Kann die implantierbare Collamer-Linse mit Aquaport eine Winkelblockproblematik sicher verhindern?: Erste Erfahrungen aus dem Homburger Zentrum für refraktive Chirurgie

Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation

PURPOSE

To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL.

METHODS

We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years.

RESULTS

ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications.

CONCLUSION

There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.

Analysis of the Effect of Intraocular Lens Implantation on Retinal Nerve and Postoperative Nursing Outcome Based on Ultrasound Imaging

Traumatic cataract is a common complication of ocular contusion. Caused by various forms of trauma, the course and prognosis of traumatic cataract are also different. Intraocular lens (IOL) implantation is the most effective treatment at the present time and can provide good visual quality and near, medium, and far vision. In this study, an adaptive medical ultrasound image denoising algorithm was constructed based on the biological vision mechanism and was applied to observe IOL implantation and postoperative care of 30 patients with traumatic cataract. Results showed that eyesight could be restored to the original healthy state after IOL implantation, and eyesight was close to normal 3 months after surgery. The corresponding noise pixel block of the noise reduction algorithm was obviously the lowest. A total of 30 patients (9 patients with contusion, 13 patients with intraocular foreign body, and 8 patients with perforation) were treated with aspheric and multifocal IOL to achieve the expected outcome. The noise reduction algorithm constructed in this study effectively reduced the speckle noise of ultrasound images, improved the clarity of ultrasound images, and achieved the effective observation of medical nursing outcome after traumatic cataract IOL implantation. After IOL implantation, the retinal nerves of patients with traumatic cataract were affected to different degrees.

[Intraocular pressure after implantation of an ICL with aquaport : Development of intraocular pressure after implantation of an ICL (model V4c) with aquaport without iridotomy]

BACKGROUND AND OBJECTIVE

The latest version of the intraocular lens (ICL V4c) has a central hole (aquaport) that avoids a pupillary block. Due to this laser iridotomy or intraoperative surgical peripheral iridectomy are no longer required. In this study, we examined the intraocular pressure (IOP) after implantation of the ICL with aquaport, with special reference to the development of a possible pupillary block glaucoma.

MATERIAL AND METHODS

This retrospective non-randomized study included 87 eyes from 46 patients (consecutive case series). These patients had the ICL model V4c (without a laser iridotomy or peripheral iridectomy) implanted between January 2013 and October 2014. The preoperative IOP values were compared with the postoperative values 1-2 h, 1 day, 1 week and 1 month after implantation.

RESULTS

The median intraocular pressure was 14 ± 2 mm Hg before implantation of the ICL, palpatory normotensive 1-2 h after implantation, 13 ± 3 mm Hg 1 day after implantation, 15 ± 3 mm Hg 1 week after implantation and 16 ± 4 mm Hg 1 month after implantation (a slight statistically significant increase of the intraocular pressure, p < 0.05). In 2 patients there was a steroid response in both eyes with IOP reaching up to a maximum of 28 mm Hg. There were no peaks of intraocular pressure due to a pupillary block.

CONCLUSION

It is possible to implant the latest ICL V4c with a central hole (Aquaport) without a laser iridotomy or peripheral iridectomy or development of a pupillary block.

Intraocular Pressure After Implantation of a Phakic Collamer Intraocular Lens With a Central Hole

PURPOSE

To investigate the middle-term intraocular pressure (IOP) results after implantation of a posterior chamber collagen copolymer phakic intraocular lens (IOL) (V4c Visian; STAAR Surgical Co., Nidau, Switzerland) with a central hole in patients with myopia.

METHODS

This retrospective study enrolled patients who had implantation of a phakic IOL with a central hole. IOP, central vault, and adverse events were evaluated 1, 3, 6, 12, and 24 months postoperatively.

RESULTS

The study enrolled 763 eyes (384 patients, 128 men and 256 women). Mean follow-up was 7.0 ± 7.2 months (range: 1 to 24 months). The mean IOP was 13.2 ± 2.1 mm Hg preoperatively. Postoperatively, the mean IOP was 12.4 ± 1.7 mm Hg at 1 month, 12.5 ± 1.8 mm Hg at 3 months, 12.6 ± 1.3 mm Hg at 6 months, 12.6 ± 1.4 mm Hg at 12 months, and 12.7 ± 1.1 mm Hg at 24 months. Only one case (0.13%) presented an increased IOP (> 21 mm Hg) during the observation period. No pupillary block or acute angle closure was recorded. IOP at the final follow-up visit was 12.8 ± 1.3 mm Hg.

CONCLUSIONS

Implantation of central hole phakic IOL in myopic patients provided good and safe IOP outcomes throughout the 24-month observation period. [J Refract Surg. 2017;33(4):244-249.].