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Qin Q, Yang L, He Z, Huang Z. Clinical application of TICL implantation for ametropia following deep anterior lamellar keratoplasty for keratoconus: A CONSORT-compliant article. Medicine (Baltimore) 2017; 96:e6118. [PMID: 28225492 PMCID: PMC5348139 DOI: 10.1097/md.0000000000006118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study aimed to investigate the clinical application of phakic toric intraocular collamer lens (TICL) implantation in treating ametropia following deep anterior lamellar keratoplasty (DALK) for patients with keratoconus, especially the effectiveness and safety of high astigmatism and indications of TICL implantation after corneal transplantation. METHODS Using the self-controlled case series observation approach, 9 patients with ametropia (9 eyes) who underwent DALK surgery for keratoconus 1.5 years ago with stitches removed 3 months ago were kept under observation from May 2013 to April 2014 in Ophthalmic Center of Nanjing Drum Tower Hospital affiliated to Nanjing Medical University. TICL implantation was performed in all patients. The uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were examined before surgery and 1 week, 6 months, 1 year, and 2 years after surgery. Corneal astigmatism, corneal thickness, anterior chamber depth, corneal endothelial cell density (ECD), and preoperative and postoperative intraocular pressures at different time points were measured. Intraoperative or postoperative complications of TICL implantation were observed, and the safety of the operation was evaluated. RESULTS The UCVA and BCVA in all operated eyes were better 6 months after surgery than before surgery. The spherical diopter and cylindrical diopter decreased to different degrees after surgery. Six months after surgery, the deviation of TICL axis in all operated eyes was less than 10 degrees, tending to be stable. No severe intraoperative or postoperative complication occurred. CONCLUSION TICL implantation was an optional choice for ametropia correction after DALK surgery, especially in patients with high astigmatism.
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Affiliation(s)
- Qin Qin
- Department of Ophthalmology, Jinling Clinical Medical College of Nanjing Medical University
- Department of Ophthalmology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Jiangsu Province, People's Republic of China
| | - Liping Yang
- Department of Ophthalmology, Jinling Clinical Medical College of Nanjing Medical University
| | - Zifang He
- Department of Ophthalmology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Jiangsu Province, People's Republic of China
| | - Zhenping Huang
- Department of Ophthalmology, Jinling Clinical Medical College of Nanjing Medical University
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Dougherty PJ, Priver T. Refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes. Clin Ophthalmol 2017; 11:273-277. [PMID: 28203053 PMCID: PMC5298816 DOI: 10.2147/opth.s120427] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate visual and refractive outcomes and safety of implantable collamer lens (ICL) implantation in low-to-moderate myopia. Setting Private Practice – Dougherty Laser Vision, Westlake Village, CA, USA. Methods A chart review was performed in 56 (104 eyes) consecutive patients who underwent implantation of the Visian ICL V4 model. Inclusion criteria were age between 21 and 40 years, spherical equivalent between −3.00 D and −10.00 D, and cylinder up to −5 D. Data on visual acuity, refraction, and complications were collected. Results The mean time to the last postoperative visit was 13.1±14.0 months (range, 2 to 50 months). The mean preoperative spherical equivalent was −6.96±1.60 D and the mean preoperative cylinder was −1.03±0.88 D. The mean preoperative corrected distance visual acuity (CDVA) was 20/20 (range, 20/15 to 20/80) that remained unchanged at last postoperative visit. At the last postoperative visit, the spherical equivalent was −0.08±0.01 D and the cylinder was 0.29±0.71 D. Comparison of postoperative uncorrected distance visual acuity (UCDVA) to preoperative CDVA indicated that 27 eyes (26%) had better postoperative UCDVA and 61 eyes (59%) had UDVA equivalent to the preoperative CDVA. Postoperatively, 4 eyes lost 1 line of CDVA and no eyes lost >1 line of CDVA. There were 32 eyes that gained at least ≥1 of CDVA. There were no intraoperative complications. Postoperatively, 3 patients (6 eyes) had dry eye, and 1 patient complained of nighttime halos in 1 eye. At the last postoperative visit, there were no eyes with lens opacity or glaucoma. Conclusion ICL implantation for low and moderate myopia up to −10 D in patients up to 40 years of age was safe, accurate, and efficacious. ICL implantation may be a good alternative to laser in situ keratomileusis for young myopes less than −10.00 D.
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Affiliation(s)
- Paul J Dougherty
- Dougherty Laser Vision, Westlake Village, CA, USA; Jules Stein Eye Institute at the David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Kawamorita T, Shimizu K, Shoji N. Theoretical study on the need for laser iridotomy in an implantable collamer lens with a hole using computational fluid dynamics. Eye (Lond) 2017; 31:795-801. [PMID: 28106892 DOI: 10.1038/eye.2016.279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 09/29/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeAlthough one of the advantages of the Hole-ICL implantation is that laser iridotomy (LI) is unnecessary, the evidence have not been reported from the viewpoint of aqueous humor circulation. We investigated the effect of laser iridotomy (LI) on the fluid dynamics of aqueous humor in an implantable collamer lens (ICL) with a central hole, that is, a Hole-ICL using computational fluid dynamics.MethodsA fluid dynamics simulation was performed using the thermal-hydraulic analysis software FloEFD (Mentor Graphics Corp.). For the simulation, three-dimensional eye models with a conventional ICL (Model ICM, STAAR SURGICAL) and a Hole-ICL were used. The LI diameters were 250 and 500 μm. The flow distribution between the anterior surface of the crystalline lens and the posterior surface of the ICL was also calculated.ResultsThe flow velocity 0.25 mm in front of the center of the crystalline lens in the Hole-ICL without LI, with LI of 250 μm, and with LI of 500 μm was 1.48 × 10-1, 1.20 × 10-1, and 4.52 × 10-2 mm/s, respectively. The flow velocity in the conventional ICL without LI, with LI of 250 μm, and with LI of 500 μm was 1.21 × 10-5, 3.60 × 10-4, and 6.33 × 10-4 mm/s, respectively.ConclusionsThese results suggest that there is less need for LI in a posterior chamber phakic intraocular lens with a central hole from the viewpoint of aqueous humor circulation, although the results can be considered only in an ideal condition and further studies are needed to clarify the effect of LI in clinical practice.
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Affiliation(s)
- T Kawamorita
- Department of Orthoptics and Visual Science, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - K Shimizu
- Sanno Hospital Ophthalmology, Tokyo, Japan
| | - N Shoji
- Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
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Ammar H, Anbar M, Abdellah MM. Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism. Clin Ophthalmol 2017; 11:105-114. [PMID: 28096654 PMCID: PMC5207452 DOI: 10.2147/opth.s122442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism. Patients and methods This study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated. Results This study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B. Conclusion Both procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients.
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Affiliation(s)
- Hatem Ammar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Anbar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Marwa M Abdellah
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
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Cao X, Wu W, Wang Y, Xie C, Shen Y. Comparison Over Time of Vault in Chinese Eyes Receiving Implantable Contact Lenses With or Without a Central Hole. Am J Ophthalmol 2016; 172:111-117. [PMID: 27659350 DOI: 10.1016/j.ajo.2016.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the longitudinal vault changes after implantation of a posterior chamber phakic intraocular lens (pIOL) (Visian implantable contact lens) with (ICL V4c) and without (ICL V4) a central artificial hole for moderate to high myopia in Chinese eyes. DESIGN Retrospective case series. METHODS This study comprised 78 eyes implanted with the ICL V4c model and 82 eyes implanted with the ICL V4 model at our department by the same surgeon. The time course of the postoperative pIOL vault changes was quantitatively assessed using ultrasound biomicroscopy over 6 months. RESULTS There was a trend toward a decrease in all measures of central vault, peripheral vault, and the endothelium-anterior pIOL distance for both central hole pIOL and conventional pIOL over time, although the variance was not statistically significant (all P > .05). There were no significant between-group differences in the amount of the pIOL central vault, peripheral vault, or the endothelium-anterior pIOL distance at any time point after surgery (all P > .05). CONCLUSIONS The time course of the central hole pIOL vault changes is essentially equivalent to that of the conventional pIOL vault, suggesting that the presence of the central hole did not significantly affect the pIOL position.
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Affiliation(s)
- Xinfang Cao
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Weiliang Wu
- Department of Orthopedics, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Wang
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Xie
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ye Shen
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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Zhang X, Tao XC, Li ZW, Zhou WY, Ma P, Zhang CX, Wang YM, Mu GY. Combining corneal crosslinking and phakic toric Implantable Collamer Lenses for the treatment of keratectasia: A case report. Exp Ther Med 2016; 12:1495-1498. [PMID: 27602074 DOI: 10.3892/etm.2016.3481] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/05/2016] [Indexed: 11/06/2022] Open
Abstract
The present study reports the use of a phakic toric Implantable Collamer Lens (ICL) that improved the refraction correction of high myopia and astigmatism in a case of keratectasia following corneal cross-linking. A 31-year-old male was diagnosed with keratectasia 12 years after laser-assisted in situ keratomileusis (LASIK). Following LASIK, the manifest refraction was -3.50-2.25×90 [0.1 logarithmic expression (LogMAR) best corrected visual acuity (BVCA)] in the right eye and -8.00-3.50×175 (0.3 LogMAR BCVA) in the left eye, with a LogMAR uncorrected distance visual acuity (UDVA) of 0.8 and a 'counting fingers' value of 3 ft (CF @3 ft) in the left and right eyes, respectively. Riboflavin/ultraviolet A light (UVA) corneal crosslinking (CXL) was conducted on both eyes. Seven months after cross-linking, LogMAR UDVA was 0.4, the manifest refraction was -2.75-2.50×85 and LogMAR BCVA was 0.1 in the right eye. In the left eye, LogMAR UDVA was CF @3 ft, the manifest refraction was -15.00 and LogMAR BCVA was 0.3. The corneal topography was stable 7 months after CXL. Phakic toric ICL was implanted to correct the refractive error, following which the LogMAR UDVA improved to 0.1 in the right eye and 0.3 in left eye, and visual acuity remained stable for 6 months after ICL implantation. In conclusion, combining riboflavin/UVA corneal cross-linking and phakic toric ICL implantation may be an alternative in the correction of high refractive error in patients with keratectasia.
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Affiliation(s)
- Xiao Zhang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Xiang-Chen Tao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Zhi-Wei Li
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Wei-Yan Zhou
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Ping Ma
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Chun-Xiao Zhang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Yu-Meng Wang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
| | - Guo-Ying Mu
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
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Shimizu K, Kamiya K, Igarashi A, Kobashi H. Long-Term Comparison of Posterior Chamber Phakic Intraocular Lens With and Without a Central Hole (Hole ICL and Conventional ICL) Implantation for Moderate to High Myopia and Myopic Astigmatism: Consort-Compliant Article. Medicine (Baltimore) 2016; 95:e3270. [PMID: 27057883 PMCID: PMC4998799 DOI: 10.1097/md.0000000000003270] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
UNLABELLED The study shows a promising next-generation surgical option for the correction of moderate to high ametropia. Hole implantable collamer lens (ICL), STAAR Surgical, is a posterior chamber phakic intraocular lens with a central artificial hole. As yet, however, no long-term comparison of the clinical results of the implantation of ICLs with and without such a hole has hitherto been conducted. A prospective, randomized, controlled trial was carried out in order to compare the long-term clinical outcomes of the implantation, in such eyes, of ICLs with and without a central artificial hole.Examinations were conducted of the 64 eyes of 32 consecutive patients with spherical equivalents of -7.53 ± 2.39 diopters (D) (mean ± standard deviation) in whom implantation of a Hole ICL was performed in 1 eye, and that of a conventional ICL was carried out in the other, by randomized assignment. Before 1, 3, and 6 months, and 1, 3, and 5 years after surgery, the safety, efficacy, predictability, stability, intraocular pressure, endothelial cell density, and adverse events of the 2 surgical techniques were assessed and compared over time.The measurements of LogMAR uncorrected and corrected distance visual acuity 5 years postoperatively were -0.17 ± 0.14 and -0.24 ± 0.08 in the Hole ICL group, and -0.16 ± 0.10 and -0.25 ± 0.08 in the conventional ICL group. In these 2 groups, 96% and 100% of eyes, respectively, were within 1.0 D of the targeted correction 5 years postoperatively. Manifest refraction changed by -0.17 ± 0.41 D and -0.10 ± 0.26 D occurred in from 1 month to 5 years in the Hole and conventional ICL groups, respectively. Only 1 eye (3.1%), which was in the conventional ICL group, developed an asymptomatic anterior subcapsular cataract.Both Hole and conventional ICLs corrected of ametropia successfully throughout the 5-year observation period. It appears likely that the presence of the central hole does not significantly affect these visual and refractive outcomes. TRIAL REGISTRATION UMIN000018771.
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Affiliation(s)
- Kimiya Shimizu
- From the Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Almalki S, Abubaker A, Alsabaani NA, Edward DP. Causes of elevated intraocular pressure following implantation of phakic intraocular lenses for myopia. Int Ophthalmol 2015; 36:259-65. [PMID: 26265323 DOI: 10.1007/s10792-015-0112-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
Abstract
The purpose of this study is to present the causes and visual acuity outcomes in patients with elevated intraocular pressure (IOP) following implantable collamer lens (ICL) implantation. A chart review identified patients who developed high IOP at any postoperative examination and a minimum follow-up period of 3 months after ICL implantation. Data are reported out to 6 months postoperatively. Outcome measures included causes of elevated IOP, best-corrected visual acuity (BCVA) at last visit, number of glaucoma medications, other interventions, and glaucomatous damage. Elevated IOP occurred in 58 (10.8 %) of 534 eyes that received ICL. The mean age was 28 ± 7.2 years. The preoperative IOP was 16.3 ± 1.2 mmHg. Elevated IOP most commonly occurred on the first postoperative day (23/58 (39.7 %) eyes) due to retained viscoelastic. This was followed by steroid response in 22/58 (37.9 %) eyes at 2-4 weeks postoperatively. IOP elevation in 6 (10.3 %) eyes was related to high ICL vault and pupillary block, and in 4 (6.9 %) eyes due to synechial angle closure. At last visit, BCVA was 20/40 or better in 56/58 (96.6 %) eyes, and 5/58 (8.6 %) eyes remained on glaucoma medications due to persistent steroid response (2 eyes), synechial angle closure glaucoma (1 eye), and other causes (2 eyes). One eye showed glaucomatous damage. Two eyes with high vault and elevated IOP underwent ICL explantation. There is a moderate risk of transiently developing elevated IOP after ICL implantation. Thorough removal of viscoelastic and use of anti-glaucoma medications during steroid use will reduce the majority of cases with postoperative IOP elevation.
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Affiliation(s)
- Salem Almalki
- King Khaled Eye Specialist Hospital, Al Aroubah Road, PO Box 7191, Riyadh, Kingdom of Saudi Arabia.
| | | | | | - Deepak P Edward
- King Khaled Eye Specialist Hospital, Al Aroubah Road, PO Box 7191, Riyadh, Kingdom of Saudi Arabia.,Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
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Canan J, Akkan U, Tuncer K, Elbay A. Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report. Case Rep Ophthalmol 2015; 6:223-7. [PMID: 26265909 PMCID: PMC4519595 DOI: 10.1159/000437013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. METHODS Case report. RESULTS A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. CONCLUSIONS To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.
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Affiliation(s)
- Julide Canan
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Kamiya K, Shimizu K, Ando W, Igarashi A, Iijima K, Koh A. Comparison of vault after implantation of posterior chamber phakic intraocular lens with and without a central hole. J Cataract Refract Surg 2015; 41:67-72. [DOI: 10.1016/j.jcrs.2014.11.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/28/2014] [Accepted: 05/28/2014] [Indexed: 02/08/2023]
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Lee D, Lee SJ, Kyung H. Rotational Stability after Toric Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.4.477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Seung Jae Lee
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Haksu Kyung
- Department of Ophthalmology, National Medical Center, Seoul, Korea
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Price MO, Price FW. Evaluation of the toric implantable collamer lens for simultaneous treatment of myopia and astigmatism. Expert Rev Med Devices 2014; 12:25-39. [PMID: 25418502 DOI: 10.1586/17434440.2015.984685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Myopic astigmatism is a prevalent condition that can be treated with spectacles, contact lenses, or laser refractive surgery. However, these treatment options have functional limitations at higher levels of refractive error. The toric implantable collamer lens is designed to treat a broad range of refractive error, generally up to -18 diopters with +1 to +6 diopters of astigmatism. Approval for a more limited treatment range of up to 15 diopters of myopia with +1 to +4 diopters of astigmatism is being sought in the US, where this device has not yet received marketing approval. Surgical correction of high-myopic astigmatism can be life-altering and allow people to participate in activities that were not previously feasible because of visual limitations. The toric implantable collamer lens is implanted behind the iris and in front of the natural crystalline lens. With earlier lens designs, it was necessary to create an iridectomy or iridotomy to prevent pupillary block. The newest toric implantable collamer lens model has a small central hole that is not visually noticeable. This eliminates the need to create a hole in the iris, thereby enhancing the safety of the procedure.
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Affiliation(s)
- Marianne O Price
- Cornea Research Foundation of America, 9002 N. Meridian St, Suite 212, Indianapolis, IN 46260, USA
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Kamiya K, Shimizu K, Igarashi A, Kobashi H. Factors influencing long-term regression after posterior chamber phakic intraocular lens implantation for moderate to high myopia. Am J Ophthalmol 2014; 158:179-184.e1. [PMID: 24699155 DOI: 10.1016/j.ajo.2014.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 03/18/2014] [Accepted: 03/20/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the factors affecting the long-term regression after posterior chamber phakic intraocular lens (Visian ICL; STAAR Surgical) implantation for myopia. DESIGN Retrospective observational case series. METHODS We retrospectively examined 60 eyes of 35 consecutive patients (age, 38.4 ± 9.3 years [mean ± standard deviation]) with myopic refractive errors of -4.00 to -15.25 diopters (D) undergoing ICL implantation. We assessed the amount of myopic regression from 1 month to 6 years after surgery. Stepwise multiple regression analysis was used to assess the factors affecting the amount of myopic regression. RESULTS The mean myopic regression from 1 month to 6 years after surgery was -0.33 ± 0.71 D (0.75 to -3.00 D). Explanatory variables relevant to the myopic regression were, in order of influence, patient age (partial regression coefficient B = -0.042, P < .0001) and preoperative axial length (B = -0.186, P = .013) (adjusted R(2) = 0.300). No significant correlation was seen with other clinical factors such as sex, preoperative refraction, intraocular pressure, white-to-white distance, anterior chamber depth, central corneal thickness, or mean keratometric readings. CONCLUSIONS Although the great majority of the variance remains unexplained, eyes of older patients and eyes with longer axial length are more predisposed to show greater myopic regression after ICL implantation. These results indicate that not only patient age but also axial length may play some role in predicting the long-term refractive outcomes of this surgical procedure.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Hidenaga Kobashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Alfonso JF, Lisa C, Alfonso-Bartolozzi B, Pérez-Vives C, Montés-Micó R. Collagen copolymer toric phakic intraocular lens for myopic astigmatism: One-year follow-up. J Cataract Refract Surg 2014; 40:1155-62. [DOI: 10.1016/j.jcrs.2013.11.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
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Evaluation of a Toric Implantable Collamer Lens After Corneal Collagen Crosslinking in Treatment of Early-Stage Keratoconus. Cornea 2014; 33:475-80. [DOI: 10.1097/ico.0000000000000094] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Read SA, Vincent SJ, Collins MJ. The visual and functional impacts of astigmatism and its clinical management. Ophthalmic Physiol Opt 2014; 34:267-94. [PMID: 24635572 DOI: 10.1111/opo.12128] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/25/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE To provide a comprehensive overview of research examining the impact of astigmatism on clinical and functional measures of vision, the short and longer term adaptations to astigmatism that occur in the visual system, and the currently available clinical options for the management of patients with astigmatism. RECENT FINDINGS The presence of astigmatism can lead to substantial reductions in visual performance in a variety of clinical vision measures and functional visual tasks. Recent evidence demonstrates that astigmatic blur results in short-term adaptations in the visual system that appear to reduce the perceived impact of astigmatism on vision. In the longer term, uncorrected astigmatism in childhood can also significantly impact on visual development, resulting in amblyopia. Astigmatism is also associated with the development of spherical refractive errors. Although the clinical correction of small magnitudes of astigmatism is relatively straightforward, the precise, reliable correction of astigmatism (particularly high astigmatism) can be challenging. A wide variety of refractive corrections are now available for the patient with astigmatism, including spectacle, contact lens and surgical options. CONCLUSION Astigmatism is one of the most common refractive errors managed in clinical ophthalmic practice. The significant visual and functional impacts of astigmatism emphasise the importance of its reliable clinical management. With continued improvements in ocular measurement techniques and developments in a range of different refractive correction technologies, the future promises the potential for more precise and comprehensive correction options for astigmatic patients.
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Affiliation(s)
- Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Comparison of iris-claw and posterior chamber collagen copolymer phakic intraocular lenses in keratoconus. J Cataract Refract Surg 2014; 40:383-94. [DOI: 10.1016/j.jcrs.2013.07.052] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 02/07/2023]
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Liu TX, Luo X. Stability of axis and patient satisfaction after toric implantable collamer lens implantation for myopic astigmatism. Pak J Med Sci 2014; 29:1371-4. [PMID: 24550956 PMCID: PMC3905361 DOI: 10.12669/pjms.296.3986] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/05/2013] [Accepted: 08/10/2013] [Indexed: 11/21/2022] Open
Abstract
Objectives: To assess the stability of axis and patient satisfaction after toric visian implantable collamer lens (TICL) implantation for moderate to high myopic astigmatism. Methods: Total 33 eyes of 21 consecutive patients who underwent implantation of TICL for the correction of moderate to high myopic astigmatism were recorded and a minimum follow-up of six months was performed. The deviation of axis of TICL was detected from one week to six months postoperatively. The evaluation of the visual functions was done by the same clinician at six months after surgery. Results: The mean refractive cylinder decreased from -2.48±0.91 diopters (D) preoperatively to -0.54±0.25D and -0.50±0.19D at one week and six months after surgery respectively. Mean changes in astigmatism from one week to six months after surgery was 0.03±0.17D. The mean deviation of axis of TICL from one week to six months postoperatively was 2.48±1.25°(range,1°~ 6°) and no TICL required secondary repositioning. 14.3% patients felt difficult about the middle distant visual function (Reading Computer Screen). Evaluations of other visual functions were positive or very positive. Conclusions: Six months after implantation of the TICL, it showed slightly axis rotation and high satisfaction about the visual functions.
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Affiliation(s)
- Tai-Xiang Liu
- Tai-xiang Liu, Zhongshan Ophthalmic centre of Sun Yat-Sen University, Guangzhou 510060, China. Department of Ophthalmology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
| | - Xin Luo
- Xin Luo, Department of Ophthalmology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
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Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. ACTA ACUST UNITED AC 2014. [DOI: 10.5005/jp-journals-10025-1074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Objective
The purpose of this study is to assess the predictability, safety, efficacy and stability of correction of refractive errors in patients with keratoconus using Visian implantable collamer lens (ICL) following collagen cross-linking.
Materials and methods
This prospective, non-comparative study evaluated 20 eyes of 14 patients with keratoconus subjected to implantation of intraocular collamer lens at least 1 year following collagen cross-linking and stable refraction. Mean preoperative myopia was −8.43 ± 5.13 Diopters (D) (–3.5 to −20.0D and mean cylinder was −2.19 ± 1.28D (0.0 to −4.5D). The preoperative spherical equivalent (SE) was −9.52 ± 5.33D (–3.75 to −21.25D). During the 12 months follow-up, uncorrected visual acuity, best corrected visual acuity, refraction, intraocular pressure and vaulting are measured.
Results
At 12 months postoperatively, 90% of eye had refractive cylinder of <1.0D with (p = 0.003) and 20 (100%) eyes was within ±0.75D of sphere at 1 year (r2 = 0.99) and (p = 0.0085). The mean postoperative BCVA in decimal was 0.498 ± 0.232, while the mean preoperative BCVA was 0.484 ± 0.285. The safety index at 12 months was 1.02. The mean postoperative UCVA in decimal was 0.498 ± 0.232 and the mean preoperative BCVA is 0.484 ± 0.29 and the efficacy index at 12 months was 1.01.
Conclusion
Implantation of Visian Intraocular collamer lens is predictable, safe and effective way to correct refractive error in patients with keratoconus following collagen cross-linking.
How to cite this article
Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. Int J Kerat Ect Cor Dis 2014;3(1):29-35.
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Bamashmus MA, Al-Salahim SA, Tarish NA, Saleh MF, Mahmoud HA, Elanwar MF, Awadalla MA. Posterior vitreous detachment and retinal detachment after implantation of the Visian phakic implantable collamer lens. Middle East Afr J Ophthalmol 2013; 20:327-31. [PMID: 24339683 PMCID: PMC3841951 DOI: 10.4103/0974-9233.120019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. Materials and Methods: This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana’a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. Results: Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. Conclusions: Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist.
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Affiliation(s)
- Mahfouth A Bamashmus
- Eye Department, Sana'a University, Sana'a, Republic of Yemen, Cairo, Egypt ; Refractive Surgery Unit, Republic of Yemen, Cairo, Egypt
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Ju Y, Gao XW, Ren B. Posterior chamber phakic intraocular lens implantation for high myopia. Int J Ophthalmol 2013; 6:831-5. [PMID: 24392333 DOI: 10.3980/j.issn.2222-3959.2013.06.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 08/20/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia. METHODS Retrospective case review of 82 eyes (43 patients) undergoing implantable Collamer lens (ICL) placement by a single surgeon (Xiao-Wei Gao) to correct preoperative mean spherical equivalents between -9.00 diopter (D) and -23.00D. Main outcome measures included uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), intraocular pressure (IOP), lens transparency, postoperative uveitis. Visante anterior segment optical coherence tomography (AS-OCT) was used to measure anterior chamber depth (ACD) and the position of ICL. RESULTS Mean follow-up was 6.54±3.26 months (range 3-12 months). Predictability of the manifest spherical equivalent (SE) refraction to within ±1.00D was achieved in 88% of eyes and ±0.50D in 72.5% of eyes. The mean postoperative manifest SE refraction was -1.85±0.72D, with 96.34% of eyes maintaining or gaining ≥1 line(s) of BSCVA. The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD. Of the 7 eyes (8.54%) with a mild transient increase in intraocular pressure (up to 30mmHg), none required a second surgical procedure or prolonged topical medication. There was no loss of lens transparency. Pigmented precipitates were observed in 5 eyes (6.09%). The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm, three months after surgery, the mean ACD was 2.45±0.22mm. Anterior chamber depth showed a statistically significant reduction. One eye (1.22%) had ICL spontaneous rotation, 81 eyes (98.78%) of the lens remained correctly centered. CONCLUSION The implantation of ICL is an effective surgical option for the management of high myopia. But its long time effect and safety still need more time to prove.
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Affiliation(s)
- Yan Ju
- Department of Ophthalmology, No.474 Hospital of Chinese PLA, Urumqi 830013, Xinjiang Uygur Autonomous Region, China
| | - Xiao-Wei Gao
- Department of Ophthalmology, No.474 Hospital of Chinese PLA, Urumqi 830013, Xinjiang Uygur Autonomous Region, China
| | - Bing Ren
- Department of Ophthalmology, No.474 Hospital of Chinese PLA, Urumqi 830013, Xinjiang Uygur Autonomous Region, China
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Wissiak E, Lackner EM, Vidic B, Ardjomand N. Phakic intraocular lenses: past and present. SPEKTRUM DER AUGENHEILKUNDE 2013. [DOI: 10.1007/s00717-013-0190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gomez-Bastar A, Jaimes M, Graue-Hernández EO, Ramirez-Luquin T, Ramirez-Miranda A, Navas A. Long-term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation. Int Ophthalmol 2013; 34:583-90. [PMID: 24114502 PMCID: PMC4028544 DOI: 10.1007/s10792-013-9860-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 09/14/2013] [Indexed: 11/25/2022]
Abstract
To report the long-term refractive outcomes, safety, predictability, efficacy and complications of 349 eyes treated with posterior chamber phakic intraocular lenses (pIOLs). A retrospective review of consecutive clinical cases of patients who underwent spheric implantable collamer lens (ICL) and toric ICL (TICL) implantation. The study included 349 eyes of 216 patients with sphere between +8 to −24 diopters (D) and 0 to −6.5 D of astigmatism. Statistical analysis was performed to identify differences between preoperative and postoperative refractive outcomes. Main outcome measures were preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical errors and spherical equivalent and significant postoperative complications. 194 eyes were treated with TICL and 155 eyes with ICL. The mean age of the patients was 29 ± 6.7 years. The mean preoperative sphere was −10.35 ± 5.1 D (+8 to −24) and the postoperative sphere was −0.09 ± 1.06 D (+3.25 to −6.5), p < 0.001. Preoperative cylinder was −2.63 ± 1.44 (0 to −6.5 D) and postoperative cylinder was −0.97 ± 0.89 D (0 to −3.5), p < 0.001. The preoperative mean spherical equivalent was −11.6 ± 5.12 D (+7.875 to −25.625) and postoperative spherical equivalent was −0.52 ± 1.03 (+2.25 to −6.75), p < 0.001. The mean preoperative UDVA was 1.72 ± 0.49 and postoperative UDVA was 0.23 ± 0.22, p < 0.001. The mean preoperative CDVA was 0.21 ± 0.17 and postoperative CDVA was 0.12 ± 0.138, p < 0.001. The implantation of posterior chamber pIOLs is a safe, predictable and effective strategy to manage refractive errors during long-term follow-up.
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Affiliation(s)
- Arturo Gomez-Bastar
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Chimalpopoca 14, Col Obrera, 06800, Mexico City, Mexico
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Outcome of posterior chamber phakic intraocular lens procedure to correct myopia. Saudi J Ophthalmol 2013; 27:259-66. [PMID: 24371421 DOI: 10.1016/j.sjopt.2013.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To assess the safety and efficacy of the implantable contact lens (ICL™) to treat myopia. DESIGN Clinical, retrospective, single center, non-randomized case series. PARTICIPANTS Sixty-nine eyes of 46 patients with myopia ranging from -3.00 to 25.00 D were included in this study. INTERVENTION Implantation of the ICL™. MAIN OUTCOME MEASURES Uncorrected Visual Acuity (UCVA), refraction, best spectacle corrected visual acuity (BSCVA), adverse events, operative and postoperative complications, subjective assessment and symptoms. RESULTS The mean follow-up was 12.35 ± 6.13 (SD) months (range, 6 months-32 months). At the last visit, 49.20% of eyes had 20/20 or better UCVA compared to preoperative 20/20 or better BSCVA of 31.9% of eyes; 69.23% of eyes had postoperative UCVA better than or equal to preoperative BSCVA. The mean manifest refractive cylinder was 1.93 ± 1.21 D at baseline and 1.00 ± 0.92 D postoperatively. The mean manifest refraction spherical equivalent (MRSE) was -11.70 ± 4.24 D preoperatively and -0.69 ± 1.13 D postoperatively. A total of 69.8% of eyes were within ±0.5 D of the predicted MRSE; 84.1% were within ±1.0 D, and 88.90% were within ±2.0 D. BSCVA of 20/20 or better was achieved in 64.6% of eyes postoperatively, compared to 31.9% preoperatively. Mean improvement in BSCVA was 1line. One eye (1.5%) lost ⩾2 lines of BSCVA at the last visit, whereas 20% of eyes improved by ⩾2 lines. A total of 56.92% of cases gained ⩾1 line of BSCVA and 4.62% of cases lost ⩾1 line. Four ICL lenses were removed without significant loss of BSCVA, and 2 eyes with clinically significant lens opacities were observed. Four eyes (5.8%) developed a pupillary block the first day postoperatively. One eye (1.4%) developed a hypotony and AC shallowing. CONCLUSION Implantation of ICL for the correction of myopia was a safe procedure with good visual and refractive results from the early postoperative period to 1 year. Long-term follow-up is required to confirm the long-term safety of this implant.
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Comparison of optical quality and intraocular scattering after posterior chamber phakic intraocular lens with and without a central hole (Hole ICL and Conventional ICL) implantation using the double-pass instrument. PLoS One 2013; 8:e66846. [PMID: 23825575 PMCID: PMC3692553 DOI: 10.1371/journal.pone.0066846] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 05/13/2013] [Indexed: 01/29/2023] Open
Abstract
Purpose To objectively compare the optical quality and the intraocular scattering after implantation of the posterior chamber phakic implantable collamer lens (Visian ICL™, STAAR Surgical) with and without a central artificial hole for moderate to high ametropia. Methods This retrospective study comprised 28 eyes of 28 consecutive patients undergoing Hole ICL implantation (mean age ± standard deviation, 30.3±5.8 years), and 24 age-matched eyes of 24 patients undergoing conventional ICL implantation (age, 30.4±6.1 years). We quantitatively assessed the postoperative values of MTF cutoff frequency, Strehl ratio, objective scattering index (OSI), and OQAS values (OVs), using an Optical Quality Analysis System™. We compared these postoperative variables between the two groups. Results The mean MTF cutoff frequency, Strehl ratio, OSI, OV100%, OV 20%, and OV9%, were 26.21±8.32 cycles/degree, 0.16±0.04, 1.16±0.57, 0.87±0.28, 0.80±0.35, and 0.80±0.33, respectively, 3 months after Hole ICL implantation. We found no significant differences in the MTF cutoff frequency (Mann Whitney U test, p = 0.59), the Strehl ratio (p = 0.82), the OSI (p = 0.63), or the OVs at contrasts of 100% (p = 0.58), 20% (p = 0.40), and 9% (p = 0.87), between the two groups. Conclusions Both Hole ICL and conventional ICL implantation provides an excellent optical performance including intraocular scattering. Newly developed Hole ICL implantation appears to be essentially equivalent in the optical quality variables to conventional ICL implantation, suggesting that the presence of the central artificial hole does not significantly affect the optical quality and the intraocular scattering after surgery.
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Park SW, Kim MK, Wee WR, Lee JH. Partial visual rehabilitation using a toric implantable collamer lens in a patient with keratoconus: a case report with 20 months of follow-up. KOREAN JOURNAL OF OPHTHALMOLOGY 2013; 27:211-4. [PMID: 23730116 PMCID: PMC3663066 DOI: 10.3341/kjo.2013.27.3.211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Accepted: 09/07/2011] [Indexed: 11/24/2022] Open
Abstract
We report the case of a 37-year-old man with a high myopic keratoconus eye that was treated with a posterior chamber toric implantable collamer lens (ICL) in Korea. The patient had a history of contact lens intolerance and did not want to have a corneal transplantation. His uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity were 0.02 and 0.4 in the left eye, respectively. Preoperatively, the manifest refraction was -12.0 -3.5 × 30A. Postoperatively, the manifest refraction was -1.75 × 180A. UCVA improved markedly after implantation. No intraoperative or postoperative complications were observed during 20 months of follow-up. Toric ICL implantation may be a possible alternative surgical option for the visual rehabilitation of high myopic astigmatism in keratoconus patients with rigid gas permeable contact lens intolerance and in patients who do not want to get a corneal transplant.
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Affiliation(s)
- Sung Wook Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
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Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for moderate to high myopic astigmatism. PLoS One 2013; 8:e56453. [PMID: 23409187 PMCID: PMC3568037 DOI: 10.1371/journal.pone.0056453] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 01/08/2013] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To assess the 3-year clinical outcomes of toric phakic intraocular lens (Visian ICL™; STAAR Surgical) implantation for moderate to high myopic astigmatism. METHODS This retrospective study evaluated fifty eyes of 28 patients who underwent toric ICL implantation for the correction of moderate to high myopic astigmatism and who regularly returned for postoperative examination. Before, and 1, 3, and 6 months after, and 1, 2, and 3 years after surgery, we assessed the safety, efficacy, predictability, stability, and adverse events of the surgery in eyes undergoing toric ICL implantation. RESULTS The logarithm of the minimal angle of resolution (LogMAR) uncorrected visual acuity and LogMAR best spectacle-corrected visual acuity were -0.10 (corresponding to Snellen equivalents 20/16) ± 0.16 and -0.20 (corresponding to 20/12.5) ± 0.07, 3 years postoperatively, respectively. The safety and efficacy indices were 1.16 ± 0.20 and 0.94 ± 0.28. At 3 year, 82% and 98% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of -0.15 ± 0.31 D occurred from 1 month to 3 year. No vision-threatening complications occurred during the observation period. CONCLUSIONS On the basis of the clinical results of this study, toric ICL implantation was good in all measures of safety, efficacy, predictability, and stability for the correction of moderate to high myopic astigmatism throughout a 3-year observation period.
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Pérez-Vives C, Domínguez-Vicent A, Madrid-Costa D, Ferrer-Blasco T, Montés-Micó R. Myopic astigmatism correction: comparison of a Toric Implantable Collamer Lens and a bioptics technique by an adaptive optics visual simulator. Ophthalmic Physiol Opt 2013; 33:114-22. [PMID: 23297759 DOI: 10.1111/opo.12019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/20/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the optical and visual quality of a simulated Toric Implantable Collamer Lens (TICL) and a bioptics technique to treat high myopic astigmatism. METHODS An adaptive optics visual simulator was used to simulate the vision after TICL implantation and a bioptics procedure from the wavefront aberration pattern for moderate and high-myopic astigmatism. Visual acuity (VA) at different contrasts and contrast sensitivity (CS) at 10, 20 and 25 cycles degree(-1) were measured for 3 and 5-mm pupils. Modulation Transfer Function (MTF) and Point Spread Function (PSF) were calculated for a 5-mm pupil. RESULTS At a 3-mm pupil we only found statistically significant differences in VA between the two simulated surgeries at low-contrast for moderate- and high-myopic astigmatism (p < 0.05). Statistically significant differences were found in CS at 3-mm pupil between both procedures at the highest spatial frequency for moderate-myopic astigmatism and at all frequencies for high-myopic astigmatism (p < 0.05). At a 5-mm pupil we found statistically significant differences in VA and CS between both simulated surgeries at all contrasts and frequencies evaluated for both groups (p < 0.05). In all cases VA and CS were better with the TICL than with the bioptics technique. MTFs for the bioptics technique were worse than those computed for the TICL. The TICL showed less spread out of the PSF than the bioptics procedure. CONCLUSIONS Simulated TICL and bioptics procedures provided good optical and visual quality, although TICL implantation provided slightly better outcomes than the bioptics procedure, especially when the pupil diameter was increased.
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Affiliation(s)
- Cari Pérez-Vives
- GIO, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain.
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Jung Y, Kim KH. Comparison of White-to-White Diameters Measured by IOLMaster, Lenstar, Orbscan, and a Manual Method. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.8.1187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yun Jung
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
| | - Kyun Hyung Kim
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
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Lindland A, Heger H, Kugelberg M, Zetterström C. Changes in vaulting of myopic and toric implantable collamer lenses in different lighting conditions. Acta Ophthalmol 2012; 90:788-91. [PMID: 21834924 DOI: 10.1111/j.1755-3768.2011.02224.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the changes in vaulting of myopic and toric Implantable Collamer Lenses (ICLs) in different lighting conditions. METHODS Thirty-seven eyes of 37 patients implanted with a myopic ICL and 26 eyes of 26 patients implanted with a toric ICL were examined using Visante optical coherence tomography (OCT) in photopic (257 lux) and mesopic (2 lux) conditions. Pupil diameter and distance changes between the ICL and adjacent intraocular structures were measured. RESULTS The mean horizontal pupillary diameters in mesopic conditions were 5.3 ± 0.9 (SD) mm. In photopic conditions, a mean decrease of -1.8 ± 0.6 mm [95% confidence interval (95% CI) -2.0 to -1.7; p < 0.0001] was observed. The mean distances between the ICL and the crystalline lens in mesopic conditions were 0.33 ± 0.17 mm. In photopic conditions, a mean decrease of -0.04 ± 0.06 mm (95% CI -0.05 to -0.02; p < 0.0001) in the ICL-crystalline lens distance was found. There was a -0.02 ± 0.04 mm (95% CI -0.03 to -0.01; p = 0.0022) decrease in the anterior chamber depth and a 0.02 ± 0.06 mm (95% CI 0.002 to 0.032; p = 0.0275) increase in the distance between the cornea and the ICL. We found no difference in the change in vaulting between the two ICLs in different lighting conditions. CONCLUSION There is a decrease in the central vaulting of myopic and toric ICLs in photopic conditions. This is due to both posterior movement of the ICL and anterior protrusion of the crystalline lens.
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Affiliation(s)
- Are Lindland
- Department of Ophthalmology, University of Oslo, Oslo, Norway.
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Kamiya K, Nakamura A, Miyake H, Nishimoto H, Shimizu K. Successful toric intraocular lens implantation in a patient with induced cataract and astigmatism after posterior chamber toric phakic intraocular lens implantation: a case report. J Med Case Rep 2012; 6:109. [PMID: 22507132 PMCID: PMC3349471 DOI: 10.1186/1752-1947-6-109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 04/16/2012] [Indexed: 12/01/2022] Open
Abstract
Introduction We report the case of a patient in whom simultaneous toric phakic intraocular lens removal and phacoemulsification with toric intraocular lens implantation were beneficial for reducing pre-existing astigmatism and acquiring good visual outcomes in eyes with implantable collamer lens-induced cataract and astigmatism. Case presentation A 53-year-old woman had undergone toric implantable collamer lens implantation three years earlier. After informed consent was obtained, we performed simultaneous toric implantable collamer lens removal and phacoemulsification with toric intraocular lens implantation. Preoperatively, the manifest refraction was 0, -0.5 × 15, with an uncorrected visual acuity of 0.7 and a best spectacle-corrected visual acuity of 0.8. Postoperatively, the manifest refraction was improved to 0, -0.5 × 180, with an uncorrected visual acuity of 1.2 and a best spectacle-corrected visual acuity of 1.5. No vision-threatening complications were observed. Conclusion Toric intraocular lens implantation may be a good surgical option for the correction of spherical and cylindrical errors in eyes with implantable collamer lens-induced cataract and astigmatism.
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Sari ES, Pinero DP, Kubaloglu A, Evcili PS, Koytak A, Kutlutürk I, Ozerturk Y. Toric implantable collamer lens for moderate to high myopic astigmatism: 3-year follow-up. Graefes Arch Clin Exp Ophthalmol 2012; 251:1413-22. [PMID: 23052720 DOI: 10.1007/s00417-012-2172-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 08/23/2012] [Accepted: 09/27/2012] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND To evaluate the 3-year clinical outcomes after toric implantable collamer lens (ICL) implantation for the management of moderate to high myopic astigmatism. METHODS Thirty-four eyes of 20 patients who underwent toric ICL implantation were reviewed. All eyes completed 3-year follow-up. Uncorrected (UDVA) and corrected (CDVA) distance LogMAR visual acuities, refraction, endothelial cell density (ECD), and surgical complications were evaluated. Vectorial analysis of astigmatic correction was also done. RESULTS A significant improvement in UDVA, CDVA, manifest spherical and cylindrical refraction was observed at 1 week and remained stable after 3 years. Twenty-six eyes (76.5%) gained lines of CDVA, and two eyes (5.9%) showed a loss of 1 line of CDVA. The spherical equivalent (SE) was within ±0.50 D of emmetropia in 18 eyes (52.9%) and within ±1.00 D in 28 eyes (82.4%). Differences between target-induced astigmatism (TIA) and surgically-induced astigmatism (SIA) were statistically significant (p < 0.01), and a trend to undercorrection of the refractive astigmatism was present after 3 years. The magnitude of flattening effect (FE) was found to be significantly lower than the magnitude of TIA (p < 0.01). The magnitude of the torque vector was always positive, with a value below 0.50 D in all cases. No vision-threatening complications were observed during the follow-up. CONCLUSION Toric ICL implantation is an effective and safe surgical option that provides a relatively predictable and stable refractive correction of myopic astigmatism. Further improvements are needed to minimize the degree of undercorrection.
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Alfonso JF, Lisa C, Fernández-Vega Cueto L, Fernandes P, González-Méijome JM, Montés Micó R. Comparison of visual and refractive results of Toric Implantable Collamer Lens with bioptics for myopic astigmatism. Graefes Arch Clin Exp Ophthalmol 2012; 251:967-75. [PMID: 23001585 DOI: 10.1007/s00417-012-2155-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 08/24/2012] [Accepted: 08/29/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To compare visual and refractive results of Toric Implantable Collamer Lens (TICL) and bioptics (ICL plus excimer corneal surgery) to treat myopic astigmatism. METHODS Eighty-one eyes underwent TICL implantation and 83 eyes were treated with bioptics (corneal ablation was performed between 1.5 and 6 months after ICL implantation). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, adverse events, safety, and efficacy were evaluated 12 months postoperatively. RESULTS At 12 months postoperatively, the mean spherical equivalent was -0.15 ± 0.36 diopters (D) in the TICL group and -0.08 ± 0.26 D in the bioptics group (p = 0.099). Sixty-six (81.5 %) and 78 (94.0 %) eyes were within ±0.50 D for TICL and bioptics groups, respectively. The mean Snellen UDVA was not statistically different between both procedures (p = 0.909); 53 (65.4 %) and 54 (65.1 %) eyes achieved at least 20/25 or better in TICL and bioptics groups, respectively. No eye had lost more than two lines of CDVA, and 32.1 % of eyes (26/81) in the TICL group and 57.8 % of eyes (48/83) in the bioptics group had better postoperative UDVA than preoperative CDVA (p < 0.001). Safety was not statistically different between groups (p = 0.464) while efficacy was significantly higher in the bioptics group (p = 0.000). Two eyes with a TICL were treated to correct TICL decentration. CONCLUSIONS Bioptics showed slightly better outcomes in some clinical measures such as uncorrected visual acuity, efficacy, and refractive predictability. TICL implantation shows reliable results similar to bioptics. A single procedure with TICL implantation might be preferred, eliminating the inherent risks of laser treatments and the risks of a second surgical procedure.
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Affiliation(s)
- J F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda Dres Fernández-Vega 114, 33012 Oviedo, Spain.
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Hashemian SJ, Soleimani M, Foroutan A, Joshaghani M, Ghaempanah J, Jafari ME. Toric implantable collamer lens for high myopic astigmatism in keratoconic patients after six months. Clin Exp Optom 2012; 96:225-32. [PMID: 22963113 DOI: 10.1111/j.1444-0938.2012.00800.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 04/06/2012] [Accepted: 05/05/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The aim was to evaluate the safety, efficacy, stability and predictability of posterior chamber collagen copolymer phakic intraocular lens (pIOL) implantation to correct myopia and myopic astigmatism associated with keratoconus. METHODS The unaided vision and visual acuity, refraction and adverse events were measured in 22 keratoconic eyes of 14 patients after using an implantable collamer lens (ICL) (STAAR Surgical Inc.) to correct refractive error. The outcome was evaluated over six months. RESULTS The mean pre-operative spherical equivalent (SE) and cylinder changed from -4.98 ± 2.63 DS and -2.77 ± 0.99 DC to -0.33 ± 0.51 DS and -1.23 ± 0.65 DC, respectively at the end of six months. Before the surgery the mean Snellen decimal visual acuity was 0.63 ± 0.20. The mean unaided vision and visual acuity changed to 0.76 ± 0.23 and 0.85 ± 0.21, respectively at the end of six months. The mean safety and efficacy indices were 1.40 ± 0.32 and 1.24 ± 0.34, respectively. No eye lost a line of visual acuity and 17 eyes (77.3 per cent) gained one or more lines. Fifteen eyes (68.2 per cent) were within 0.50 D and 20 (90.9 per cent) were within 1.00 D of the desired spherical equivalent refraction. There was a change in manifest refraction of 0.09 ± 0.21 (ranging from -0.25 to +0.75) from one week to six months after the surgery. CONCLUSION The clinical outcomes of the current study demonstrate the safety, efficacy and predictability of toric implantable collamer lens in the correction of myopia and myopic astigmatism associated with keratoconus. The patients' refractions achieved early stability and remained stable during the course of the study.
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Affiliation(s)
- Seyed Javad Hashemian
- Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Shimizu K, Kamiya K, Igarashi A, Shiratani T. Intraindividual comparison of visual performance after posterior chamber phakic intraocular lens with and without a central hole implantation for moderate to high myopia. Am J Ophthalmol 2012; 154:486-494.e1. [PMID: 22818905 DOI: 10.1016/j.ajo.2012.04.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/01/2012] [Accepted: 04/02/2012] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare postoperative visual performance after implantable Collamer lenses with and without a central hole (Hole ICL and conventional ICL) are implanted to correct moderate to high myopia. DESIGN Prospective intraindividual comparative study. PATIENTS AND METHODS This study evaluated 58 eyes of 29 patients with spherical equivalents of -7.55 ± 2.09 diopters (D) [mean ± standard deviation] who underwent Hole ICL implantation in one eye and conventional ICL implantation in the other eye by randomization assignment. Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry and a contrast sensitivity unit before and 3 months after surgery, respectively. From the contrast sensitivity, the area under the log CS function was calculated. RESULTS For 4-mm and 6-mm pupils, the changes after Hole ICL implantation in coma-like aberrations, spherical-like aberrations, and total HOAs are similar to those after conventional ICL implantation (P > .05, Wilcoxon signed rank test). The postoperative area under the log CS function was significantly increased after Hole ICL implantation (P < .05), and was equivalent to that after conventional ICL implantation under photopic, mesopic, or mesopic with glare conditions. Subjective symptoms such as glare or halo were also essentially equivalent after Hole ICL and conventional ICL implantation. CONCLUSIONS A newly developed Hole ICL implantation appears to be equivalent in the induction of HOAs and CS function to conventional ICL implantation for the correction of moderate to high myopia, suggesting its viability as a surgical option for the treatment of such eyes, because it does not require additional peripheral iridotomies and may also reduce the risk of cataract formation.
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Affiliation(s)
- Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
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Sheng XL, Rong WN, Jia Q, Liu YN, Zhuang WJ, Gu Q, Sun Y, Pan B, Zhu DJ. Outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of the Toric implantable collamer lens for high myopic astigmatism. Int J Ophthalmol 2012; 5:459-65. [PMID: 22937505 DOI: 10.3980/j.issn.2222-3959.2012.04.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 06/27/2012] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the visual outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of Toric implantable collamer lens (TICL) for the correction of high myopic astigmatism. METHODS In this prospective, nonrandomized clinical study, 54 consecutive eyes of 29 patients with high myopic astigmatism received TICL implantation. To evaluate postoperative axis deviation from the intended axis, a digital anterior segment photograph was taken. The ultrasound biomicroscopy(UBM) was used to observe footplate-position. RESULTS After mean follow-up of 8.6 months, mean manifest refractive cylinder (MRC) decreased 79.3% from (-1.88±1.49)D preoperatively to (0.39±0.61)D postoperatively. MRC within 1.00 D occurred in 68.5% (37/54) of eyes, whereas 48.1% (26/54) had MRC within 0.50 D. Mean manifest refraction spherical equivalent (MRSE) changed from (-12.08±4.22)D preoperatively to (-0.41±0.61)D postoperatively. Uncorrected binocular vision of 20/20 or better occurred in 72.2% (39/54) of patients compared with binocular best-corrected visual acuity (BCVA) of 20/20 or better in 44.4% (24/54) preoperatively. The mean difference between intended and achieved TICL axes was (6.96±8.37)°. Footplates of TICLs were in the ciliary sulcus in 22 eyes (46.3%), below the ciliary sulcus in 32 eyes (53.7%). The angle of TICL rotation had significant correlation with the footplates-position (t=2.127; P=0.045) and the postoperative TICL vaulting (r=-0.516; P=0.000). CONCLUSION The results of our study further support the safety, efficacy and predictability of TICL for the correct high myopic astigmatism. The footplate-position of TICL and vault value should be taken into consideration as two possible risks factors for TICL rotation.
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Affiliation(s)
- Xun-Lun Sheng
- Department of Ophthalmology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750001, Ningxia Hui Autonomous Region, China
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Muñoz G, Cardoner A, Albarrán-Diego C, Ferrer-Blasco T, Belda-Salmerón L. Iris-fixated toric phakic intraocular lens for myopic astigmatism. J Cataract Refract Surg 2012; 38:1166-75. [DOI: 10.1016/j.jcrs.2012.02.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 01/18/2012] [Accepted: 02/18/2012] [Indexed: 11/30/2022]
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Résultats à long terme de l’implantation phaque de chambre postérieure pour la correction des amétropies fortes. J Fr Ophtalmol 2012; 35:402-11. [DOI: 10.1016/j.jfo.2011.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 06/05/2011] [Accepted: 06/23/2011] [Indexed: 11/21/2022]
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Navas A, Tapia-Herrera G, Jaimes M, Graue-Hernández EO, Gomez-Bastar A, Ramirez-Luquín T, Ramirez-Miranda A. Implantable collamer lenses after intracorneal ring segments for keratoconus. Int Ophthalmol 2012; 32:423-9. [DOI: 10.1007/s10792-012-9582-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 04/21/2012] [Indexed: 11/27/2022]
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Factors affecting rotation of a posterior chamber collagen copolymer toric phakic intraocular lens. J Cataract Refract Surg 2012; 38:568-73. [PMID: 22342008 DOI: 10.1016/j.jcrs.2011.11.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 11/03/2011] [Accepted: 11/04/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the correlation between postoperative rotation of the toric Implantable Collamer Lens phakic intraocular lens (pIOL) and associated factors. SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Case series. METHODS The toric pIOL axis was analyzed by calculating the ocular internal cylinder power and axis from the total refractive cylinder and corneal astigmatism using vector analysis (Jaffe and Clayman method). The correlation between the toric pIOL rotation over 6 months postoperatively and the associated factors (ie, age, preoperative manifest refractive sphere, preoperative manifest spherical equivalent, mean keratometric power, axial length, toric pIOL intraoperative fixation angle, postoperative toric pIOL vault [distance between toric pIOL and anterior surface of crystalline lens], toric pIOL spherical power) were evaluated. RESULTS The mean age of the 34 patients (58 eyes) was 35.7 years ± 6.5 (SD). The mean rotation 6 months postoperatively was 4.82 ± 6.98 degrees (range 0.0 to 47.2 degrees). The intraoperative toric pIOL fixation angle and postoperative toric pIOL rotation were significantly correlated (Spearman rank correlation: P=.0096 and R(2) = 0.1140; multiple logistic regression analysis: P=.009). In the 1 eye with significant rotation (47.2 degrees), the toric pIOL was exchanged for a larger toric pIOL. CONCLUSIONS A small toric pIOL rotation occurred during the 6-month follow-up. One cause of rotation could be the intraoperative fixation angle of the toric pIOL. A toric pIOL with a minimum intraoperative fixation angle should be used to prevent postoperative rotation.
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Central vault after phakic intraocular lens implantation: correlation with anterior chamber depth, white-to-white distance, spherical equivalent, and patient age. J Cataract Refract Surg 2012; 38:46-53. [PMID: 22153092 DOI: 10.1016/j.jcrs.2011.07.035] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare the central postoperative vault of a phakic intraocular lens (pIOL) to correct myopia, myopic astigmatism, and hyperopia and identify ocular and lens parameters that might predict the vault amount. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Cohort study. METHODS Three months after implantation of Implantable Collamer Lens pIOLs to correct myopia, hyperopia, and myopic astigmatism, central vault was measured using optical coherence tomography. Patients were divided into groups according to the preoperative anterior chamber depth (ACD) to compare the effects of ACD, white-to-white (WTW) distance, and lens diameter on postoperative pIOL vault. RESULTS Hyperopic pIOLs had statistically significantly lower vault followed by myopic pIOLs and toric pIOLs, which had a higher mean value and narrower range (260 to 860 μm). Measured vaults had a positive correlation with preoperative ACD (r = .32, P<.001) and WTW (r = .29, P<.001) and a negative correlation with preoperative spherical equivalent (SE) (r = -0.21, P<.001) and patient age (r = -0.12, P=.025). Eyes with a vault of 250 μm or less had a shallower ACD than eyes with a vault between 250 μm and 750 μm (mean difference -0.11 mm; P=.012) and those with a vault greater than 750 μm (mean difference -0.25 mm; P<.001). CONCLUSIONS Central vaulting was lower in hyperopic eyes. Current nomograms for pIOL diameter selection based on ACD and WTW might yield ideal vault and may have to be adjusted for older patients, shallower ACD, lower WTW, and lower SE.
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Astigmatism correction: Laser in situ keratomileusis versus posterior chamber collagen copolymer toric phakic intraocular lens implantation. J Cataract Refract Surg 2012; 38:574-81. [PMID: 22321354 DOI: 10.1016/j.jcrs.2011.10.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 10/10/2011] [Accepted: 10/14/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the stability and predictability of astigmatism correction between toric phakic intraocular lens (pIOL) implantation and laser in situ keratomileusis (LASIK). SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Comparative case series. METHODS Consecutive patients who had Implantable Collamer Lens pIOL implantation or LASIK were divided into 3 subgroups according to the amount of refractive cylinder correction (low, 0.00 to 1.25 diopters [D]; moderate, 1.50 to 2.75 D; high, ≥ 3.00 D). Manifest refraction was measured preoperatively and 1, 3, 6, and 12 months postoperatively. Based on these data, the predictability and stability of the refractive cylinder correction, error of the refractive cylinder correction, and error of the refractive cylinder correction axis were evaluated. RESULTS The study comprised 338 eyes (196 patients) in the toric pIOL group and 351 eyes (202 patients) in the LASIK group. In the moderate cylinder subgroup, more eyes were corrected within ± 0.50 D of the postoperative refractive cylinder in the LASIK group (132 eyes [91%]) than in the toric pIOL group (111 eyes [79%]). In the high refractive cylinder subgroup, the error of the refractive cylinder correction in the LASIK group was significantly higher than in the toric pIOL group (P=.032). The postoperative manifest refractive cylinder did not change in either group during the follow-up period. CONCLUSIONS The stability of the refractive cylinder after toric pIOL implantation was as high as after LASIK. Although predictability in the LASIK group was higher than in the toric pIOL group in eyes with moderate refractive cylinder, the toric pIOL group had higher predictability than the LASIK group in eyes with high refractive cylinder.
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Kawamorita T, Uozato H, Shimizu K. Fluid dynamics simulation of aqueous humour in a posterior-chamber phakic intraocular lens with a central perforation. Graefes Arch Clin Exp Ophthalmol 2011; 250:935-9. [DOI: 10.1007/s00417-011-1850-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 10/05/2011] [Accepted: 10/12/2011] [Indexed: 10/16/2022] Open
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Lee SY, Kwon HJ, Ahn HS, Seo KY, Kim EK, Kim TI. Comparison of patient outcomes after implantation of Visian toric implantable collamer lens and iris-fixated toric phakic intraocular lens. Eye (Lond) 2011; 25:1409-17. [PMID: 21852802 DOI: 10.1038/eye.2011.176] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We compared visual and refractive outcomes after implantation of Visian toric implantable collamer lenses (toric ICLs) and iris-fixated toric pIOLs (toric Artisans). PATIENTS AND METHODS A comparative retrospective analysis was performed. Toric ICLs were implanted into 30 eyes of 18 patients, and toric Artisans into 31 eyes of 22 recipients. We measured the logarithms of the minimum angle of resolution of uncorrected visual acuity (logMAR UCVA), logMAR of best spectacle-corrected corrected VA (logMAR BSCVA), MR, SE, and astigmatism (by the power vector method) before surgery and 1, 3, and 6 months thereafter. Differences between patients receiving each type of lens were compared by using a mixed model of repeated measures. RESULTS Visual improvements were evident after operation in both groups. By comparing the attempted to the achieved SE values, we were able to confirm that correction of refractive error was similar in both groups. However, the logMAR UCVA was significantly higher in the toric ICL group at all postoperative time points. Although manifest cylinder power and astigmatism (calculated by using the power vector method) gradually decreased in the toric ICL group, cylinder power 1 month postoperatively increased from -2.62 to -2.75 D; astigmatism was also increased at this time in the toric Artisan group. CONCLUSION The two tested toric pIOLs were similar in terms of the ability to correct refractive error, as assessed 3 months postoperatively. However toric ICLs corrected astigmatism more rapidly and safely. Notably, the large difference in astigmatism level between the two groups 1 month postoperatively indicates that toric ICLs are more effective when used to correct astigmatism.
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Affiliation(s)
- S Y Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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95
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Biermann J, Bredow L, Boehringer D, Reinhard T. Evaluation of ciliary sulcus diameter using ultrasound biomicroscopy in emmetropic eyes and myopic eyes. J Cataract Refract Surg 2011; 37:1686-93. [PMID: 21752592 DOI: 10.1016/j.jcrs.2011.03.048] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 02/01/2011] [Accepted: 03/11/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE To measure the ciliary sulcus-to-sulcus (STS) diameter in 4 axes in emmetropic and myopic eyes using ultrasound biomicroscopy (UBM) and compare the measurements with automated horizontal white-to-white (WTW) diameter measurements. SETTING University Eye Hospital Freiburg, Freiburg im Breisgau, Germany. DESIGN Evaluation of diagnostic technology. METHODS The STS diameter was measured at 0, 45, 90, and 135 degrees using 35 MHz UBM. The 0-degree WTW diameters were obtained using scanning-slit topography (Orbscan) and partial coherence interferometry (PCI) biometry (IOLMaster). The 0-degree STS and 90-degree STS were compared using the paired t test; the Pearson correlation was used to assess whether the 0-degree STS diameter could be predicted from the 0-degree WTW diameter. RESULTS The mean SE refraction was -0.48 diopter (D) ± 0.35 (SD) in emmetropic eyes and -9.55 ± 3.70 D in myopic eyes. In 35 of 37 eyes, 90-degree STS was greater than 0-degree STS. The mean 90-degree STS was 12.51 ± 0.43 mm. The mean 0-degree STS was 12.19 ± 0.47 mm (P<.01). The mean 0-degree WTW diameters were 11.73 ± 0.37 mm (scanning-slit topography) and 12.20 ± 0.42 mm (PCI biometry). The correlations were good between 0-degree STS and 0-degree WTW with PCI biometry (r(2) = 0.82) and scanning-slit topography (r(2) = 0.86) in emmetropic eyes but weak between 0-degree STS and 0-degree WTW in myopic eyes (r(2) = 0.36 and r(2) = 0.40, respectively). CONCLUSIONS Sulcus diameter measurements were most precise using UBM. The ciliary sulcus is vertically oval. The WTW diameter is not suitable for calculating a PC pIOL diameter, particularly in myopic eyes.
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Affiliation(s)
- Julia Biermann
- University Eye Hospital Freiburg, Freiburg im Breisgau, Germany.
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Fernandes P, González-Méijome JM, Madrid-Costa D, Ferrer-Blasco T, Jorge J, Montés-Micó R. Implantable collamer posterior chamber intraocular lenses: a review of potential complications. J Refract Surg 2011; 27:765-76. [PMID: 21710954 DOI: 10.3928/1081597x-20110617-01] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 05/27/2011] [Indexed: 01/31/2023]
Abstract
PURPOSE To review the peer-reviewed literature reporting postoperative complications of the most recent models of Visian Implantable Collamer posterior chamber intraocular lenses (ICL, STAAR Surgical Co). METHODS A literature search of the PubMed database was performed to identify all articles related to ICL complications. Articles were obtained and reviewed to identify those that reported complications using the latest ICL designs. RESULTS Cataract was the major postoperative complication reported: 136 (5.2%) in 2592 eyes. Of those, 43.4% (n=59) were reported within 1 year, 15.4% (n=21) between 1 and 3 years, and 35.3% (n=48) ≥ 3 years after ICL implantation. Twenty-one (15.4%) cataracts were reported as surgically induced, 46 (33.8%) eyes had poor vault (<200 μm), and cataract surgery was carried out in 27.9% (n=38) of eyes. Early acute intraocular pressure increase was also reported to be relatively frequent, whereas acute pupillary block was less frequent and mostly resolved with additional iridotomies. A total of 42 ICLs were explanted due to cataract and IOP. Reported endothelial cell loss varied from 9.9% at 2 years to 3.7% 4 years postoperatively. This loss was reported to be more pronounced within the first 1 to 2 years, with stability or lower progression after that time. CONCLUSIONS The majority of reported complications after ICL implantation are cataract formation. The improvements in lens geometry and more accurate nomograms applied to the selection of the lens to be implanted, in addition to the surgeon's learning curve, might be factors in the decreased occurrence of postoperative complications reported currently.
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Alfonso JF, Baamonde B, Fernández-Vega L, Fernandes P, González-Méijome JM, Montés-Micó R. Posterior chamber collagen copolymer phakic intraocular lenses to correct myopia: Five-year follow-up. J Cataract Refract Surg 2011; 37:873-80. [DOI: 10.1016/j.jcrs.2010.11.040] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 10/21/2010] [Accepted: 11/03/2010] [Indexed: 11/30/2022]
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98
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Mertens EL. Toric phakic implantable collamer lens for correction of astigmatism: 1-year outcomes. Clin Ophthalmol 2011; 5:369-75. [PMID: 21468348 PMCID: PMC3065582 DOI: 10.2147/opth.s7259] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Indexed: 12/04/2022] Open
Abstract
Purpose: The purpose of this study was to assess predictability, efficacy, safety and stability in patients who received a toric implantable collamer lens to correct moderate to high myopic astigmatism. Methods: Forty-three eyes of 23 patients underwent implantation of a toric implantable collamer lens (STAAR Surgical Inc) for astigmatism correction. Mean spherical refraction was −4. 98 ± 3.49 diopters (D) (range: 0 to −13 D), and mean cylinder was −2.62 ± 0.97 D (range: −1.00 to −5.00 D). Main outcomes measures evaluated during a 12-month follow-up included uncorrected visual acuity (UCVA), refraction, best-corrected visual acuity (BCVA), vault, and adverse events. Results: At 12 months the mean Snellen decimal UCVA was 0.87 ± 0.27 and mean BCVA was 0.94 ± 0.21, with an efficacy index of 1.05. More than 60% of the eyes gained ≥1 line of BCVA (17 eyes, safety index of 1.14). The treatment was highly predictable for spherical equivalent (r2 = 0.99) and astigmatic components: J0 (r2 = 0.99) and J45 (r2 = 0.90). The mean spherical equivalent dropped from −7.29 ± 3.4 D to −0.17 ± 0.40 D at 12 months. Of the attempted spherical equivalent, 76.7% of the eyes were within ±0.50 D and 97.7% eyes were within ±1.00 D, respectively. For J0 and J45, 97.7% and 83.7% were within ±0.50 D, respectively. Conclusion: The results of the present study support the safety, efficacy, and predictability of toric implantable collamer lens implantation to treat moderate to high myopic astigmatism.
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Ieong A, Hau SC, Rubin GS, Allan BD. Quality of Life in High Myopia before and after Implantable Collamer Lens Implantation. Ophthalmology 2010; 117:2295-300. [DOI: 10.1016/j.ophtha.2010.03.055] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Revised: 02/04/2010] [Accepted: 03/24/2010] [Indexed: 11/29/2022] Open
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Kamiya K, Shimizu K, Aizawa D, Igarashi A, Komatsu M, Nakamura A. One-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism. Ophthalmology 2010; 117:2287-94. [DOI: 10.1016/j.ophtha.2010.03.054] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 02/07/2010] [Accepted: 03/24/2010] [Indexed: 10/19/2022] Open
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