The Implantable Collamer Lens with a central port: review of the literature

Safety of implantable Collamer lens implantation without ophthalmic viscosurgical device: A retrospective cohort study

To compare the safety of implantable Collamer lens (ICL) implantation with and without ophthalmic viscosurgical device (OVD).A total of 148 eyes underwent a conventional ICL implantation with OVD (OVD group), and 112 eyes underwent a modified ICL implantation without OVD (OVD-free group). The balanced salt solution was used to load ICL and maintain the anterior chamber in the OVD-free group. The surgical time, postoperative uncorrected distance visual acuity, intraocular pressure, endothelial cell density (ECD), and percentage of hexagonal cells were compared between the OVD and the OVD-free groups.No significant differences were detected in uncorrected distance visual acuity, intraocular pressure, ECD, and percentage of hexagonal cells at any time post-surgery between the 2 groups (P > .05). The mean ECD loss was 1.9% in the OVD-free group and 2.3% in the OVD group at 2 years post-surgery (P = .680). The surgical time was much shorter in the OVD-free group than that in the OVD group (P ≤ .001). None of the following occurred at any time during the 2-year follow-up period in both groups: cataract formation, macular degeneration, or any other vision-threatening complications.OVD-free ICL implantation presented satisfactory results for safety. Compared to OVD, the OVD-free technique had the advantages of decreased surgical time, increased efficiency, and reduced cost.

Phakic intraocular lenses: Recent advances and innovations

Phakic intraocular lenses (pIOL) are recommended when counselling refractive surgery candidates presenting with high ametropia or ocular surface and/or corneal conditions that contraindicate corneal refractive surgery. This review aims to present the state-of-the-art regarding pIOL models currently available in Europe, addressing their newer indications and recent design innovations. These include, in the case of posterior chamber pIOLs, the addition of a central hole to improve aqueous humour circulation, the availability of larger optical zones, and multifocal optics for the compensation of presbyopia. The review also highlights their good safety and efficacy results, as well as the role of patient education to ensure adequate outcomes in the medium-long term. The indications of pIOLs in special situations, as well as bi-lensectomy, a procedure that most pIOL patients may eventually require as they age and develop cataracts, are also addressed.

Pupillary capture of implantable collamer lens after oral antidepressants

We report the case of a 26-year-old man under treatment with the antidepressant drugs olanzapine and buspirone, which are associated with anticholinergic effects, in whom an implantable collamer lens (ICL) became spontaneously dislocated. ICL dislocation and pupil capture occurred 10 months postoperatively. The lens was successfully repositioned. The possible role of these drugs in the dislocation of the ICL is discussed.

Phakic Posterior Chamber Intraocular Lens with a Central Hole in Treating Patients with Moderate to High Myopia: A Meta-Analysis

Purpose

To evaluate the efficacy of phakic posterior chamber intraocular lens with a central hole (ICL V4c) in treating patients with moderate to high myopia.

Methods

PubMed, Embase, Cochrane Library, Clinical Trial, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and China Science Periodical Database (CSPD) were searched online. The search included publications from the building of the library until December 2018. All randomized controlled trials containing moderate to high myopia treated by phakic posterior chamber intraocular lens with a central hole were collected. Literature search, screening literature, data extraction, and quality evaluation were independently performed by two reviewers. Meta-analysis was performed using RevMan 5.3 software.

Results

Meta-analysis results based on five randomized controlled trials showed that ICL V4c and ICL without a central hole had similar UCVA results (SMD = 0.08, 95% CI (−0.71, 0.88), P=0.84), SE (SMD = −0.18, 95% CI (−0.52, 0.15), P=0.29), BCVA (SMD = −0.27, 95% CI (−0.93, 0.40), P=0.43), and IOP (SMD = 0.03, 95% CI (−0.24, 0.30), P=0.84), and the difference was not statistically significant. In addition, no complications that could jeopardize vision occurred.

Conclusions

Implanting ICL V4c in patients with moderate to high myopia is safe and effective.

Initial Results From a New Model of Posterior Chamber Implantable Phakic Contact Lens: IPCL V2.0

The aim of this study was to evaluate the corneal safety, intraocular pressure (IOP), vault and refractive efficiency of the new implantable phakic contact lens, IPCL V2.0 (Care Group, India). A prospective case series study was performed to evaluate 100 consecutive surgeries with IPCL V2.0 (spherical and toric models). Refractive results, corneal endothelial cell density (CD) and central corneal thickness (CCT) were measured at baseline and 6 months after surgery. Intraocular pressure was measured at baseline, 1 day and 6 months, and vault, 3 and 6 months after surgery. Surgical complications and cataract development were also evaluated. The mean corneal endothelial CD decreased by 2.9% with a statistically significance difference (p: 0.03). The mean CCT decreased by 0.87% at 6 months postoperative, without a statistical significance difference (p: 0.35). The mean ± standard deviation (SD) of IOP at baseline was 13.72 ±1.4 mm Hg, at 1 day postoperative was 13.88 ±1.2 mm Hg, and at 6 months was 13.62 ±1.3 mm Hg. These differences were not statistically significant (p: 0.37). The difference in vault between 3 and 6 months after surgery was not statistically significant (p: 0.97). The coefficient of correlation between the attempted versus achieved spherical equivalent (SE) change was R²: 0.958. Postoperative SE was between -0.50 D to +0.50 D in 52% of cases. The remaining of the eyes had SE values ranging from -1.5 D to +1.35 D. No intra or postoperative complications occurred and specifically cataract was not developed. The corneal endothelial CD, CCT, vault and IOP remained stable 6 months after surgery. Refraction was improved and the IPCL V 2.0 was implanted safely.