lens (TICL) (STAAR Surgical) in eyes with low vault and analyze factors related to rotational stability. METHODS This prospective observational study included 59 eyes of 59 patients with insufficient vault (< 250 µm). Postoperative rotation was defined as the difference between the achieved angle and the intraoperative fixation angle, and assessed with a digital anterior segment photograph after full mydriasis at 1 week and 1, 3, and 6 months postoperatively. Ultrasound biomicroscopy was used to determine the ciliary body morphology and position of the footplate. Correlation analysis was employed to identify the risk factors associated with TICL rotation at 6 months postoperatively. RESULTS At 6 months postoperatively, the mean central vault was 137.4 ± 61.0 µm (range: 40 to 236 µm), and the mean efficacy and safety indices were 1.04 and 1.15, respectively. The mean manifest refractive astigmatism decreased from -1.67 ± 0.82 diopters (D) preoperatively to -0.43 ± 0.33 D postoperatively, and the mean absolute rotation was 4.50 ± 3.08 degrees (range: 0 to 12.50 degrees). The angle of rotation was correlated with the preoperative spherical power (r = -0.318, P = .014), the average value of TICL footplates position (r = 0.284, P = .029), and postoperative astigmatism (r = -.469, P⩽ .001). CONCLUSIONS TICL implantation is predictable, safe, and effective in correcting myopic astigmatism in eyes with low vault. The rotational stability was acceptable and related to the malposition of the footplate and preoperative spherical power. [J Refract Surg. 2024;40(7):e460-e467.].
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Wan T, Chen H, Wu S, Jin H. Analysis of surgically induced astigmatism of the anterior, posterior, and total cornea after implantable collamer lens implantation: a comparative study between temporal and superior clear corneal incisions. BMC Ophthalmol 2024; 24:252. [PMID: 38867207 PMCID: PMC11170833 DOI: 10.1186/s12886-024-03501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions. METHODS One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-KAnt) and posterior (Sim-KPost) corneal curvature; and astigmatism of the anterior (CAAnt), posterior (CAPost), and total (CATCRP) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups. RESULTS There were no significant intergroup differences for TCRP, Sim-KAnt, Sim-KPost, CAAnt, CAPost, or CATCRP, preoperatively. However, values of CAAnt, CAPost, and CATCRP with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea. CONCLUSIONS A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs. TRIAL REGISTRATION Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.
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Affiliation(s)
- Ting Wan
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
| | - Huaicheng Chen
- Department of Ophthalmology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Shirou Wu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
| | - Hongying Jin
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
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Yiming Y, Xi C, Huan Y, Liming C, Na Y, Pei C, Ying Y, Yan L, Keming Y. Evaluation of ciliary body morphology and position of the implantable collamer lens in low-vault eyes using ultrasound biomicroscopy. J Cataract Refract Surg 2023; 49:1133-1139. [PMID: 37586102 DOI: 10.1097/j.jcrs.0000000000001285] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE To investigate the ciliary body anatomy and position of the implantable collamer lens (ICL) in low-vault eyes and analyze factors related to insufficient vault. SETTING Zhongshan Ophthalmic Center, Guangzhou, China. DESIGN Retrospective case-control observational study. METHODS In this study, 73 eyes of 73 patients with an insufficient vault (<250 μm) were matched with 73 eyes with an ideal vault (250 to 750 μm). Ultrasound biomicroscopy was used to determine the ciliary body morphology and ICL position. The biometric parameters acquired by Scheimpflug tomography were compared. The correlation between the vault and these factors was analyzed, and the least absolute shrinkage and selection operator method was used to screen the risk factors for low vault. RESULTS The low-vault group had a steeper corneal curvature, thicker lens thickness (LT), higher crystalline lens rise, and shorter axial length (AL) (all P < .005). The ciliary process length (CPL) and maximum ciliary body thickness (CBTmax) were significantly smaller, and the trabecular-ciliary angle (TCA), iris-ciliary angle (ICA), and ciliary sulcus width (CSW) were significantly greater in the low-vault eyes (all P < .005). The low-vault group had more ICL haptics below the ciliary process, and TCA, ICA, CPL, CBTmax, CSW, and haptic position were related to the postoperative vault (all P < .05). CPL, AL, and LT were identified as predictors of a low vault. CONCLUSIONS Malposition of ICL haptics behind the ciliary process is a risk factor for low vault. A shorter CPL, thicker LT, and shorter AL are significant risk factors for the postoperative low vault.
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Affiliation(s)
- Ye Yiming
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Shiga S, Kojima T, Horai R, Nakamura T. Evaluation of long-term clinical outcomes after toric implantable collamer lens implantation. J Cataract Refract Surg 2023; 49:964-969. [PMID: 37395497 DOI: 10.1097/j.jcrs.0000000000001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To evaluate the long-term (8-10 years) outcomes of toric implantable collamer lens (TICL) surgery. SETTING Nagoya Eye Clinic, Nagoya, Aichi, Japan. DESIGN Retrospective observational study. METHODS Patients who underwent TICL surgery from 2005 to 2009 to correct myopia and myopic astigmatism were enrolled. The safety, efficacy, predictability, astigmatism correction efficacy, and complications were evaluated using preoperative, 1-year postoperative, and final examination data. RESULTS 133 eyes of 77 patients were included. At the final visit, the mean uncorrected and corrected visual acuities were -0.01 ± 0.2 and -0.17 ± 0.05, respectively. The mean safety and efficacy indices were 0.91 ± 0.26 and 0.68 ± 0.21, respectively. The manifest astigmatism was -0.45 ± 0.43 diopters (D). The mean corneal astigmatism change from 1 year postoperatively to the final visit was 0.40 ± 0.26 D. Of the 38 eyes with a change in corneal astigmatism ≥0.5 D, 30 eyes (78.9%) changed to against-the-rule (ATR) astigmatism, 1 (2.6%) changed to oblique astigmatism, and 7 (18.4%) changed to with-the-rule (WTR) astigmatism. The mean manifest astigmatism change from 1 year postoperatively to the final visit was 0.43 ± 0.52 D. Of the 60 eyes with a change in manifest astigmatism ≥0.5 D, 25 (41.7%) changed to ATR astigmatism, 18 (30.0%) changed to oblique astigmatism, and 17 (28.3%) changed to WTR astigmatism. During follow-up, 8 (6.0%) of 133 eyes developed anterior subcapsular cataracts, among which 4 (3.0%) underwent TICL removal and phacoemulsification and aspiration. No vision-threatening complications occurred. CONCLUSIONS TICL surgery showed good long-term astigmatism-correcting effects, although the long-term uncorrected visual acuity decreased. The procedure was effective in correcting myopia and astigmatism.
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Affiliation(s)
- Suguru Shiga
- From the Japanese Red Cross Gifu Hospital, Gifu, Japan (Shiga, Kojima); Nagoya Eye Clinic, Nagoya, Japan (Kojima, Horai, Nakamura)
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Kilic D, Förster A, Mertens E, Dick HB, Taneri S. Rotational Stability After Implantation of Two Different Phakic Toric Intraocular Lenses. J Refract Surg 2023; 39:463-472. [PMID: 37449509 DOI: 10.3928/1081597x-20230512-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
PURPOSE To compare clinical outcomes and rotational stability of the toric implantable Collamer lens (TICL) and toric implantable phakic contact lens (TIPCL). METHODS Charts were reviewed from January 2011 to January 2023 to identify all TICLs and TIPCLs implanted by a single surgeon. Implant size was generally chosen according to the manufacturer's recommendation, but 15 TIPCLs 0.25 mm larger than recommended to increase vaulting were included. RESULTS Eighty-four TICLs and 98 TIPCLs were identified and yielded excellent refractive and visual results in eyes with high myopic astigmatism at the last follow-up visit. No case of acute glaucoma or cataract induction was observed. In total, 15 (8.2%) rotated lenses were recorded; 2 (2.4%) TICLs and 13 (13.3%) TIPCLs (P = .013). Eyes in both groups were similar in preoperative spherical equivalent, cylinder, white-to-white distance, anterior chamber depth (ACD), anterior chamber angle, and mean follow-up times (P = .925, .673, .822, .794, .358, and .873, respectively). Average TICL size was larger than TIPCL size (P < .001). Rotation of the lenses was positively correlated with cylinder and negatively correlated with ACD but not with vaulting (P = .001, r = 0.253; P = .011, r = -0.193; P = .488, r = -0.057; respectively). Vaulting was positively correlated with preoperative ACD (P ≤ .001, r = .329). In eyes with a rotated TIPCL, preoperative cylinder was higher and ACD was shallower than in eyes with a stable TIPCL (P = .001 and .007, respectively). Increasing the implant size had no significant effect on rotation rate (P = .685). CONCLUSIONS Although both implants were safe and effective in highly myopic eyes, TICL rotated less frequently than TIPCL and required fewer secondary interventions. Rotation was correlated with preoperative cylinder and ACD but not lens vaulting. [J Refract Surg. 2023;39(7):463-472.].
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Tan X, Liu W, Chang Y, Wu W, Yang L, Liu J. Analysis of Inter-Eye Vault Differences After Implantable Collamer Lens (V4c) Implantation. Int J Gen Med 2023; 16:2451-2459. [PMID: 37346811 PMCID: PMC10281286 DOI: 10.2147/ijgm.s384858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
Purpose The safety and stability of implantable collamer lens (ICL) implantation are closely related to the vault. We aimed to assess clinical data from patients with similar anterior segment anatomy who received ICL of the same model placed in the same position and analyze common range and factors affecting the vault inter-eye difference. Patients and Methods A prospective study was performed, including 162 eyes of 81 patients with a bilateral ICL (V4c) implantation. Subjects were evaluated before the surgery and 1 day, 1 week, and 1 month postoperatively, and they were divided into 4 groups based on the ICL size. Bivariate correlation and multiple linear regression (stepwise) analyzed associations between vault inter-eye differences and horizontal sulcus-to-sulcus diameter, anterior chamber depth, lens thickness, ICL size, spherical equivalent, and vault. Results One month after surgery, mean vault inter-eye differences were 74.59 ± 55.59 µm. Nearly 70% of patients presented with vault inter-eye differences lower than 100 µm. The second eye vault variance of 69% was attributed to the first eye vault. Vault inter-eye differences were positively correlated with ICL spherical equivalent (regression equation: vault inter-eye differences (μm) = 139.415 + 6.295 × ICL spherical equivalent). Vaults after ICL implantation were similar in fellow eyes, with some considerable differences. The 95% confidence interval of the vault inter-eye difference was -34.4 ~ 183.6 μm. Conclusion In eyes with similar anterior segment anatomy, there is a 95% probability that the vault will vary from -34.4 μm to -183.6 μm when a similar ICL is implanted. These results can help surgeons to select an appropriate ICL size to achieve an ideal vault. The smaller the spherical equivalent, the larger the difference between the two vaults, which provides a reference for size in moderate myopia. ICL spherical equivalent affects and predicts vault inter-eye differences after ICL implantation.
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Affiliation(s)
- Xin Tan
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Wenjie Liu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Ying Chang
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Wanmin Wu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Lichun Yang
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Jiewei Liu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
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Yang J, Zou Z, Wu M, He R, Nong Y, Li H, Zhou S. Development and validation of a new multivariable prediction model to estimate risk of abnormal vault. BMC Ophthalmol 2023; 23:203. [PMID: 37165326 PMCID: PMC10170721 DOI: 10.1186/s12886-023-02956-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/03/2023] [Indexed: 05/12/2023] Open
Abstract
PURPOSE To develop and validate a new multivariable prediction model to estimate risk of abnormal vault after EVO Implantable Collamer Lens (EVO-ICL) implantation using the preoperative parameters. METHODS This retrospective study comprised 282 eyes of 143patients who underwent EVO-ICL surgery between May 2021 and April 2022. We measured preoperative parameters before surgery and vaults in 1 week after the operation using swept-source optical coherence tomography (SS-OCT). Risk factors for abnormal vault were determined by univariate and multivariate logistic regression analyses, and a nomogram was developed to forecast the risk of abnormal vault after EVO-ICL implantation. We assessed the performance of nomogram in terms of discrimination and calibration, including concordance index (C-index), receiver operating characteristic curve (ROC), area under the ROC curve (AUC), and decision curve analysis (DCA). Bootstrap resampling was used as an internal verification method. RESULTS The logistic regression analysis revealed the independent risk factors for abnormal vault were white-to-white(WTW), anterior chamber angle(ACA), pupil size, and ICL-size, all of them were used to establish a nomogram based on multivariate logistic regression to predict the risk of abnormal vault. The C-indexes and AUC were 0.669 (95%CI, 0.605, 0.733). The calibration curves of the nomogram showed relatively small bias from the reference line, implicating an acceptable degree of confidence. The DCA indicates the potential clinical significance of the nomogram. CONCLUSIONS We developed a new multivariable prediction model to estimate risk of abnormal vault. The model shows good prediction effect and can provide assistance for clinical decision of ICL size.
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Affiliation(s)
- Jing Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Zongyin Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Minhui Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Runzhang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yating Nong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Sheng Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Yang K, Li J, Zhang W, Liu Z, Song C, Zhao Y. Implanting toric implantable collamer lens displays better astigmatism correction than implantable collamer lens combined with manually limbal relaxing incision. BMC Ophthalmol 2023; 23:198. [PMID: 37147624 PMCID: PMC10161410 DOI: 10.1186/s12886-023-02941-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND This retrospective study aimed to compare the outcomes of toric implantable collamer lens (TICL) surgery with those of implantable collamer lens (ICL) implantation combined with limbal relaxing incision (LRI) in patients with low myopia and astigmatism. METHODS A total of 40 eyes of 28 patients who underwent TICL implantation and 40 eyes of 27 patients who underwent ICL implantation combined with manually LRI between 2021 and 2022 were included. Primary outcomes were manifest sphere and cylinder, intraocular pressure, visual acuity, and astigmatism parameters at 1 day, 1 week, and 1, 3, and 6 months postoperatively. RESULTS The two surgeries showed comparable effects on manifest sphere and cylinder, intraocular pressure, and visual acuity (all p > 0.1). Surgery-induced astigmatism (SIA) was maintained as stable in the TICL group (1.73 to 1.68, p = 0.420), but was significantly reduced in the ICL/LRI group (1.74 to 1.17, p = 0.001) from preoperative to postoperative 6 months. The TICL group displayed significantly higher SIA and correction index at postoperative 1, 3, and 6 months than the ICL/LRI group (at 6 months: SIA, 1.68 (1.26, 1.96) vs., 1.17 (1.00, 1.64), p = 0.010; CI: 0.98 (0.78, 1.25) vs. 0.80 (0.61, 1.04), p = 0.018). No complications occurred during follow-up. CONCLUSIONS The effects of ICL/LRI are comparable to those of TICL in correcting myopia. TICL implantation displays better astigmatism correction than ICL/LRI.
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Affiliation(s)
- Ke Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Jiaxin Li
- Medical School, Pingdingshan University, Pingdingshan, 467000, China
| | - Weihua Zhang
- Liaocheng People's Hospital, Liaocheng, 252000, China
| | - Zhanjiang Liu
- Chaoyang Central Hospital, Liaoning Province, 122000, China
| | - Chenjie Song
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Yang Zhao
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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Wan H, Tao Y, Duan J, Wang L, Tang L. Association between the site of clear corneal Phakic intraocular lens implantation incisions and the inflow of ocular surface fluid into the anterior chamber. Front Med (Lausanne) 2023; 10:1063003. [PMID: 36936228 PMCID: PMC10019354 DOI: 10.3389/fmed.2023.1063003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/06/2023] [Indexed: 02/28/2023] Open
Abstract
Background Posterior chamber phakic intraocular implantable collamer lens (ICL) implantation is an effective surgical option for the management of myopia. Over the past few years, the number of ICL surgeries has significantly increased. Postoperative inflammation and endophthalmitis are among the most serious complications after successful ICL surgery. Sometimes, when the blepharospasm is removed at the end of surgery, a small amount of the ocular surface fluid will flow into the anterior chamber, which can lead to an increased risk of infection and inflammation. However, little attention has been paid to this phenomenon. Purpose We conducted a retrospective study to compare the incidence of extraocular fluid inflow into the eye through the clear corneal incision (CCI) at two different positions (superior and temporal sides). Methods A total of 116 patients with myopia underwent superior CCI ICL implantation (n = 58) or temporal CCI ICL implantation (n = 58) at our hospital from October to December 2021. The incidence of conjunctival sac fluid entering the anterior chamber after eyelid fixative was removed was compared in both groups. Results Both groups were well matched in all parameters. Ocular surface fluid inflow into the anterior chamber was significantly higher in the superior CCI group (25/58, 47.1%) than in the temporal CCI group (1/58, 1.7%) (p < 0.05). Conclusion In the patients with ICL implantation, the temporal CCI was better than the superior CCI in avoiding the ocular surface fluid inflow into the anterior chamber, and the potential risk of infection and inflammation was lower.
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Affiliation(s)
- Huan Wan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, People's Hospital of Meishan, Meishan, Sichuan, China
| | - Yunhan Tao
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jianan Duan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lin Wang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Lin Wang,
| | - Li Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Li Tang,
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Wannapanich T, Kasetsuwan N, Reinprayoon U. Intraocular Implantable Collamer Lens with a Central Hole Implantation: Safety, Efficacy, and Patient Outcomes. Clin Ophthalmol 2023; 17:969-980. [PMID: 36998514 PMCID: PMC10046236 DOI: 10.2147/opth.s379856] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
This review summarizes the available literature and provides updates on the efficacy, safety, and patient outcomes of phakic intraocular lens implantation using implantable collamer lens (ICL), with a focus on newer models with a central port (EVO/EVO+ Visian Implantable Collamer Lens, STAAR Surgical Inc.). All studies included in this review were identified from the PubMed database and were reviewed for relevancy of their topic. Data on hole-ICL implantation performed between October 2018 and October 2022 in 3399 eyes showed a weighted average efficacy index of 1.03 and a weighted average safety index of 1.19 within an average follow-up of 24.7 months. The incidence of complications such as elevated intraocular pressure, cataract, and corneal endothelial cell loss was low. Moreover, both quality of vision and quality of life improved after ICL implantation, confirming the benefits of this procedure. In conclusion, ICL implantation is a promising refractive surgery alternative to laser vision correction with excellent efficacy, safety, and patient outcomes.
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Affiliation(s)
- Trakanta Wannapanich
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Ngamjit Kasetsuwan
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Correspondence: Ngamjit Kasetsuwan, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand, Tel +6622564142, Email
| | - Usanee Reinprayoon
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Sánchez Trancón A, Cerpa Manito S, Torrado Sierra O, Baptista AM, Serra PM. Vault differences in eyes implanted with spherical and toric implantable collamer lenses: an inter-eye analysis. BMC Ophthalmol 2022; 22:435. [PMCID: PMC9664806 DOI: 10.1186/s12886-022-02653-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose
To determine the influence of implantable collamer lenses (ICL) geometry, i.e. spherical and toric on the vault, and report the refractive and visual outcomes of patients bilaterally implanted with the two ICL geometries.
Methods
This retrospective case series analysed 41 patients implanted with a spherical ICL (sICL) in one eye and an equal sized toric ICL (tICL) in the fellow eye. The anatomical and ICL-related parameters were assessed using anterior-segment optical coherence tomography (AS-OCT Visante, Zeiss Meditec AG) and optical tomography (Pentacam, OCULUS). The influence of the anatomical and ICL-related parameters on the vault was determined using generalised estimating equations (GEE) to incorporate inter-eye correlations.
Results
Postoperative spherical equivalent was within ± 0.50D in 66% and 83% of the eyes, respectively implanted with sICL and tICL. The efficacy index in the sICL group was 1.06 and 1.14 in the tICL group. The mean inter-eye vault difference was -1.46 µm, anatomical and ICL-related parameters showed similar associations with the vault for sICL and tICL. The GEE identified the ICL size minus the anterior chamber width, the ICL spherical power and ICL central thickness as significant factors influencing the vault.
Conclusions
Spherical and toric ICL showed good efficacy for the correction of myopia and astigmatism. Patients implanted bilaterally with sICL and tICL tend to present similar vaults. The vault produced by both types of ICL was mainly regulated by the oversizing of the ICL. This suggests that the ICL geometry (spherical vs toric) is a factor with limited influence on the vault, thus the sizing method of a sICL and tICL should be similar.
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Baamonde B, Madrid-Costa D, Alfonso JF. Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty. EYE AND VISION 2022; 9:34. [PMID: 36068603 PMCID: PMC9450313 DOI: 10.1186/s40662-022-00306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up.
Methods
This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed.
Results
The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery (P < 0.0001) and remained unchanged throughout the whole follow-up (P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up (P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%.
Conclusions
The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.
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Monteiro T, Pinto C, Franqueira N, Faria-Correia F, Mendes J, Alfonso Sánchez J, Vaz F. Efficacy and Safety After Toric Posterior Chamber Implantable Collamer Lens and Toric Iris-Fixated Foldable Phakic Intraocular Lens for Myopic Astigmatism. J Refract Surg 2022; 38:339-347. [PMID: 35686710 DOI: 10.3928/1081597x-20220406-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare visual, refractive, and safety outcomes of toric posterior chamber Implantable Collamer Lens (T-ICL) (STAAR Surgical) and toric iris-fixated foldable phakic intraocular lens (IOL) (T-Artiflex; Ophtec BV) implantation for the correction of myopic astigmatism. METHODS This retrospective cohort study included 312 eyes of 312 patients who had phakic IOL implantation for myopic astigmatism. Two groups were defined: 205 eyes that underwent T-ICL implantation and 107 eyes that underwent T-Artiflex implantation. Safety, efficacy, and predictability outcomes were evaluated preoperatively and at 12 months postoperatively. Refractive and corneal astigmatic vector analysis were performed using the Alpins method. RESULTS One year postoperatively, uncorrected distance visual acuity was 0.05 ± 0.18 (T-ICL) and 0.10 ± 0.16 (T-Artiflex) logMAR, with efficacy indexes of 1.16 ± 0.27 and 1.05 ± 0.31, respectively (P < .001). Safety indexes were 1.28 ± 0.30 and 1.21 ± 0.31, respectively (P = .04). Spherical equivalent was within ±0.50 diopters (D) of emmetropia in 165 (80.5%) and 88 (82.2%) eyes, respectively. Refractive astigmatic analysis showed an index of success of 0.28 ± 0.33 (T-ICL) and 0.31 ± 0.26 (T-Artiflex) (P = .07). Surgically induced corneal astigmatism was 0.48 ± 0.74 and 0.81 ± 0.61 D, respectively (P < .001). Mean endothelial loss was 1.11% and 2.05%, respectively (P = .42). Six (2.9%) eyes in the T-ICL group and 1 (0.9%) eye in the T-Artiflex group had phakic IOL repositioning due to significant misalignment. No vision-threatening complications occurred. CONCLUSIONS Both the T-ICL and T-Artiflex groups showed high visual and refractive efficacy with a good safety profile for the correction of myopic astigmatism. T-ICL implantation demonstrated significantly better efficacy and safety indexes after 12 months. Vector analysis showed similar refractive astigmatic correction in both groups, but T-Artiflex implantation revealed higher surgically induced corneal astigmatism. [J Refract Surg. 2022;38(6):339-347.].
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Branger GA, Baenninger P. Late-Onset Toric Implantable Collamer Lens Rotation: A Case Report. Klin Monbl Augenheilkd 2022; 239:416-417. [PMID: 35472781 DOI: 10.1055/a-1785-4276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zhang J, Xia Z, Han X, Liu Z, Lin H, Qiu X, Zhang M, Ruan X, Chen X, Jin G, Gu X, Tan X, Luo L, Liu Y. Accuracy of Intraocular Lens Calculation Formulas in Patients Undergoing Combined Phakic Intraocular Lens Removal and Cataract Surgery. Am J Ophthalmol 2022; 234:241-249. [PMID: 34624249 DOI: 10.1016/j.ajo.2021.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/19/2021] [Accepted: 09/27/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the prediction accuracy of intraocular lens (IOL) calculation formulas, and the impact of anterior chamber depth (ACD) and lens thickness (LT) measurement errors on IOL power calculation in patients undergoing combined phakic IOL (PIOL) removal and cataract surgery. DESIGN Retrospective, consecutive case series study. METHODS Thirty-six PIOL implanted eyes (12 anterior chamber PIOLs and 24 posterior chamber PIOLs [PC-PIOL]) undergoing cataract surgery were included. The prediction accuracy of new formulas (Barrett universal II, Emmetropia verifying optical, Kane, and Ladas super formula) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) with or without Wang-Koch (WK) axial length (AL) adjustment was evaluated. The influence of ACD and LT measurement errors of IOLMaster 700 on refractive outcomes was also investigated. RESULTS The Kane and traditional formulas with WK AL adjustment had no significant systematic prediction error and displayed a smaller median absolute error, whereas the other formulas showed significant hyperopia shift (P < .05) and relatively lower prediction accuracy. The accuracy rate of IOLMaster 700 in measuring the ACD and LT was 100% in eyes with anterior chamber PIOL implantation, and 37.50% in the PC-PIOL subgroup. No significant difference was observed in refractive outcomes of formulas using correct and wrong parameters in the PC-PIOL subgroup (P > .05). CONCLUSIONS The Kane and traditional formulas with WK AL adjustment exhibited relatively higher prediction accuracy in patients who underwent combined PIOL removal and cataract surgery. The IOLMaster 700 displayed low accuracy in ACD and LT measurements for PC-PIOL implanted eyes, but showed negligible impact on IOL prediction accuracy.
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Affiliation(s)
- Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Zhaoxia Xia
- Department of Ophthalmology, the Sixth Affiliated Hospital of Sun Yat-sen University (Z.X.), Guangzhou, Guangdong, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Haowen Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaozhang Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Miao Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaoting Ruan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaoxun Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.).
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.).
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
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First Experiences with Implantation of Phakic Lenses in Correction of Myopia in R. N. Macedonia. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021; 42:37-46. [PMID: 35032378 DOI: 10.2478/prilozi-2021-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective: Analysis of visual acuity parameters in patients with moderate to high myopia and myopic astigmatism 1 year after treatment with phakic intraocular lenses. Material and methods: This was a retrospective study on 35 patients (52 eyes) with moderate to high myopia who were implanted with the Visian V4c phakic implantable Collamer lens (Staar Surgical, Nidau, Switzerland). Examined parameters were: uncorrected distance visual acuity (UDVA) and best corrected visual acuity (CDVA), manifest and cycloplegic refraction, intraocular pressure, and endothelial cell count. The investigated parameters were measured preoperatively, 1, 3, 6 and 12 months postoperatively. Results: In 17 patients, phakic lenses were implanted binocularly and in 18 patients monocularly. Preoperatively 34.62% of patients had CDVA from 0.9 to 1.0. One year after the surgery 48.08% of patients had UDVA from 0.9 to 1.0. Preoperatively 80.77% of patients had diopter range from -6.00 Dsph to -10.00 Dsph. At 1 year postoperatively 78.85% of patients were within 0.00 Dsph to -1.00 Dsph. Preoperatively, in patients with astigmatism -4 Dcyl to -2 Dcyl dominated, as opposed to significant improvement postoperatively when 94.23% had astigmatism ranging from -1.0 Dcyl to 0 Dcyl. Conclusion: The implantation of phakic lenses demonstrated a successful postoperative outcome in the treatment of myopia and myopic astigmatism. Visual acuity and refraction show a gradual and significant improvement in visual function parameters within 1 year of lens implantation.
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Owaidhah O, Al-Ghadeer H. Bilateral Cataract Development and Pupillary Block Glaucoma Following Implantable Collamer Lens. J Curr Glaucoma Pract 2021; 15:91-95. [PMID: 34720499 PMCID: PMC8543747 DOI: 10.5005/jp-journals-10078-1309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim and objective We report the first case of bilateral cataract formation and pupillary block glaucoma and high intraocular pressure (IOP) following implantable Collamer lens (ICL) implantation that resulted in advanced visual field loss. Background The patient who underwent bilateral ICL implantation can develop bilaterally elevated IOP and an anterior subcapsular cataract with altitudinal visual field defect. Case description A 38-year-old man with high myopia presented for routine follow-up status post bilateral phakic ICL placement. The visual acuity was reduced due to an anterior subcapsular cataract and elevated IOP in both eyes with advanced glaucomatous visual field defects. The patient was treated with topical glaucoma medications. The left eye underwent same-day phakic ICL explanation and cataract surgery to prevent further visual field loss. Conclusion Cataract and glaucoma are serious complications after phakic ICL implantation; therefore, regular postoperative monitoring may prevent advanced visual impairment. Clinical significance The use of a phakic intraocular lens for the correction of myopia may result in complications. As a measure is to reduce such complications, refractive surgeons preferred using phakic posterior chamber intraocular Collamer lens for the correction of myopia. How to cite this article Owaidhah O, Al-Ghadeer H. Bilateral Cataract Development and Pupillary Block Glaucoma Following Implantable Collamer Lens. J Curr Glaucoma Pract 2021;15(2):91–95.
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Affiliation(s)
- Ohoud Owaidhah
- Department of Glaucoma, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Huda Al-Ghadeer
- Department of Anterior Segment, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
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21
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Bohac M, Biscevic A, Gabric I, Gabric K, Shijakova V, Patel S. A critical evaluation of longitudinal changes of astigmatism following implantation of toric implantable collamer lens (TICL): a comparison between treated and untreated cases over 4 years. Graefes Arch Clin Exp Ophthalmol 2021; 260:1377-1386. [PMID: 34655333 DOI: 10.1007/s00417-021-05449-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/07/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate residual astigmatism following correction with toric implantable collamer lens (TICL) (group I) over a period of 4 years and compare with the change of astigmatism in spectacle wearers (group II). METHODS Groups I (86 cases implanted with TICL [EVO + Visian ICL, Staar Surgical, Nidau, Switzeland], preop refractive error [sphere and cylinder] - 22.25 DS to - 1.00 DS and - 5.50 DC to - 1.00 DC) and II (80 cases initial refractive error [sphere and cylinder] - 18.00 DS to 0.00 DS and - 7.00 DC to - 1.00 DC) were reviewed annually. Refractive and tomography data were subjected to vector analysis to determine surgically induced astigmatism (SIA), angle of error [Δθ° = angle of target-induced astigmatism (TIA) - angle of SIA], and ΔC [TIA-SIA powers] and total corneal astigmatism (TCA) in group I and induced change in astigmatism (ICA) in group II. RESULTS In group I, on all occasions, SIA correlated with TIA (p < 0.05); differences between SIA and TIA means were insignificant and changes in TCA were not correlated with ΔC. Mean (± sd, 95% CI) residual astigmatic powers (RA) in attending group I cases (1-4 years) were - 0.40 DC (0.58, - 0.52 to - 0.28), - 0.40 DC (0.59, - 0.52 to - 0.27), - 0.41 DC (0.58, - 0.54 to - 0.28), and - 0.61 DC (0.74, - 0.82 to - 0.40). In group II, the corresponding ICA powers were - 0.47 DC (0.53, - 0.61 to - 0.32), - 0.49 DC (0.48, - 0.69 to - 0.29), - 0.60 DC (0.40, - 0.76 to - 0.44), and - 0.86 DC (0.71, - 1.19 to - 0.52). Differences between RA and ICA were not significant. Of the group I cases presenting at 1-4 years postop, 23, 18, 16, and 28 had RA powers ≤ - 0.75 DC. Of these 12, 10, 6, and 16 were associated with Δθ° > 5° (ΔC - 0.50 to 0 DC) and 5, 1, 4, and 4 were related to ΔC (Δθ° < 5°). CONCLUSION The development of astigmatism after TICL implantation is on par with the natural change in astigmatism in untreated cases. In about 50% of TICL cases presenting with astigmatism ≤ - 0.75 DC, the residual astigmatism could be neutralized by realigning the TICL.
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Affiliation(s)
- Maja Bohac
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia.
| | - Alma Biscevic
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Ivan Gabric
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Kresimir Gabric
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Violeta Shijakova
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Sudi Patel
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
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22
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Kamiya K, Ando W, Takahashi M, Shoji N. Comparison of magnitude and summated vector mean of surgically induced astigmatism vector according to incision site after phakic intraocular lens implantation. EYE AND VISION 2021; 8:32. [PMID: 34470645 PMCID: PMC8411523 DOI: 10.1186/s40662-021-00257-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/11/2021] [Indexed: 11/12/2022]
Abstract
Background To compare the arithmetic mean (M-SIA) and the summated vector mean of surgically induced astigmatism (SVM-SIA) according to the incision site after phakic intraocular lens (Visian implantable collamer lens (ICL), STAAR Surgical) implantation. Methods This study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision. The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer. The M-SIA and the SVM-SIA were determined according to the incision site. Results The magnitude of corneal astigmatism significantly increased from 1.23 ± 0.59 D preoperatively to 1.46 ± 0.72 D postoperatively in the temporal incision group (Wilcoxon signed-rank test, P < 0.001), but it significantly decreased from 1.09 ± 0.36 D preoperatively to 0.86 ± 0.41 D postoperatively in the superior incision group (P < 0.001). The M-SIA was 0.48 ± 0.30 D, and the SVM-SIA was 0.23 ± 0.52 D at a meridian of 82° in the temporal incision group. The M-SIA was 0.57 ± 0.30 D, and the SVM-SIA was 0.47 ± 0.45 D at a meridian of 1° in the superior incision group. Conclusions ICL implantation induces the M-SIA by approximately 0.5 D, but the SVM-SIA decreased to 50% and 80% of the M-SIA in magnitude through temporal and superior incisions, respectively. The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site. It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site. Trial registration University Hospital Medical Information Network Clinical Trial Registry (000044269)
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Wakako Ando
- Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Masahide Takahashi
- Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan
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23
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Brar S, Gautam M, Sute SS, Pereira S, Ganesh S. Visual and Refractive Outcomes With the Eyecryl Phakic Toric IOL Versus the Visian Toric Implantable Collamer Lens: Results of a 2-Year Prospective Comparative Study. J Refract Surg 2021; 37:7-15. [PMID: 33432990 DOI: 10.3928/1081597x-20201013-04] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the 2-year visual and refractive outcomes with the Eyecryl Phakic Toric IOL (EP TIOL) (Biotech Vision Care Pvt Ltd) and Visian Toric ICL (TICL) (STAAR Surgical) for correction of high myopic astigmatism. METHODS This prospective, interventional, non-randomized comparison study included eligible patients who underwent toric phakic IOL surgery in one or both eyes with either the EP TIOL or TICL for myopic astigmatism. Two years postoperatively, both lenses were compared for their safety, efficacy, stability, and patient satisfaction. Vector analysis of astigmatism was performed using the Alpins method with the ASSORT software (ASSORT Party Ltd). RESULTS A total of 50 eyes were included, of which 25 eyes received EP TIOL implantation and the remaining 25 received TICL implantation. Preoperative mean ± standard deviation of spherical equivalent (SE) and cylinder was -10.15 ± 4.04 and -2.08 ± 0.86 diopters (D) in the EP TIOL group and -10.21 ± 3.97 and -2.17 ± 0.95 D in the TICL group, respectively. At 2 years of follow-up, there was no significant difference between the mean uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, and residual astigmatism between the two groups (P > .05 for all parameters). Ninety-two percent of eyes in the EP TIOL group and 88% of eyes in the TICL group were within ±0.50 D of refractive astigmatism. Vector analysis of astigmatism showed a comparable Correction Index of 0.98 in the EP TIOL group and 0.94 in the TICL group, signifying a mild undercorrection of 2% and 6%, respectively. Two eyes in the TICL group underwent exchange for high vault and one eye required realignment due to significant postoperative rotation. CONCLUSIONS At least for the first 2 years postoperatively, both toric phakic IOLs were safe and effective in managing high myopic astigmatism with comparable visual results and patient satisfaction. [J Refract Surg. 2021;37(1):7-15.].
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24
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Moshirfar M, Bundogji N, Tukan AN, Ellis JH, McCabe SE, Patil A, Ronquillo YC, Hoopes PC. Toric Implantable Collamer Lens for the Treatment of Myopic Astigmatism. Clin Ophthalmol 2021; 15:2893-2906. [PMID: 34262249 PMCID: PMC8274236 DOI: 10.2147/opth.s321095] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To report visual outcomes following surgical correction of myopic astigmatism with Visian Toric implantable collamer lens (ICL) (STAAR Surgical, Monrovia, CA, USA) at a single tertiary refractive center in the United States. Patients and Methods Toric ICL was implanted in 96 eyes (55 patients) with mean preoperative sphere of −8.98 ± 3.04 diopters (D) and cylinder of −2.67 ± 1.02 D from December 2018 to February 2021. Primary visual outcomes of efficacy, safety, stability, predictability of refractive correction, and astigmatic analysis were reported at three and twelve months postoperatively. Secondary subjective outcomes included patient-reported dry eye symptoms and glare/halos at postoperative visits. Other secondary outcomes were biometric data and postoperative vault over time. Results At three and twelve months, 75 and 46 eyes were evaluated, respectively. At twelve months, the mean manifest refraction spherical equivalent (MRSE) was −0.23 ± 0.47 D with 93% achieving within ±1.00 D of target refraction. The manifest refractive cylinder (MRC) at twelve months was −0.73 ± 0.51 D, with 86% within ±1.00 D of target. Uncorrected distance visual acuity (UDVA) was 20/20 or better in 74% of eyes at twelve months. No patients lost ≥2 lines of corrected distance visual acuity (CDVA) at twelve months. The mean angle of error was −0.9 ± 10.2° at three months and −1.6 ± 12.8° at twelve months. One patient required bilateral lens rotation, four patients underwent secondary enhancement with LASIK/PRK, and seven patients underwent postoperative limbal relaxing incisions. Conclusion This initial single-site experience finds Toric ICL implantation for myopic astigmatism to be safe and effective. Patients can achieve markedly improved UDVA in a single surgery with stable vision over time and minimal adverse subjective symptoms.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, 84020, USA.,John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.,Utah Lions Eye Bank, Murray, UT, USA
| | - Nour Bundogji
- University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
| | - Alyson N Tukan
- University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
| | - James H Ellis
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Shannon E McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, 84020, USA.,Mission Hills Eye Center, Pleasant Hill, CA, USA
| | - Ayesha Patil
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Phillip C Hoopes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, 84020, USA
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25
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Cerpa Manito S, Sánchez Trancón A, Torrado Sierra O, Baptista AM, Serra PM. Biometric and ICL-related risk factors associated to sub-optimal vaults in eyes implanted with implantable collamer lenses. EYE AND VISION 2021; 8:26. [PMID: 34225809 PMCID: PMC8256545 DOI: 10.1186/s40662-021-00250-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/30/2021] [Indexed: 12/05/2022]
Abstract
Background To identify biometric and implantable collamer lens (ICL)-related risk factors associated with sub-optimal postoperative vault in eyes implanted with phakic ICL. Methods This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL. Preoperatively, white-to-white (WTW), central keratometry (Kc) and central corneal thickness (CCT) were measured using the Pentacam. Anterior-segment optical coherence tomography (AS-OCT, Visante) was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance (ATA), internal anterior chamber depth (ACD), crystalline lens rise (CLR), anterior-chamber angle (ACA) and postoperatively the vault. Eyes were divided into three vault groups: low (LVG: ≤ 250 μm), optimal (OVG: > 250 and < 1000 μm) and high (HVG: ≥ 1000 μm). Multinomial logistic regression (MLR) was used to find the sub-optimal vault predictors. Results MLR showed that CLR, ICL size minus the ATA (ICL size-ATA), age, ICL spherical equivalent (ICLSE) and ICL size as contributing factors for sub-optimal vaults (pseudo-R2 = 0.40). Increased CLR (OR: 1.01, CI: 1.00–1.01) and less myopic ICLSE (OR: 1.22, CI: 1.07–1.40) were risk factors for low vaults. Larger ICL size-ATA (OR: 41.29, CI: 10.57–161.22) and the 13.7 mm ICL (OR: 7.08, CI: 3.16–15.89) were risk factors for high vaults, whereas less myopic ICLSE (OR: 0.85, CI: 0.76–0.95) and older age (OR: 0.92, CI: 0.88–0.98) were protective factors. Conclusion High CLR and low ICLSE were the major risk factors in eyes presenting low vaults. In the opposite direction, ICL size-ATA was the major contributor for high vaults. This relationship was more critical in higher myopic ICLSE, younger eyes and when 13.7 mm ICL were used. The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault (low, optimal or high). Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00250-6.
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Affiliation(s)
- Santiago Cerpa Manito
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain
| | - Angel Sánchez Trancón
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain
| | - Oscar Torrado Sierra
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain
| | | | - Pedro Miguel Serra
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain. .,Optics and Optometry Department, Instituto Superior de Educação e Ciências, Lisbon, Portugal.
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26
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Singh R, Vanathi M, Kishore A, Tandon R, Singh D. An anterior segment optical coherence tomography study of the anterior chamber angle after implantable collamer lens-V4c implantation in Asian Indian Eyes. Indian J Ophthalmol 2021; 68:1418-1423. [PMID: 32587181 PMCID: PMC7574076 DOI: 10.4103/ijo.ijo_1540_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: To quantitatively assess anterior chamber and angle parameters by anterior segment optical coherence tomography (AS-OCT) in myopic eyes undergoing Implantable Collamer Lens (ICL V4c) implantation. Methods: Prospective noncomparative observational case series. Pre and postoperative (1st and 3rd month) AS-OCT angle parameters (anterior chamber depth [ACD], anterior chamber angle [ACA], Angle opening distance [AOD], trabecular iris space area [TISA], scleral spur angle [SSA]) were evaluated in 32 eyes (16 patients). SPSS version 20 with paired t-test for intragroup and Mann-Whitney U value test for intergroup comparisons. Results: It included 6 (37.5%) males and 10 (62.5%) females. Preoperative ACA of 34.6 ± 2.3° reduced to 32.2 ± 2.4°, 31.9 ± 2.5° at 1 and 3 months postoperatively (P = 0.001). Preoperative mean AOD500, AOD750, TISA500, TISA750, SSA of 0.34 ± 0.06 mm, 0.52 ± 0.15 mm, 0.09 ± 0.02 mm2, 0.20 ± 0.04 mm2, 34.27 ± 4.6° decreased to 0.32 ± 0.06 mm, 0.48 ± 0.15 mm, 0.08 ± 0.02 mm2, 0.17 ± 0.05 mm2, 32.5 ± 4.3° at 1-month (P = 0.001); 0.32 ± 0.06 mm, 0.47 ± 0.13 mm, 0.08 ± 0.02 mm2, 0.17 ± 0.05 mm2 and 32.4 ± 4.6° (P = 0.001) at 3-months, respectively. Correlation analysis between preoperative ACD/intraocular pressure (IOP) was − 0.62 (P = 0.0002) [1st month], −0.40 (0.024) [third month]; between IOP/postoperative ACA, AOD500, AOD750, TISA500, TISA750, SSA was − 0.04 (0.81), −0.03 (0.85), −0.08 (0.64), −0.12 (0.48), −0.10 (0.57), −0.06 (0.73) at 1 month; −0.09 (0.58), 0.04 (0.78), 0.12 (0.48), −0.02 (0.9), −0.04 (0.79), 0.02 (0.88) at 3 months; between ICL vault/ACA, AOD500, AOD750, TISA500, TISA750, SSA was 0.38 (0.02), 0.24 (0.17), 0.21 (0.25), 0.05 (0.75), 0.15 (0.41), 0.27 (0.13) at 1st month; 0.19 (0.28), 0.06 (0.71), −0.03 (0.85), 0.005 (0.97), 0.05 (0.78), 0.07 (0.68) at 3rd month. Conclusion: Postoperatively significant angle narrowing was noted. There was a negative correlation between IOP and preoperative ACD. There was no significant correlation between IOP and ICL vault with postoperative AS-OCT angle parameters.
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Affiliation(s)
- Rashmi Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Murugesan Vanathi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Alisha Kishore
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Radhika Tandon
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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27
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Sucu ME, Agca A, Tulu B. One-year follow-up of a new posterior chamber toric phakic intraocular lens implantation for moderate-to-high myopic astigmatism. Int Ophthalmol 2021; 41:2941-2949. [PMID: 33880683 DOI: 10.1007/s10792-021-01853-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate refractive and visual outcomes as well as rotational stability following implantation of Eyecryl phakic toric intraocular lens (pIOL) for moderate-to-high myopic astigmatism. METHODS The efficacy, safety, predictability, stability, and adverse events of Eyecryl toric pIOL were evaluated in patients with spherical refraction from - 4.50 to - 18.50 diopters (D) and cylindrical refraction from - 0.50 to - 5.50 D. RESULTS This study included 60 eyes of 31 patients. The mean manifest refraction spherical equivalent (MRSE) dropped from - 10.45 ± 2.74 D preoperatively to - 0.34 ± 0.51 D and - 0.40 ± 0.56 D at 6 and 12 months postoperatively, respectively. There was an 81% decrease in astigmatism after surgery. The safety and efficacy of indices were 1.36 ± 0.43 and 1.20 ± 0 .32. At the final follow-up, the rate of eyes within ± 1.00 D and ± 0.50 D of the desired MRSE were 85% and 68.33%, respectively. Vision-threatening complications were not observed during the follow-up. CONCLUSIONS The implantation of pIOL was effective, safe, and predictable in patients with moderate-to-high myopic astigmatism during 1-year follow-up.
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Affiliation(s)
- M E Sucu
- Department of Ophthalmology, Idil State Hospital, 73300, Şırnak, Turkey.
| | - A Agca
- Ataköy Dünya Göz Hospital, Istanbul, Turkey
| | - B Tulu
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
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28
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Buckhurst PJ, Wolffsohn JS, Davies LN, Naroo SA. Surgical correction of astigmatism during cataract surgery. Clin Exp Optom 2021; 93:409-18. [PMID: 20735787 DOI: 10.1111/j.1444-0938.2010.00515.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Phillip J Buckhurst
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
| | - James S Wolffsohn
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
| | - Leon N Davies
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
| | - Shehzad A Naroo
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
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29
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Zhuang ZM, Li HY, Tan SJ. Toric intraocular collamer lens with anterior chamber maintainer for myopic astigmatism following penetrating keratoplasty: a case report. Int J Ophthalmol 2021; 14:330-332. [PMID: 33614467 DOI: 10.18240/ijo.2021.02.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Zong-Ming Zhuang
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.,Jingliang Eye Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Hao-Yu Li
- Jingliang Eye Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Shao-Jian Tan
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.,Jingliang Eye Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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30
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Jabbour S, Bower KS. Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement ("Bioptics") in the Treatment of High Myopic Astigmatism. Clin Ophthalmol 2021; 15:635-643. [PMID: 33623364 PMCID: PMC7896759 DOI: 10.2147/opth.s283888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Describe three-year outcomes of spherical implantable Collamer lens (ICL) followed by excimer laser enhancement (bioptics) in eyes with high myopic astigmatism. Patients and Methods Retrospective case series of thirty-four cases that underwent bioptics enhancement at the Johns Hopkins Wilmer Eye Institute. All eyes had a preoperative sphere of −6.00 D or more with a cylinder of at least 2.00 D. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest spherical equivalent refraction (MSE), ICL vault measurements and central corneal thickness (CCT) were collected. Endothelial cell counts (ECC), root mean square (RMS) of higher order aberrations (HOAs), adverse events and subsequent surgeries were also assessed. Results All patients had a minimum follow-up of 3 years. Preoperative UDVA was 2.29 ± 0.46 logMAR and improved to 0.03 ± 0.23 logMAR at 3 years (p<0.05). MSE was −12.30 ± 4.05 preoperatively and changed to −0.21 ± 0.46 at 3 years (p<0.05). The efficacy and safety indices were 1.28 ± 0.32 and 1.47 ± 0.27 at 3 years post-enhancement. HOA did not significantly change throughout the follow-up (p<0.05). Endothelial cell loss at 12 months was calculated at 5.7%. Two eyes required ICL exchange due to vault-related issues. Conclusion Bioptics offered excellent long-term safe, predictable, and efficient outcomes for high myopic astigmatism and can be considered an option if toric ICL is not available. Results confirm that wavefront-guided photoablation remains an excellent option to manage residual refractive error after phakic IOL.
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Affiliation(s)
- Samir Jabbour
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kraig S Bower
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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31
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Nie D, Yan P, Yan Z, Zhang J, He W, Li M, Sun L, Huang M, Liu X, Lin H. Polar value analysis of astigmatic change and rotational stability after implantation of V4c toric implantable collamer lens. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:139. [PMID: 33569441 PMCID: PMC7867885 DOI: 10.21037/atm-20-7835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background To evaluate the clinical results and rotational stability of V4c toric implantable collamer lens (TICL, STAAR Surgical Company, Monrovia, CA, USA) in patients with moderate to high myopic astigmatism. Retrospective, interventional case series was performed at Shenzhen Eye Hospital, Shenzhen, Guangdong, China. Methods This study enrolled 43 patients (72 eyes) who received TICL implantation to correct myopia and myopic astigmatism. The patients underwent visual and refractive examinations before and 1 month after surgery. Astigmatic changes were estimated using polar value analysis. The difference between the achieved axis and the intended axis at the last follow-up was taken as the rotation of the V4c TICL. Results At 1 month postoperatively, the mean safety and efficacy indices were 1.17 and 1.13, respectively. A significant reduction of 8.92±2.58 D was observed in the spherical equivalent refraction (SER), which decreased from −9.29±2.41 D preoperatively to −0.37±0.55 D postoperatively. The astigmatic error of treatment in cylinder format was calculated to 0.50±0.41 @ 15.08° relative to the preoperative stronger meridian at 1 month, postoperatively. At 1 month postoperatively, the mean absolute rotation was 8.30±10.00 degrees (median =5.46 degrees; range, 0.00–58.88 degrees). Conclusions TICL could achieve good astigmatic outcomes for correcting moderate to high myopic astigmatism. After TICL implantation, corneal astigmatism remained unchanged. To optimize postoperative astigmatic outcomes in TICL, polar value analysis can be used to build a nomogram.
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Affiliation(s)
- Danyao Nie
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Pisong Yan
- Cloud Intelligent Care Technology (Guangzhou) Co. Ltd., Guangzhou, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Jing Zhang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Wenling He
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Ming Li
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Liangnan Sun
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Mingquan Huang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Xinhua Liu
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
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Moshirfar M, Thomson RJ, West Jnr WB, McCabe SE, Sant TM, Shmunes MH, Ronquillo YC, Hoopes PC. Visual Outcomes After Sequential Posterior Chamber Phakic IOL with Corneal Refractive Surgery (Bioptics) for the Treatment of Myopic Astigmatism. Clin Ophthalmol 2020; 14:4337-4346. [PMID: 33328722 PMCID: PMC7734069 DOI: 10.2147/opth.s285140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/06/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To report the outcomes of sequential posterior chamber phakic intraocular lens (PC-pIOL) with corneal refractive surgery in conventional (PC-pIOL prior to refractive surgery) and reverse (refractive surgery prior to PC-pIOL) bioptics for treating high myopic astigmatism. Setting Tertiary refractive center, Draper, Utah, USA. Design Retrospective case series. Methods Medical records of patients who underwent planned bioptics were reviewed. Surgery involved PC-pIOL placement using an implantable collamer lens (ICL) with preceding or subsequent LASIK or PRK. Pre- and postoperative manifest spherical equivalent (SEQ), visual acuity, and PC-pIOL vault were analyzed. Results Of the 51 eyes present at 12 months postoperatively, 49 eyes (96%) achieved target SEQ within ±1.00 D and an identical amount achieved refractive astigmatism ≤1.00 D. Post-bioptics eyes achieved a postoperative UDVA equal to or better than preoperative CDVA in 45 eyes (88%). Efficacy and safety indices were 1.08 ± 0.20 (41 eyes) and 1.13 ± 0.22 (44 eyes) for conventional bioptics and 0.99 ± 0.42 (7 eyes) and 1.15 ± 0.38 (7 eyes) for reverse bioptics eyes at 12 months. The maximum PC-pIOL vault of conventional bioptics eyes (27 eyes) within 6 months before and after LASIK/PRK was 385 ± 159 μm and 377 ± 135 μm, respectively (P = 0.71). Conclusion Bioptics for high myopic astigmatism was safe and effective. Reverse bioptics, although not as traditional, could provide similar results. Additionally, the PC-pIOL vault does not appear to be affected by LASIK/PRK.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.,Utah Lions Eye Bank, Murray, UT, USA
| | - Robert J Thomson
- McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Shannon E McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,Mission Hills Eye Center, Pleasant Hill, CA, USA
| | - Thomas M Sant
- University of Utah School of Medicine, Salt Lake City, UT, USA
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Chaitanya SR, Anitha V, Ravindran M, Ghorpade A, Rengappa R, Uduman MS. Safety and efficacy of toric implantable collamer lens V4c model - A retrospective South Indian study. Indian J Ophthalmol 2020; 68:3006-3011. [PMID: 33229687 PMCID: PMC7856968 DOI: 10.4103/ijo.ijo_1492_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the safety, efficacy, and complications of V4c Toric implantable collamer Lens (TICL) implantation for myopic astigmatism in the south Indian population. Methods: In this retrospective observational case series, a total of 109 eyes of 67 patients who underwent V4c TICL implantation (ICL, V4C Staar Surgical, Nidau, Switzerland) between January 2012 and August 2019 were studied with a minimum follow-up period of 6 months (mean 24 months). The main outcome measures were objective and subjective refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), safety, predictability, adverse events, and postoperative complications. Results: At 6 months, mean manifest refractive spherical equivalent (SE) decreased from - 10.90 ± 3.7D preoperatively to - 0.02 ± 0.13D postoperatively (P < 0.001) and mean cylinder decreased from - 2.3 ± 1.3 D preoperatively to - 0.04 ± 0.2 D postoperatively (P < 0.001). Postoperatively, SE within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 96.3 (105 eyes) and 100% (109 eyes), respectively. Manifest refractive cylinder within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 97.2 (106 eyes) and 100% (109 eyes), respectively. Sixty-two percent (68 eyes) showed no change in CDVA postoperatively, and no eye had lost lines of CDVA. The safety index was 1.12, and the efficacy index was 1.10. Complications were seen in two eyes (1.8%) due to high postoperative vault requiring secondary surgical interventions. Conclusion: V4c TICL is a highly effective, safe, and predictable option in treating myopic astigmatism with excellent improvement in vision and spectacle independence.
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Affiliation(s)
- S Ravi Chaitanya
- Fellow in Cornea and External Diseases, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Venugopal Anitha
- HOD, Cornea and Refractive Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Meenakshi Ravindran
- HOD, Paediatric and Strabismus Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Aditya Ghorpade
- Consultant, Cornea and External Diseases, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Ramakrishnan Rengappa
- Prof of Ophthalmology, Glaucoma Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Mahammed Sithiq Uduman
- Statistics, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
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Ghoreishi M, Kashfi A, Peyman M, Mohammadinia M. Comparison of Toric Implantable Collamer Lens and Toric Artiflex Phakic IOLs in Terms of Visual Outcome: a Paired Contralateral Eye Study. Am J Ophthalmol 2020; 219:186-194. [PMID: 32621900 DOI: 10.1016/j.ajo.2020.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study sought to compare the postoperative visual outcomes of toric implantable collamer lens (T-ICL) with toric Artiflex (T-Artiflex) lenses. DESIGN Alternating treatment, contralateral eye matched clinical study. METHODS This study compared 82 eyes of 41 patients with T-ICL lenses in one eye and toric Artiflex implantation in the contralateral eye to correct myopic astigmatism. Safety, efficacy, predictability, astigmatic vector changes, contrast sensitivity, endothelial cell count, and possible adverse events were assessed at least 12 months postoperatively. RESULTS After a mean follow-up of 12 months, the safety index was mean 1.40 ± 0.70 in the T-ICL group and 1.20 ± 0.21 in the T-Artiflex group. Furthermore, their mean efficacy indexes were 1.24 ± 0.42 and 1.08 ± 0.23, respectively (P = .029). A total of 39 eyes (95%) in the T-ICL group and 41 eyes (100%) in the T-Artiflex group were within ±1.00 diopter (D) of emmetropia and 33 eyes (80%) and 34 eyes (83%) were within ±0.5 D of emmetropia, respectively. Vector analysis revealed mean index of success as large as 0.25 ± 0.22 in the T-ICL group and 0.24 ± 0.15 in the T-Artiflex group. Postoperative contrast sensitivities were equal in both groups under mesopic conditions for any given spatial frequency. There was an endothelial loss of 2.18% and 1.95% in the T-ICL and T-Artiflex groups, respectively. There were no significant complications in any of the groups. CONCLUSIONS Both lenses showed promising results in terms of safety, efficacy, and predictability for correction of myopic astigmatism. As shown in this paired-eye study, most outcomes were almost identical, and neither of these lenses were clinically superior to the other.
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Cerpa Manito S, Sánchez Trancón A, Torrado Sierra O, Baptista AMG, Serra PM. <p>Inter-Eye Vault Differences of Implantable Collamer Lens Measured Using Anterior Segment Optical Coherence Tomography</p>. Clin Ophthalmol 2020; 14:3563-3573. [PMID: 33154615 PMCID: PMC7605967 DOI: 10.2147/opth.s258817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/12/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | | | | | - Pedro Miguel Serra
- Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain
- Optics and Optometry Department, Instituto Superior de Educação e Ciências, Lisbon, Portugal
- Correspondence: Pedro Miguel Serra Email
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Wan T, Yin H, Wu Z, Yang Y. Vector analysis of small incision lenticule extraction and toric implantable collamer lens implantation for astigmatism correction. Eur J Ophthalmol 2020; 31:994-1001. [PMID: 32468871 DOI: 10.1177/1120672120930607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis. METHODS In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis. RESULTS At 3-months postoperatively, the residual cylinder was -0.10 ± 0.21 D in the SMILE group and -0.30 ± 0.32 D in the TCL group (p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, -0.19 ± 0.25, -2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, -0.05 ± 0.20, -0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group (p < 0.05). CONCLUSION Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.
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Affiliation(s)
- Ting Wan
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Houfa Yin
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhiyi Wu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yabo Yang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Yu Y, Zhang C, Zhu Y. Femtosecond laser assisted cataract surgery in a cataract patient with a "0 vaulted" ICL: a case report. BMC Ophthalmol 2020; 20:179. [PMID: 32370735 PMCID: PMC7201666 DOI: 10.1186/s12886-020-01440-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Femtosecond laser assisted cataract surgery (FLACS) combined with implantable collamer lenses (ICLs) extraction has been shown to be a feasible method for patients developing cataracts after the ICL implantation. All reported cases had shallow vaults, ranging from 47 μm (μm) to 100 μm. We report for the first time, a case in which the FLACS was performed on the "0" vault eye. CASE PRESENTATION A 38-year-old man with anterior subcapsular cataracts underwent the FLACS combined with ICLs extraction 6 years after ICLs implantation in both eyes. In his left eye, the ICL touched the anterior capsule, existing "0" vault. During the capsulotomy, cavitation bubbles were trapped in the shallow space beneath the ICL, developing from small bubbles into big ones, which resulted in the incomplete capsulotomy. Comparatively, in the right eye, the ICL vault was measured 72 μm, and the capsulotomy was complete and no big cavitation bubbles formed. In both eyes, capsulotomy zones were manually assigned to the anterior capsule surface in the process of laser identification. However, the nuclear pre-fragmentations were unsuccessful in both eyes. Other steps of surgeries were performed uneventfully. Depending on the design of monovision, the uncorrected distance visual acuity (UDVA) was 20/32, and the near uncorrected visual acuity (UCVA) was 20/25 in both eyes postoperatively. CONCLUSIONS This case suggested that the surgeon should pay attention to the incomplete laser capsulotomy when using a femtosecond laser in cataractous cases with "0" vaulted ICLs, and manual adjustment was required in the process of laser identification.
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Affiliation(s)
- Yibo Yu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, China
| | - Chengshou Zhang
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, China
| | - Yanan Zhu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, China.
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Choi JH, Lim DH, Nam SW, Yang CM, Chung ES, Chung TY. Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia. J Cataract Refract Surg 2019; 45:1555-1561. [DOI: 10.1016/j.jcrs.2019.06.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
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Nakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y. Posterior Chamber Phakic Intraocular Lens Implantation for the Correction of Myopia and Myopic Astigmatism: A Retrospective 10-Year Follow-up Study. Am J Ophthalmol 2019; 206:1-10. [PMID: 31078536 DOI: 10.1016/j.ajo.2019.04.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/10/2019] [Accepted: 04/23/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the 10-year clinical outcomes of implantable collamer lens (ICL) implantation for myopia and astigmatism. DESIGN Retrospective observational case series. METHODS This study included 114 eyes of 61 patients who underwent ICL implantation for correction of myopia and myopic astigmatism. We assessed the safety, efficacy, predictability, stability, and adverse events preoperatively, at 6 months (106 eyes) and 1 (94 eyes), 3 (58 eyes), 5 (65 eyes), 8 (89 eyes), and 10 (70 eyes) years postoperatively. Only the eyes with clinical data available at each follow-up time were analyzed. RESULTS The mean logMAR uncorrected and corrected distance visual acuities were -0.01 ± 0.24 and -0.18 ± 0.07 at 10 years postsurgery. The mean indices for safety and efficacy were 0.88 ± 0.15 and 0.66 ± 0.26, respectively. At 10 years postsurgery, 71.4% and 87.1% of the eyes were within 0.5 and 1.0 diopters (D), respectively, of the attempted spherical equivalent correction. The mean intraocular pressure was 13.1 ± 2.4 mmHg preoperatively and 13.1 ± 2.9 mmHg at 10 years postoperatively. The mean endothelial cell loss was 5.3% at 10 years postsurgery. Twelve of 114 eyes (10.5%) developed anterior subcapsular cataract during 5-10 years' follow-up; among these, 4 eyes (3.5%) were symptomatic and ICL explantation and phacoemulsification surgery were performed. No vision-threatening complications occurred during the observation period. CONCLUSION ICL implantation offered good overall outcomes in all measures of safety, efficacy, predictability, and stability for the correction of myopia and myopic astigmatism throughout a long-term follow-up period of 10 years.
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Affiliation(s)
| | | | - Takashi Kojima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Takagi Y, Nakamura T, Ichikawa K, Kojima T. Recurrent prolapse of toric implantable collamer lens after blunt ocular trauma under mesopic conditions. Clin Case Rep 2019; 7:626-629. [PMID: 30997050 PMCID: PMC6452523 DOI: 10.1002/ccr3.2055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 12/03/2022] Open
Abstract
Implantable collamer lenses (ICL) carry a risk of prolapse caused by direct ocular trauma, especially in mesopic conditions and when oversized ICLs are implanted. We recommend early surgical repositioning, as well as patient education that encourages goggle use during active sports.
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Affiliation(s)
- Yuki Takagi
- Department of OphthalmologyIida Municipal HospitalNaganoJapan
| | | | | | - Takashi Kojima
- Department of OphthalmologyKeio University School of MedicineTokyoJapan
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Fernández-Vega-Cueto L, Lisa C, Esteve-Taboada JJ, Montés-Micó R, Alfonso JF. Implantable collamer lens with central hole: 3-year follow-up. Clin Ophthalmol 2018; 12:2015-2029. [PMID: 30349185 PMCID: PMC6188208 DOI: 10.2147/opth.s171576] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the long-term predictability, stability, safety, and efficacy of the V4c Visian implantable collamer lens (ICL) with central hole to correct myopia. Patients and methods One hundred and eighty-four eyes of 92 patients were evaluated during 3 years after implantation of the V4c ICL. The refraction, uncorrected distance visual acuity, best-corrected distance visual acuity, IOP, endothelial cell count, vault, and adverse effects were evaluated every 12 months during the whole follow-up. Results The mean spherical equivalent dropped from -8.30±2.98 D preoperatively to −0.37±0.47 D at 36 months post-surgery, with 91.8% eyes being within ±1.00 D of emmetropia. With respect to the astigmatic components J0 and J45, 98.4% and 99.5% of eyes, respectively, were within ±0.50 D of the desired refraction. At 36 months, 78.8% of eyes had no change in the Snellen lines of best-corrected distance visual acuity, while 8.7% gained one line and 6.5% gained two or more lines; mean safety and efficacy indexes were 1.03 and 0.90, respectively. Mean endothelial cell count was 2,742±340 cells/mm2 before and 2,663±366 cells/mm2 at 36 months post-surgery. Mean IOP reduced from 13.7±1.9 mmHg preoperatively to 12.8±1.7 mmHg at 36 months post-surgery. Mean vault varied from 409±196 µm at 12 months to 349±165 µm at 36 months. Conclusion The visual and refractive outcomes were very good and highly stable throughout the follow-up period, indicating that this ICL model may be predictable, stable, safe, and effective to correct myopia in the long term.
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Affiliation(s)
| | - Carlos Lisa
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain,
| | - José J Esteve-Taboada
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - José F Alfonso
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain, .,School of Medicine, University of Oviedo, Oviedo, Spain,
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Lee H, Kang DSY, Choi JY, Ha BJ, Kim EK, Seo KY, Kim TI. Rotational Stability and Visual Outcomes of V4c Toric Phakic Intraocular Lenses. J Refract Surg 2018; 34:489-496. [PMID: 30001453 DOI: 10.3928/1081597x-20180521-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/07/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the clinical outcomes and rotational stability following implantation of V4c toric implantable collamer lenses (ICLs) (STAAR Surgical Company, Monrovia, CA) and to analyze the factors that influence rotational stability. METHODS In this prospective observational case series, the authors analyzed the visual outcomes and rotational stability in 52 eyes of 52 patients immediately and 3 and 6 months after implantation. Postoperative rotation was defined as the angle between the adjusted axis and alignment axis. Central vaulting of the ICL was measured in a non-accommodative state using Visante optical coherence tomography (Carl Zeiss Meditec, Jena, Germany). Vector analysis of refractive astigmatism was performed. Regression analysis was used to investigate the association between the degree of rotation 6 months postoperatively and the associated variables. RESULTS The mean efficacy index and safety index 6 months postoperatively were 1.35 ± 0.19 and 1.38 ± 0.22, respectively. In vector analysis, the magnitude of error was -0.20 diopters (D), indicating slight undercorrection. Absolute degree of rotation was 2.81° ± 1.87° immediately after the operation and 3.75° ± 2.92° and 3.87° ± 3.07° at 3 and 6 months postoperatively, respectively (P = .009). Bonferroni-adjusted post-hoc comparison showed that the absolute degree of rotation immediately after the operation was significantly smaller than that after 3 (P = .043) and 6 (P = .023) months, with barely any change after 3 months. No explanatory variable relevant to the absolute degree of rotation was discovered. CONCLUSIONS The V4c toric ICL is predictable, safe, and effective in correcting low and high levels of astigmatism, showing relatively good postoperative rotational stability. [J Refract Surg. 2018;34(7):489-496.].
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Abstract
We report a case of myopic astigmatism, not eligible for laser vision correction and with an anterior chamber depth below that recommended for application of phakic implantable collamer lens. In this case, the only refractive surgery option that remained for the patient was intracorneal ring implantation. The aim of the current presentation was to document the clinical and refractive outcomes after continuous intracorneal ring implantation in both eyes in this patient with myopic astigmatism. The results presented were collected during a 4-year follow-up period. Surgery was performed at Lasik specialty center, Baghdad, Iraq, in 2013.
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Affiliation(s)
- Suzan Amana Rattan
- Department of Surgery, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq,
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Vector Analysis of the Effects of FS-LASIK and Toric ICL for Moderate to High Astigmatism Correction. J Ophthalmol 2018; 2018:6952710. [PMID: 30147948 PMCID: PMC6083598 DOI: 10.1155/2018/6952710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/28/2018] [Accepted: 06/24/2018] [Indexed: 12/26/2022] Open
Abstract
Purpose To estimate the treatment effectiveness of femtosecond-assisted laser in situ keratomileusis (FS-LASIK) and Toric implantable collamer lens (Toric ICL) for moderate and high astigmatism via vector analysis. Materials and Methods The study involved 44 eyes from 44 patients who had a preoperative refractive cylinder ≥1.0 diopters (D) and underwent bilateral FS-LASIK or Toric ICL surgery. The examinations included corrected distance visual acuity measurement and subjective refraction before and 3 months after surgery. The astigmatic changes were estimated using vector analysis. Results No statistically significant differences were found in cylindrical refraction and percentage of spherical equivalent within 0 D, ±0.50 D, ±1.00 D, and ±1.50 D between the FS-LASIK and Toric ICL groups at 3 months after surgery. The parameters of the vector analysis included intended refractive correction, surgically induced refractive correction, error vector, correction ratio, error ratio, error of magnitude, and error of angle, with no significant differences between the groups. However, error ratio the of the off-axis correction in the FS-LASIK and Toric ICL groups was 4.11 ± 3.02 and 8.11 ± 3.82, respectively, and the difference was significant (t = −2.46, p=0.02). Conclusion Both FS-LASIK and Toric ICL were effective for correcting moderate and high astigmatism, although Toric ICL might produce a larger error of angle than FS-LASIK when an off-axis correction occurs.
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Long-Term Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation in Young Population. Eye Contact Lens 2018; 44 Suppl 2:S365-S369. [PMID: 29944497 DOI: 10.1097/icl.0000000000000497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the clinical outcomes and vision-related quality of life after implantable collamer lens (ICL) implantation for younger patients (17 years ≤ age ≤21 years) and for older patients (age >21 years). METHODS Design: Retrospective observational study. This study-enrolled patients underwent ICL implantation and finished 5-year follow-up who were divided into two groups based on age. Uncorrected distance visual acuity and corrected distance visual acuity (CDVA), refractions for the evaluation of efficacy, safety, stability, and predictability, intraocular pressure, corneal endothelial cell, ICL vaults, higher-order aberration (HOA), contrast sensitivity (CS) functions, adverse events, and quality of life were evaluated on 1, 3, 7, 14 days, 1, 3, 6 months and 1, 3, 5 years after surgery. RESULTS The study enrolled 164 eyes (82 patients), 84 in younger group (17 years ≤ age ≤21 years) and 80 in older group (age >21 years). The mean postoperative log of minimal angle of resolution CDVA of younger group was better than those of older group. The mean spherical equivalent values were more myopic in younger group than older group. As for CS and HOA, the younger and older groups showed similar data. The NEI-RQL scores of dependence on correction, worry, suboptimal correction, appearance, and satisfaction of older group were higher, whereas the score of symptom and near vision was worse. Both groups showed similar results in vaults, endothelial cell density and adverse events. CONCLUSIONS The ICL performed well for the ametropia correction of both younger and older patients throughout the 5-year period. In the younger group, the visual quality was even better, but the myopic shift was quicker.
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Zhang X, Chen X, Wang X, Yuan F, Zhou X. Analysis of intraocular positions of posterior implantable collamer lens by full-scale ultrasound biomicroscopy. BMC Ophthalmol 2018; 18:114. [PMID: 29743110 PMCID: PMC5944172 DOI: 10.1186/s12886-018-0783-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background To analyze the positions of intraocular posterior Implantable Collamer Lens (ICL) and its possible relationship with vault. Methods This cross-sectional study included 72 patients with high myopia (134 eyes) who were followed up after phakic intraocular lens implantation. The postoperative time ranged from 1 week to 7 years. We obtained the images of ICL by using Compact Touch STS UBM and observed the position of ICL in posterior chamber and ciliary sulcus. The horizontal lines vault was measured and recorded. Results There were various positions in the posterior chamber as observed by full-scale ultrasound biomicroscopy and the haptics were inserted at different positions. -Eight seven eyes (64.9%) that obtained ideal vault, 29 eyes (21.6%) had insufficient vaults and 18 eyes (13.4%) had excessive vault. The vault with various positions of haptics was in ideal range (250 μm–750 μm) almost in each group. Three eyes in this study with haptics on the top of ciliary sulcus obtained excessive vault (mean vault, 850.00 ± 70.71 μm) and one eye appeared one side haptics pushing forward the iris. Among five eyes (3.7%) with iridociliary body cysts, three eyes (60%) obtained ideal vault. One eye (0.7%) with ICL decentralization after implantation surgery had an ideal vault, but the patient had serious glare. Conclusions Though ICL in the posterior chamber had different positions and the haptics in most cases were not in the ciliary sulcus, the postoperative vault was almost in the ideal range.
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Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China.
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
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Zhang X, Chen X, Wang X, Zhou X. Iridociliary cysts do not impact on posterior phakic intraocular lens implantation for high myopia correction: A prospective cohort study in 1569 eyes. PLoS One 2018; 13:e0196460. [PMID: 29698452 PMCID: PMC5919658 DOI: 10.1371/journal.pone.0196460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/13/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose To investigate the clinical characters and effect of iridociliary cysts among patients who had undergone posterior phakic intraocular lens implantation. Methods A total 1569 eyes of 866 high myopia patients, who underwent phakic intraocular lens implantation from 1 September 2011 to 31 August 2016, was included in this prospective cohort study. These patients were followed up for more than 12 months postoperatively. Results During the study period, 218 eyes (14%) of 154 patients were diagnosed with iridociliary cysts by ultrasound biomicroscopy. There were 74.3% patients with unilateral cysts and the cysts tended to have occurred in patients ages 20 to 30 years old (22%). The location of the cysts varied with temporal position as the most (50%) and superior position as the least (9.6%). After 1 week postoperative follow-up, there were no significant differences in clinical outcomes between the cysts group and no cysts group, but the proportion of 20/20 or better uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and the 2 types of vector astigmatism. Intraocular pressure (IOP), refraction, and vault remained stable at different time points of the follow-up period, while vault of cysts patients tend to be lower than patients without cysts at more than 12 months. Conclusions Iridociliary cysts were more common than estimated and it had no impact on Phakic Intraocular Lens implantation because there was no clue to show significantly difference on postoperative clinical outcomes between the patients with and without iridociliary cysts in this study.
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Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
- Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, PR China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
- Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, PR China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
- Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, PR China
- * E-mail:
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
- Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, PR China
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A comparison of visual outcome and rotational stability of two types of toric implantable collamer lenses (TICL) : V4 versus V4c. PLoS One 2017; 12:e0183335. [PMID: 28846701 PMCID: PMC5573270 DOI: 10.1371/journal.pone.0183335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the efficacy and rotational stability after implantation of two types of toric implantable collamer lenses (Toric ICL™(TICL);V4 and V4c, STAAR Surgical Co.). STUDY DESIGN Retrospective case series. METHODS This retrospective study evaluated total 48 eyes of 48 patients who underwent the implantation with V4 and V4c TICL with a central hole; A twenty-four eyes of 24 patients with V4 TICL and 24 eyes of 24 patients with V4c TICL with a central hole. Visual acuity, manifest refraction, and intraocular pressure were evaluated before and after surgery. Rotational stability (disparity between the intended axis and achieved axis) was assessed in both groups using digital anterior segment photographs, and vector analysis was also performed. RESULTS Uncorrected visual acuity improved in both groups without significant difference (P = .111). There were no statistical differences between two groups in postoperative SE and cylindrical errors (P = .067 and .384, respectively). The mean value of rotation was 4.17±3.31° and 3.39±2.36° in the V4 and V4c TICL groups, respectively without significant difference (P = .364). Vector analysis of astigmatic correction showed no significant diffrence between two groups. CONCLUSION V4 and V4c TICL have similar efficacy with regard to visual acuity and refractive outcomes and rotational stability.
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Zheng LY, Zhu SQ, Su YF, Zou HY, Wang QM, Yu AY. Comparison between toric and spherical phakic intraocular lenses combined with astigmatic keratotomy for high myopic astigmatism. EYE AND VISION 2017; 4:20. [PMID: 28828390 PMCID: PMC5561629 DOI: 10.1186/s40662-017-0085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 08/09/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND To compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical PIOL combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism. METHODS This study enrolled patients with high myopic astigmatism, including 30 eyes (22 patients) that received a toric PIOL implantation (TICL group), and 32 eyes (24 patients) that received combined AK and a spherical PIOL implantation (AK+ ICL group). The outcomes were compared between the two groups before surgery, and at the following time points after surgery: 1 week, 1, 3, 6 months, and 1, 2 years. RESULTS Preoperatively, the mean manifest spherical equivalent (SE) was -14.14 ± 2.12 D in the TICL group and -14.83 ± 2.79 D in the AK + ICL group (P = 0.28), and the mean manifest refractive cylinder, -2.87 ± 1.09 D and -2.58 ± 0.85 D, respectively (P = 0.28). Two years postoperatively, the mean safety index was 1.53 ± 0.55 in the TICL group and 1.60 ± 0.70 in the AK + ICL group (P = 1.00), and the mean efficacy index, 1.18 ± 0.45 and 1.38 ± 0.52, respectively (P = 0.86). The mean manifest refractive cylinder correction was 1.94 ± 1.07 D in the TICL group and 1.39 ± 0.71 D in the AK + ICL group (P = 0.02). The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0.50 D in both groups. CONCLUSIONS Both TICL implantation and AK + ICL implantation are a good alternative for correction of astigmatism in addition to high myopia. TICL implantation has better predictability in correction of high myopic astigmatism. TRIAL REGISTRATION NCT03202485.
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Affiliation(s)
- Lin-Yan Zheng
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Shuang-Qian Zhu
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Yan-Feng Su
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Hu-Yong Zou
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Qin-Mei Wang
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - A-Yong Yu
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
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Lu Y, Yang N, Li X, Kong J. Four-year Follow-up of the Changes in Anterior Segment After Phakic Collamer Lens Implantation. Am J Ophthalmol 2017; 178:140-149. [PMID: 28342721 DOI: 10.1016/j.ajo.2017.03.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the changes and relationship in central vaulting, flare intensity, and crystalline lens thickness during a follow-up period of 4 years after implantable collamer lens (ICL) implantation in eyes with high myopia. DESIGN Retrospective observational study. METHODS Ninety-eight eyes of 50 patients were followed up with routine measurements of central vaulting, crystalline lens thickness, endothelial cell density, and aqueous flare postoperatively. Data were analyzed by repeated-measures analysis of variance. The relationship between the annual change in crystal lens thickness after surgery and age was evaluated by Pearson correlation coefficient and linear regression. RESULTS There was a continuous reduction in central vaulting and endothelial cell density as well as an increase in crystalline lens thickness in ICL eyes from 1 month onward to 5 years postoperatively (P < .001). Although the trend of variation during the individual visit period was accentuated, the variation turned out to be smaller between 12 and 36 months or 60 months postoperatively (P = .42, P = .65). Aqueous flare intensity increased significantly after surgery and returned to normal 1 year later. Additionally, a positive correlation between patient age and crystalline lens thickness (r = 0.617, P < .0001) was observed in eyes with ICL implantation. CONCLUSIONS The changes in central vaulting, endothelial cell density, and crystalline lens thickness are more prominent during the first year after ICL implantation, tending to be relatively stable afterwards. The anterior inflammation during the early postoperative period synchronizes with the sharp progression of crystalline lens changes within the first year.
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