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Yuan J, Wu S, Hu Z, Chen C, Ye S, Ye J. Clinical Observation of Posterior-Chamber Phakic Implantable Collamer Lens V4c Implantation in Myopic Patients with Shallow Anterior Chamber Depth: A Retrospective, Consecutive Observational Study. J Ophthalmol 2024; 2024:3181569. [PMID: 38812725 PMCID: PMC11136544 DOI: 10.1155/2024/3181569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/09/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose The reference range for the preoperative anterior chamber angle width for ICL surgery is unclear. Our objective was to assess the clinical effect and the range of anterior chamber angle width of posterior-chamber implantable collamer lens V4c (ICL V4c) implantation in patients with anterior chamber depth (ACD) < 2.8 mm. Methods Patients who underwent ICL V4c implantation with shallow ACD were included in this retrospective study. The patients' uncorrected and corrected distance visual acuity, angle of trabecular-iris (TIA), angle-opening distance (AOD500), trabecular-iris space area (TISA500), corneal endothelial cell density, vault, retinal nerve fiber layer thickness, intraocular pressure, visual field, and complications were analyzed. Results Forty-one patients (68 eyes) completed at least 12 months of follow-up (median follow-up, 30 months). The effectiveness and safety indices were 1.09 ± 0.13 and 1.04 ± 0.21, respectively. The preoperative TIA values on the nasal and temporal sides were 39.78 ± 7.68 degree (range, 25.8-65.1 degree) and 41.54 ± 8.03 degree (range, 28.5-63.00 degree). Forty-seven eyes had uncorrected distance visual acuity ≥1.0, and 55 had corrected distance visual acuity ≥1.0 at the last follow-up visit. The TIA, AOD500, and TISA500 on the nasal and temporal sides were significantly reduced compared to those before surgery (all P < 0.01); no eye had an angle closure or elevated intraocular pressure. The ICL V4c vault was 290.88 ± 153.36 μm (range, 60.0-880.0 μm). No severe complications occurred in any patient. Conclusions In patients with myopia with shallow ACD (2.55-2.79 mm), a preoperative TIA >25.8° is safe and effective for a relatively long time after surgery; however, an extended long-term close follow-up is needed.
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Affiliation(s)
- Juan Yuan
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Shuang Wu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Zongli Hu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Chunlin Chen
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Shiyang Ye
- Department of Ophthalmology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jian Ye
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
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Yoon HY, Byun YS, Kim HS, Chung SH. Causes and outcomes of implantable collamer lens explantation in patients with corneal endothelial cell loss. J Cataract Refract Surg 2024; 50:453-459. [PMID: 38270485 DOI: 10.1097/j.jcrs.0000000000001406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate the correlated factors of corneal endothelial cell density (ECD) loss and ECD change in implantable collamer lens (ICL) explantation patients. SETTING Seoul St. Mary's Hospital, Seoul, South Korea. DESIGN Retrospective analysis. METHODS The study cohort consisted of 93 eyes from 50 patients who underwent ICL explantation. Correlation analysis was performed to assess the ocular parameters associated with ECD loss, while percentage of ECD change (ΔECD%) was monitored up to 6 months postoperatively. Receiver operating characteristic (ROC) curve was used to set cutoff values of ocular parameters to prevent ECD loss after explantation. RESULTS In multiple regression analysis, high vaulting, high vaulting/anterior chamber depth (ACD), low anterior chamber angle (ACA), and high iris pigmentations are the significant factors of ECD loss. At postoperative 6 months, 14 eyes (15.1%) had decrease (10.5% loss), 47 eyes (51.0%) were stationary, and 32 eyes (34.4%) had increase (12.7% gain) of ECD. The ROC curve analysis showed that vaulting had the highest area under the curve (AUC = 0.822), followed by vaulting/ACD (AUC = 0.821), ECD (AUC = 0.753), and ACA (AUC = 0.723) (all P < .01). Preoperative ECD showed a sensitivity of 77.6% and specificity of 86.7% in preventing ECD loss after explantation, with a cutoff value of 1722 cells/mm 2 , as determined by ROC curve analysis. CONCLUSIONS Our study demonstrated that high vaulting is a significant factor in ECD loss among ICL-inserted patients. To prevent continuous ECD loss in ICL patients, close monitoring of ECD and making appropriate decisions regarding explantation may be necessary.
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Affiliation(s)
- Hye Yeon Yoon
- From the Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
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Lin F, Liu F, Niu L, Yao P, Wang X, Zhou X, Zhao J. The rate of vault changes after ICL V4c implantation and its correlation with anterior segment parameters. Heliyon 2024; 10:e25823. [PMID: 38352750 PMCID: PMC10863321 DOI: 10.1016/j.heliyon.2024.e25823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Purpose To investigate the rate of vault changes after implantation of ICL V4c and the correlation with anterior segment parameters. Methods A total of 64 eyes were studied from the 37 myopic subjects recruited. CASIA2 was used to record the vault at 1 week, 1 month, 3 months and 6 months after the operation as well as the preoperative anterior segment parameters including pupil diameter, lens vault, anterior chamber depth, anterior chamber width, iris area (IA), iris thickness, angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle. The rates of vault change in different time intervals were compared and the correlations between the rates and anterior segment parameters were analyzed. P < 0.05 was considered statistically significant. Results The rate of vault decrease was -19.53 ± 111.28 μm/month between 1 week and 1 month, -19.90 ± 29.71 μm/month between 1 month and 3 months and -4.25 ± 18.10 μm/month between 3 months and 6 months; hence the rate was shown to slow down significantly from 3 months post-operation (P = 0.024). The average rate of vault changes showed a significant positive correlation with IA (R2 = 0.140, F = 4.980, P = 0.01). No significant correlation was found with other anterior segment parameters (all P > 0.05). Conclusion The rate of decreasing vault significantly slowed down from 3 months post-operation. A larger IA may imply a lower decreasing rate of vault change.
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Affiliation(s)
- Feng Lin
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Fang Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
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Jiang F, Yang Y, Ni Y, Qin Y, Yuan F, Ju R, Wu M. Smurf1 Modulates Smad Signaling Pathway in Fibrotic Cataract Formation. Invest Ophthalmol Vis Sci 2024; 65:18. [PMID: 38324299 PMCID: PMC10854413 DOI: 10.1167/iovs.65.2.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
Purpose TGF-β/BMP signaling pathway plays a significant role in fibrotic cataract. Smurf1, a ubiquitin protein ligase, regulates the TGF-β/BMP signaling pathway through the ubiquitin-proteasome system (UPS). This study aims to investigate the role of Smurf1 in the progression of fibrotic cataract and its underlying mechanism. Methods We used a mouse model of injury-induced anterior subcapsular cataract (ASC) and administered the Smurf1 inhibitor A01 for in vivo investigations. RNA sequencing was performed to examine global gene expression changes. Protein levels were assessed by Simple Western analysis. The volume of subcapsular opacity was determined using whole-mount immunofluorescence of lens anterior capsules. Lentivirus was utilized to establish cell lines with Smurf1 knockdown or overexpression in SRA01/04. Lens epithelial cell (LEC) proliferation was evaluated by CCK8 and EdU assays. Cell cycle profile was determined by flow cytometry. LEC migration was measured using Transwell and wound healing assays. Results The mRNA levels of genes associated with cell proliferation, migration, epithelial-mesenchymal transition (EMT), TGF-β/BMP pathway, and UPS were upregulated in mouse ASC model. Smurf1 mRNA and protein levels were upregulated in lens capsules of patients and mice with ASC. Anterior chamber injection of A01 inhibited ASC formation and EMT. In vitro, Smurf1 knockdown reduced proliferation, migration and TGF-β2-induced EMT of LECs, concomitant with the upregulation of Smad1, Smad5, and pSmad1/5. Conversely, overexpression of Smurf1 showed opposite phenotypes. Conclusions Smurf1 regulates fibrotic cataract progression by influencing LEC proliferation, migration, and EMT through the modulation of the Smad signaling pathway, offering a novel target for the fibrotic cataract treatment.
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Affiliation(s)
- Fanying Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yuanfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yan Ni
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yingyan Qin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Fa Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Rong Ju
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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Zhao H, Tang T, Lu Y, Li X, Sun L, Chen S, Ma L, Luo Y, Wang K, Zhao M. Development and Validation of Data-Level Innovation Data-Balancing Machine Learning Models for Predicting Optimal Implantable Collamer Lens Size and Postoperative Vault. Ophthalmol Ther 2024; 13:267-286. [PMID: 37943481 PMCID: PMC10776515 DOI: 10.1007/s40123-023-00841-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION There are only four sizes of implantable collamer lens (ICL) available for selection, which cannot completely fit all patients as a result of the discontinuity of ICL sizes. Sizing an optimal ICL and predicting postoperative vault are still unresolved problems. This study aimed to develop and validate innovative data-level data-balancing machine learning-based models for predicting ICL size and postoperative vault. METHODS The patients were randomly assigned to training and internal validation sets in a 4:1 ratio. Feature selection was performed using analysis of variance (ANOVA) and Kruskal-Wallis feature importance methods. Traditional linear regression model and machine learning-based models were used. The accuracy of models was assessed using the area under the curve (AUC) and confusion matrix. RESULTS A total of 564 patients (1127 eyes) were eligible for this study, consisting of 808 eyes in the training set, 202 eyes in the internal validation set, and 117 eyes in the external validation set. Compared with the traditional linear regression method, the machine learning model bagging tree showed the best performance for ICL size selection, with an accuracy of 84.5% (95% confidence interval (CI) 83.2-85.8%), and the AUC ranged from 0.88 to 0.99; the prediction accuracy of 12.1 mm and 13.7 mm ICL sizes was improved by 49% and 59%, respectively. The bagging tree model achieved the best accuracy [90.2%, (95% CI 88.9-91.5%)] for predicting the postoperative vault, and the AUC ranged from 0.90 to 0.94. The prediction accuracies of internal and external validation dataset for ICL sizing were 82.2% (95% CI 81.1-83.3%) and 82.1% (95% CI 81.1-83.1%), respectively. CONCLUSIONS The innovative data-level data balancing-based machine learning model can be used to predict ICL size and postoperative vault more accurately, which can assist surgeons in choosing optimal ICL size, thus reducing risks of postoperative complications and secondary surgery.
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Affiliation(s)
- Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yuchang Lu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Liyuan Sun
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Sitong Chen
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lu Ma
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.
- College of Optometry, Peking University Health Science Center, Beijing, China.
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Eldanasoury A, Bains H, Pieger S. Comparison of a new implantable collamer lens formula to standards formulas using spectral domain optical coherence tomography. Int Ophthalmol 2023; 43:4613-4620. [PMID: 37665494 DOI: 10.1007/s10792-023-02861-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/20/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE To use spectral-domain optical coherence tomography (SD-OCT) data to develop a new implantable collamer lens (ICL) sizing formula and compare vault outcomes with the Online Calculation and Ordering System™ (OCOS) and the NK2 formula. METHODS Consecutive eyes (n = 237) were evaluated that had undergone ICL/toric ICL implantation. Actual ICL vaults were measured, and a what-if analysis was performed to predict vault values with the NK2 formula using SD-OCT data. To develop a new formula (EPB), multiple regression analysis was performed with different parameters than the NK2 formula. Predicted vaults with NK2 and EPB formulas were compared to the actual vaults. RESULTS Parameters that were correlated with optimal ICL size were white-to-white, anterior chamber width, lens rise and desired refractive correction. The mean postoperative vault was 489 ± 258 μm. At last visit, 94.5% of eyes were within the manufacturer's acceptable vault range. Predicted vaults in the acceptable range were 74 and 87% with the NK2 and EPB formulas, respectively. Six percent had a predicted vault less than 100 μm with the EPB formula compared to 1% for actual outcomes. The NK2 formula resulted in a shift toward higher predicted vaults while the EPB formula was similar to the actual postoperative vaults but with slightly more cases with extremely low and high vaults. CONCLUSION SD-OCT data with OCOS result in good postoperative vaults. Further refinement is required to the NK2 for use with SD-OCT data. Although the EPB formula provides acceptable predicted vaults, further refinement with a larger sample size is needed.
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Affiliation(s)
- Alaa Eldanasoury
- Magrabi Hospitals and Centers, Main Jeddah Hospital, Old Makkah Rd. K3 - Khozam St, PO Box: 7344, Jeddah, Saudi Arabia.
| | - Harkaran Bains
- Magrabi Hospitals and Centers, Main Jeddah Hospital, Old Makkah Rd. K3 - Khozam St, PO Box: 7344, Jeddah, Saudi Arabia
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Du J, Zhou W, Zhao T, Qian T, Lu Y, Li H, Zhang Z, Lian J. Efficacy and Safety of Implantable Collamer Lens V4c Implantation in 1,834 Myopic Eyes for 1 Year of Follow-up. J Refract Surg 2023; 39:694-704. [PMID: 37824302 DOI: 10.3928/1081597x-20230908-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To evaluate visual outcomes of patients with myopia after EVO Implantable Collamer Lens (ICL) (STAAR Surgical) implantation and predict risk factors of postoperative vault abnormalities. METHODS In this single-center, retrospective analysis, 1,834 eyes of 926 patients with myopia who underwent EVO ICL implantation were recruited between 2020 and 2021. Patients were followed up for 1 year, during which surgery outcomes were evaluated. In addition, 31 eyes with vault abnormalities who underwent secondary surgery were enrolled to form a generalized linear model, which aimed to predict risk factors contributing to vault abnormalities. RESULTS At the final follow-up visit, safety and efficacy indexes were 1.12 ± 0.17 and 1.10 ± 0.19, respectively, and there was no statistical significance between the low and high myopia groups. Furthermore, 79.18% of eyes achieved a residual spherical equivalent within ±0.50 diopters. Except for the temporary elevation of intraocular pressure at 1 week postoperatively, IOP and endothelial cell density remained stable during follow-up visits. The rate of postoperative adverse events was 21.97% and most adverse events were transient. Vault abnormalities accounted for the majority of complications (9.54%). Results of generalized linear model showed that age was a risk factor for postoperative vault abnormalities, and the anterior chamber depth served as a protective factor (P < .05). CONCLUSIONS Visual outcomes of EVO ICL implantation were satisfactory in safety and efficacy indexes in both the low and high myopia groups for 1 year of follow-up, with acceptable stability in postoperative spherical equivalent, intraocular pressure, and endothelial cell density. This study emphasized cautious ICL size selection for older patients and those with shallow anterior chamber depth. [J Refract Surg. 2023;39(10):694-704.].
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Li K, Yang G, Chang S, Yao J, He C, Lu F, Wang X, Wang Z. Comprehensive assessment of the anterior segment in refraction corrected OCT based on multitask learning. BIOMEDICAL OPTICS EXPRESS 2023; 14:3968-3987. [PMID: 37799701 PMCID: PMC10549746 DOI: 10.1364/boe.493065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 10/07/2023]
Abstract
Anterior segment diseases are among the leading causes of irreversible blindness. However, a method capable of recognizing all important anterior segment structures for clinical diagnosis is lacking. By sharing the knowledge learned from each task, we proposed a fully automated multitask deep learning method that allows for simultaneous segmentation and quantification of all major anterior segment structures, including the iris, lens, cornea, as well as implantable collamer lens (ICL) and intraocular lens (IOL), and meanwhile for landmark detection of scleral spur and iris root in anterior segment OCT (AS-OCT) images. In addition, we proposed a refraction correction method to correct for the true geometry of the anterior segment distorted by light refraction during OCT imaging. 1251 AS-OCT images from 180 patients were collected and were used to train and test the model. Experiments demonstrated that our proposed network was superior to state-of-the-art segmentation and landmark detection methods, and close agreement was achieved between manually and automatically computed clinical parameters associated with anterior chamber, pupil, iris, ICL, and IOL. Finally, as an example, we demonstrated how our proposed method can be applied to facilitate the clinical evaluation of cataract surgery.
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Affiliation(s)
- Kaiwen Li
- School of Electronic Science and Engineering,
University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Guangqian Yang
- School of Electronic Science and Engineering,
University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Shuimiao Chang
- Department of Cataract, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jinhan Yao
- Department of Cataract, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Chong He
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Fang Lu
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Xiaogang Wang
- Department of Cataract, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Zhao Wang
- School of Electronic Science and Engineering,
University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
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Cakir I, Sonmez O, Pehlivanoglu S, Cakir GY, Yildiz BK, Yildirim Y, Agca A. Long-term results of a new posterior chamber phakic intraocular lens in patients with high myopia: 5-year results. J Cataract Refract Surg 2023; 49:409-415. [PMID: 36888565 DOI: 10.1097/j.jcrs.0000000000001110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/27/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change. SETTING Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN Retrospective. METHODS Eyes that were not suitable for corneal refractive surgery, had high myopia between -6.00 diopters (D) and -20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm 2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded. RESULTS 36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% ( P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye. CONCLUSIONS Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.
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Affiliation(s)
- Ihsan Cakir
- From the Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey (I. Cakir, Sonmez, Pehlivanoglu, G.Y. Cakir, Yildiz, Yildirim); Atakoy World Eye Hospital, Istanbul, Turkey (Agca)
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Li B, Chen X, Cheng M, Lei Y, Jiang Y, Xu Y, Wang X, Zhou X. Long-Term Vault Changes in Different Levels and Factors Affecting Vault Change After Implantation of Implantable Collamer Lens with a Central Hole. Ophthalmol Ther 2023; 12:251-261. [PMID: 36335511 PMCID: PMC9834492 DOI: 10.1007/s40123-022-00606-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/21/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION This study evaluated vault changes in eyes implanted with an implantable Collamer lens (ICL) with a central hole (ICL V4c) for myopia and astigmatism correction as well as factors related to vault changes over time. METHODS This retrospective study enrolled 169 myopic eyes from 169 patients (137 women and 32 men) who underwent ICL V4c implantation to correct myopia and astigmatism. Vault values were measured quantitatively using a rotating Scheimpflug camera. Each patient underwent at least four postoperative follow-up visits at 1 month, 6 months, 1 year, and more than 2 years. We compared postoperative values between groups and identified factors affecting vault changes over time. RESULTS The mean vaults at 1 month (baseline), 6 months, 1 year, and the last follow-up time following ICL implantation were 540.83 ± 186.13, 520.00 ± 196.08, 503.79 ± 198.30, and 471.42 ± 211.35 μm, respectively. Eyes with baseline vaults of 250-750 and ≥ 750 μm exhibited a trend of vault decrease over time, and the differences were statistically significant (P < 0.05) at 6 months and 1 year postoperatively, respectively. The variables relevant to the value of vault decrease between baseline and last follow-up time were anterior chamber depth (ACD) and ICL power (adjusted R2 = 0.121, P < 0.001). CONCLUSIONS We found a trend of decreased mean objective vault values over time, which was more obvious in eyes with higher baseline vault values. The vault value of the ICL decreased more in eyes with shallower ACDs, higher ICL power, or both. Moreover, the decrease in vault values became statistically significant earlier in eyes with higher baseline vaults or shallower ACDs.
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Affiliation(s)
- Boliang Li
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xun Chen
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yadi Lei
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yinjie Jiang
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Qian T, Du J, Ren R, Zhou H, Li H, Zhang Z, Xu X. Vault-Correlated Efficacy and Safety of Implantable Collamer Lens V4c Implantation for Myopia in Patients with Shallow Anterior Chamber Depth. Ophthalmic Res 2023; 66:445-456. [PMID: 36596292 DOI: 10.1159/000528616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD). METHODS This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively. RESULTS All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739). CONCLUSIONS ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Jingxiao Du
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Ruixia Ren
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyan Li
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Martínez-Plaza E, López-Miguel A, López-de la Rosa A, Maldonado MJ. Inter-eye and postoperative prediction of vault after implantation of EVO + Visian phakic implantable collamer lens. Int Ophthalmol 2022; 43:1501-1510. [PMID: 36260197 DOI: 10.1007/s10792-022-02546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess whether the postoperative outcomes of the implantation of an EVO + implantable collamer lens (ICL) in one eye can be used as a predictor of the vault of the fellow eye, and to evaluate the vault changes of the implantation in both eyes during the postoperative period. METHODS A prospective study including 40 eyes of 20 patients with a bilateral EVO + ICL implantation was performed. Subjects were evaluated before the surgery and 1 day, 1 week and 1, 3 and 6 months postoperatively. Central vault was assessed using spectral-domain optical coherence tomography. The inter-eye and follow-up analyses were performed using lineal models and the Bland-Altman method. RESULTS The vault of the first implanted eye at the 1-day visit highly predicts the vault of the second eye (R2 = .87; P < .001); the mean inter-eye difference was - 0.95 μm, and the superior and inferior limits of agreement were -50.27 μm and 148.37 μm, respectively. This relationship was maintained during the medium-term follow-up, not finding differences in the slopes among visits (P ≥ .09). A progressive decrease of vault was found during the follow-up (P < .001). Larger vault change 6 months after the surgery was associated with higher vault 1 day after the ICL implantation (R2 = .19;P = .005). CONCLUSION One-day postoperative vault in the first eye can help to predict the optimal ICL sizing in the second eye. Vault tends to decrease during the first 6 months after EVO + ICL implantation. Eyes with higher initial vaults will also show larger reductions during the medium-term follow-up.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain.
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
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Wang Y, Yang R, Huang Y, Zhang C, Liu H, Jia Z, Zhao S. Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique. BMC Ophthalmol 2022; 22:381. [PMID: 36151534 PMCID: PMC9502894 DOI: 10.1186/s12886-022-02603-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Implantable collamer lens (ICL) surgery techniques are constantly progressing. The purpose of this study was to investigate the application effect of the modified technique and its impact on the change in corneal astigmatism in EVO-ICL surgery. Methods The analysis of retrospective cohort data included 153 eyes of 81 patients with myopia from July 2018 to May 2020. An EVO-ICL was inserted by modified surgical skills, including a single 3.0 mm corneal incision and no ophthalmic viscosurgical device (OVD) before the insertion of the ICL (modified technique group: 41 cases, 80 eyes) and standard procedure (standard technique group: 40 cases, 73 eyes). Early postoperative intraocular pressure (IOP) was monitored at 2 and 24 h. IOP, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), vault, and anterior chamber depth (ACD) were measured 1, 6, and 12 months following the initial examination. The corneal endothelial cell density (ECD) was monitored at 6 and 12 months after the operation. Surgically induced astigmatism (SIA) in the total, anterior, and posterior corneal surfaces was analysed 1 month after the operation. Results No serious complications were detected. The two groups had no difference in visual outcomes, ICL vaults, or ACD at any time point (P > 0.05). Two hours postoperatively, IOP was significantly lower in the modified technique group (16.22 ± 2.22 vs. 18.37 ± 1.92 mmHg, P < 0.05) than in the standard technique group. IOP decreased gradually after 24 h to preoperative levels. The postoperative IOP remained stable over a 12-month period. The ECD at 6 and 12 months was not significantly different between the groups (P > 0.05). SIA in the total, anterior, and posterior corneal surfaces were assumed to have no clinically meaningful differences between groups at one month after operation (P > 0.05). Conclusions The modified technique is efficient and safe, producing comparable visual and structural outcomes without adversely affecting ECD, and reduces fluctuations in IOP at the early postoperative stages. The auxiliary incision in the standard technique does not increase corneal SIA, which is also a factor to consider for inexperienced surgeons.
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Affiliation(s)
- Ying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruibo Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Yue Huang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Chen Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Hui Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Zhe Jia
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Shaozhen Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
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Zhu QJ, Zhu WJ, Chen WJ, Ma L, Yuan Y. A prediction model for sulcus-to-sulcus diameter in myopic eyes: a 1466-sample retrospective study. BMC Ophthalmol 2022; 22:307. [PMID: 35842598 PMCID: PMC9287952 DOI: 10.1186/s12886-022-02535-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background To establish and verify the accuracy and reliability of a sulcus-to-sulcus diameter (STS) prediction model. Methods In this retrospective study, the prediction formula was established with the data from 1466 eyes from 733 subjects from July 2020 to April 2021 and verified with the data from 278 eyes from 139 subjects between May 2021 and June 2021. Each subject was measured with a Pentacam, IOLMaster 700, OPD-Scan III, and ultrasound biomicroscope. The prediction formulas were established with multiple linear regression, and intergroup correlation coefficients (ICCs) and Bland–Altman tests were used to assess the agreement between the predicted and actual STS (actual STS was measured by UBM). Results The explanatory variables relevant to the horizontal STS (STSH) were the Pentacam white-to-white diameter (WTWP; standardized partial regression coefficient [β] = 0.330; p < 0.001), the flat K value (β = -0.211; p < 0.001), and the anterior corneal diameter (ACD) (β = 0.178; p < 0.001). The corresponding multiple regression equation was : STSH (mm) = 8.061 + 0.510 × WTWP − 0.090 × Flat K value + 0.430 × ACD. The explanatory variables relevant to the vertical STS (STSV) were the WTWP (β = 0.435; p < 0.001), the steep K value (β = -0.271; p < 0.001), and the ACD (β = 0.187; p < 0.001). The corresponding multiple regression equation was : STSV (mm) = 8.540 + 0.492 × WTWP − 0.075 × Steep K value + 0.329 × ACD. The bias of the predicted to the actual STSH was − 0.021, with 95% limits of agreement (95% LoA) from − 0.499 to 0.457. The bias of the predicted to the actual STSV was 0.057, with 95% LoA from − 0.462 to 0.575. The ICC was 0.883 between the predicted and actual STSH and 0.859 between the predicted and actual STSV. Conclusions The Pentacam-measured WTW, the K value and the ACD are important for predicting the STS diameter. The prediction model has good accuracy and reliability. Trial registration Not applicable.
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Affiliation(s)
- Qiu-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Wei-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Wen-Jing Chen
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Lie Ma
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - You Yuan
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China.
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First Experiences with Implantation of Phakic Lenses in Correction of Myopia in R. N. Macedonia. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021; 42:37-46. [PMID: 35032378 DOI: 10.2478/prilozi-2021-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective: Analysis of visual acuity parameters in patients with moderate to high myopia and myopic astigmatism 1 year after treatment with phakic intraocular lenses. Material and methods: This was a retrospective study on 35 patients (52 eyes) with moderate to high myopia who were implanted with the Visian V4c phakic implantable Collamer lens (Staar Surgical, Nidau, Switzerland). Examined parameters were: uncorrected distance visual acuity (UDVA) and best corrected visual acuity (CDVA), manifest and cycloplegic refraction, intraocular pressure, and endothelial cell count. The investigated parameters were measured preoperatively, 1, 3, 6 and 12 months postoperatively. Results: In 17 patients, phakic lenses were implanted binocularly and in 18 patients monocularly. Preoperatively 34.62% of patients had CDVA from 0.9 to 1.0. One year after the surgery 48.08% of patients had UDVA from 0.9 to 1.0. Preoperatively 80.77% of patients had diopter range from -6.00 Dsph to -10.00 Dsph. At 1 year postoperatively 78.85% of patients were within 0.00 Dsph to -1.00 Dsph. Preoperatively, in patients with astigmatism -4 Dcyl to -2 Dcyl dominated, as opposed to significant improvement postoperatively when 94.23% had astigmatism ranging from -1.0 Dcyl to 0 Dcyl. Conclusion: The implantation of phakic lenses demonstrated a successful postoperative outcome in the treatment of myopia and myopic astigmatism. Visual acuity and refraction show a gradual and significant improvement in visual function parameters within 1 year of lens implantation.
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Chen X, Wang X, Xu Y, Cheng M, Han T, Wang X, Zhou X. Long-term Comparison of Vault and Complications of Implantable Collamer Lens with and without a Central Hole for High Myopia Correction: 5 Years. Curr Eye Res 2021; 47:540-546. [PMID: 34894946 DOI: 10.1080/02713683.2021.2012202] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the long-term safety, efficacy, stability, vault, and complications of implantable collamer lens with (ICL V4c) and without (ICL V4) a central hole for correcting high myopia. METHODS 78 eyes (40 patients) underwent ICL V4c implantation and 78 eyes (48 patients) underwent ICL V4 implantation were enrolled. They were followed up for 5 years of the uncorrected and corrected distance visual acuity, spherical equivalent (SE), axial length, intraocular pressure, endothelial cell density and vault. RESUITS The safety indices of the ICL V4c and V4 groups at 5 years were 1.25 ± 0.40 and 1.31 ± 0.40, respectively (P = .353). The efficacy indices were 0.90 ± 0.29 and 1.00 ± 0.44, respectively (P = .098). The preoperative, 1 month and 5 year postoperative logMAR UDVAs were respectively 1.54 ± 0.48, 0.11 ± 0.17, and 0.20 ± 0.26 in the V4c group and 1.56 ± 0.44, 0.14 ± 0.19, and 0.22 ± 0.26 in the V4 group (P = .703, 0.329, 0.585). The logMAR CDVAs were resepectively 0.13 ± 0.18, 0.02 ± 0.11, and 0.05 ± 0.16 in the V4c group and 0.18 ± 0.22, 0.05 ± 0.14, and 0.09 ± 0.21 in the V4 group (P = .128, 0.169, 0.229). The SE were resepectively -15.10 ± 4.32 D, -0.71 ± 1.31 D and -1.65 ± 1.30 D in the V4c group and -15.44 ± 3.51 D, -0.61 ± 1.12 D and -1.40 ± 1.30 D in the V4 group (P = .585, 0.637, 0.296). The mean vault reduced by 97.31 ± 136.61 μm in the V4c group and by 99.74 ± 245.83 μm in the V4 group. Three eyes (3.85%) with mid-periphery anterior subcapsular opacification in the V4c group and two (2.56%) with cataract, one (1.28%) with central anterior subcapsular opacification in the V4 group were observed. The CDVA of 20/40 was obtained in the two cataract eyes after phacoemulcification and intraocular lens implantation. CONCLUSION Long-term ICL V4c and ICL V4 implantations are safe, effective, and stable for high myopia correction. ICL V4c can potentially reduce the risk of lens opacification and may be more tolerant to low vault than ICL V4.
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Affiliation(s)
- Xun Chen
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqi Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Bohac M, Biscevic A, Gabric I, Gabric K, Shijakova V, Patel S. A critical evaluation of longitudinal changes of astigmatism following implantation of toric implantable collamer lens (TICL): a comparison between treated and untreated cases over 4 years. Graefes Arch Clin Exp Ophthalmol 2021; 260:1377-1386. [PMID: 34655333 DOI: 10.1007/s00417-021-05449-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/07/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate residual astigmatism following correction with toric implantable collamer lens (TICL) (group I) over a period of 4 years and compare with the change of astigmatism in spectacle wearers (group II). METHODS Groups I (86 cases implanted with TICL [EVO + Visian ICL, Staar Surgical, Nidau, Switzeland], preop refractive error [sphere and cylinder] - 22.25 DS to - 1.00 DS and - 5.50 DC to - 1.00 DC) and II (80 cases initial refractive error [sphere and cylinder] - 18.00 DS to 0.00 DS and - 7.00 DC to - 1.00 DC) were reviewed annually. Refractive and tomography data were subjected to vector analysis to determine surgically induced astigmatism (SIA), angle of error [Δθ° = angle of target-induced astigmatism (TIA) - angle of SIA], and ΔC [TIA-SIA powers] and total corneal astigmatism (TCA) in group I and induced change in astigmatism (ICA) in group II. RESULTS In group I, on all occasions, SIA correlated with TIA (p < 0.05); differences between SIA and TIA means were insignificant and changes in TCA were not correlated with ΔC. Mean (± sd, 95% CI) residual astigmatic powers (RA) in attending group I cases (1-4 years) were - 0.40 DC (0.58, - 0.52 to - 0.28), - 0.40 DC (0.59, - 0.52 to - 0.27), - 0.41 DC (0.58, - 0.54 to - 0.28), and - 0.61 DC (0.74, - 0.82 to - 0.40). In group II, the corresponding ICA powers were - 0.47 DC (0.53, - 0.61 to - 0.32), - 0.49 DC (0.48, - 0.69 to - 0.29), - 0.60 DC (0.40, - 0.76 to - 0.44), and - 0.86 DC (0.71, - 1.19 to - 0.52). Differences between RA and ICA were not significant. Of the group I cases presenting at 1-4 years postop, 23, 18, 16, and 28 had RA powers ≤ - 0.75 DC. Of these 12, 10, 6, and 16 were associated with Δθ° > 5° (ΔC - 0.50 to 0 DC) and 5, 1, 4, and 4 were related to ΔC (Δθ° < 5°). CONCLUSION The development of astigmatism after TICL implantation is on par with the natural change in astigmatism in untreated cases. In about 50% of TICL cases presenting with astigmatism ≤ - 0.75 DC, the residual astigmatism could be neutralized by realigning the TICL.
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Affiliation(s)
- Maja Bohac
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia.
| | - Alma Biscevic
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Ivan Gabric
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Kresimir Gabric
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Violeta Shijakova
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Sudi Patel
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
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19
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Zhao J, Zhao J, Yang W, Li M, Hao G, Chen Z, Wang X, Yao P, Zhou X. Consecutive contralateral comparison of toric and non-toric implantable collamer lenses V4c in vault after implantation for myopia and astigmatism. Acta Ophthalmol 2021; 99:e852-e859. [PMID: 33369209 DOI: 10.1111/aos.14720] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
AIMS To compare the vault performance between implantable collamer lens (ICL) V4c and Toric ICL (TICL) V4c after implantation and to investigate the affecting factors. METHODS Sixty-eight eyes from 34 patients with myopia or myopia astigmatism who underwent implantation of TICL in one eye (group A) and identically sized ICL (group B) in the contralateral eye were included. Mean follow-up time were 7.58 ± 1.63 months (range: 6-10 months). Vault was compared between the two groups and correlations between vault and age, preoperative ocular biometric measurements were analysed. Generalized estimating equation (GEE) model of postoperative vault adjusting for within-patient intereye correlations was performed. RESULTS The safety indices were 1.27 and 1.35, and the efficacy indices were 1.20 and 1.24 for groups A and B, respectively. Vault of TICL was significantly higher than that of ICL (554.11 ± 219.36 μm vs 449.70 ± 172.47 μm, P < 0.001). The difference between ICL/TICL size and WTW (size-WTW) and STS (size-STS), anterior chamber depth and pupil diameter (PD) were positively correlated with vault. Patient age and clear lens rise measured by Pentacam were negatively correlated with vault. Results of GEE model showed preoperative PD, age, cylindrical power of TICL and size-WTW were influencing factors for postoperative vault. CONCLUSIONS Vault after TICL implantation is higher than that with ICL. PD, age, cylindrical power of TICL and size-WTW could affect postoperative vault.
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Affiliation(s)
- Jiao Zhao
- Department of Ophthalmology People’s Hospital of Leshan Leshan China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Wen Yang
- Department of Ophthalmology The Third People’s Hospital of Chengdu The Affiliated Hospital of Southwest Jiaotong University Chengdu China
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Gengsheng Hao
- Department of Ophthalmology People’s Hospital of Leshan Leshan China
| | - Zhuoyi Chen
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
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20
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Zhang J, Shao J, Zheng L, Zhao X, Sun Y. Changes in ocular parameters the crystalline lens after implantation of a collamer lens. Clin Exp Optom 2021; 105:587-592. [PMID: 34379036 DOI: 10.1080/08164622.2021.1958654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE Understanding changes in ocular anatomical parameters after intraocular lens implantation will allow a more accurate determination of dioptric power prior to surgery. BACKGROUND The crystalline lens position might change due to the implantation and removal of an implantable collamer lens (ICL) or toric implantable collamer lens (TICL). This study aimed to assess the effect of ICL implantation on position of the crystalline lens. METHODS This retrospective study was conducted on patients who underwent V4c ICL or V4c TICL implantation between March and September, 2018. Preoperative and post-operative (2 weeks, 3 months and 6 months) axial length, central corneal thickness, crystalline lens position, crystalline lens thickness and vault height were analysed. Multivariable linear regression was used to determine the variables associated with 6-month changes in lens position. RESULTS This study included 117 eyes of 117 patients. There were decreases in all vertical distance measures from the central corneal endothelium to the anterior and posterior crystalline lens capsule (all p > 0.05). The amount of reduction was related to the crystalline lens position before the operation and crystalline lens thickness after the operation (all p < 0.01). An error in anterior chamber depth and lens thickness may appear when the ICL/TICL is close to the crystalline lens. CONCLUSION Phakic intraocular lens implantation resulted in lens thickening and forward movement on day 1 post-operatively, which becomes stable within 6 months. Preoperative lens position and post-operative lens thickness were related to the amount of movement.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Jie Shao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Li Zheng
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Xia Zhao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Yi Sun
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
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21
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Kim BK, Chung YT. Comparison of clinical outcomes of implantable collamer lens implantation with and without use of an ophthalmic viscosurgical device. J Cataract Refract Surg 2021; 47:198-203. [PMID: 32925657 DOI: 10.1097/j.jcrs.0000000000000417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the clinical efficacy of posterior chamber phakic implantable collamer lens (ICL) implantation with and without the use of an ophthalmic viscosurgical device (OVD). SETTING Onnuri Eye Hospital, Jeonju, Jeollabuk-do, South Korea. DESIGN Retrospective case series. METHODS Included were patients who underwent ICL implantation with the use of an OVD (OVD group) and patients who underwent ICL implantation without the use of an OVD (hydro group). Refractive error, endothelial cell density (ECD), intraocular pressure (IOP), vault, and adverse events were evaluated at 1 day, 1 week, 1 month, and 3 months postoperatively. The IOP and vault were checked 1 hour postoperatively, and the surgical time was recorded. RESULTS The OVD group comprised 54 eyes of 27 patients and the hydro group 49 eyes of 25 patients. There were no significant preoperative differences between the 2 groups. At 1 hour postoperatively, the IOP was significantly higher in the OVD group (P < .001); however, there was no significant difference in IOP between the 2 groups at other follow-up timepoints. Surgical time was significantly shorter for the hydro group (P = .032). There was no statistically significant difference in vault, ECD, or refractive error between the 2 groups during the 3-month follow-up period. No adverse events were observed. CONCLUSIONS ICL implantation without the use of an OVD was safe and effective. The advantages of this technique included a short surgical time, prevention of early postoperative IOP spikes, and cost savings due to OVD elimination.
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Affiliation(s)
- Bu Ki Kim
- From the Onuuri Smile Eye Clinic (Kim), Seoul, Onnuri Eye Hospital (Chung), Jeollabuk-do, South Korea
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22
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Zhu QJ, Chen WJ, Zhu WJ, Xiao HX, Zhu MH, Ma L, Yuan Y, Song E. Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation. BMC Ophthalmol 2021; 21:199. [PMID: 33957891 PMCID: PMC8101126 DOI: 10.1186/s12886-021-01963-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/26/2021] [Indexed: 12/16/2022] Open
Abstract
Background To describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault. Methods Eighty-three eyes from eighty-three subjects with complete data who met follow-up requirements were recruited in this retrospective study between May 2019 and March 2020. We quantitatively assessed the postoperative vault at 2 h, 1 day, 1 week, and 1 month following implantation. Associations between the postoperative vault and age, ICL size, spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), flat keratometry (K), steep K, mean K, anterior chamber depth (ACD), crystalline lens thickness (LT), white-to-white (WTW) diameter obtained by three devices, horizontal and vertical sulcus-to-sulcus (STS) diameter, bright and dark pupil sizes (BPS and DPS) and DPS-BPS were investigated using Spearman’s correlation analysis and stepwise multiple regression analysis. Results The mean vault values at 2 h, 1 day, 1 week, and 1 month after ICL implantation were 672.05 ± 30.72, 389.15 ± 28.33, 517.23 ± 30.76 and 530.12 ± 30.22 μm, respectively. Significant differences were found in the vault values at 2 h, 1 day and 1 week after the operation. The ICL size (β = 0.942; p < 0.001), followed by horizontal STS (β = -0.517; p < 0.001), crystalline LT (β = -0.376; p < 0.001) and vertical STS (β = -0.257; p = 0.017), significantly influenced the vault at 1 month after the operation. The multiple regression equation was expressed as follows: central vault (µm) = -1369.05 + 657.121 × ICL size- 287.408 × horizontal STS − 432.497 × crystalline LT − 137.33 × vertical STS (adjusted R2 = 0.643). Conclusions After ICL implantation, the vault decreased and then increased, but it did not return to the vault value 2 h after surgery. The ICL size, horizontal and vertical STS and crystalline LT are key factors for predicting postoperative vaulting. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01963-x.
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Affiliation(s)
- Qiu-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Wen-Jing Chen
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Wei-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Hai-Xiang Xiao
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Man-Hui Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Lie Ma
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - You Yuan
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China.
| | - E Song
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
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23
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Yu Z, Li J, Song H. Short-time evaluation on intraocular scattering after implantable collamer lens implantation for correcting high myopia. BMC Ophthalmol 2020; 20:235. [PMID: 32552888 PMCID: PMC7301533 DOI: 10.1186/s12886-020-01482-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/25/2020] [Indexed: 01/19/2023] Open
Abstract
Background To compare the intraocular scattering before and after implantation of implantable collamer lens (ICL) V4c for correction of high myopia in a short term. Methods In this study, 38 eyes of 19 patients who underwent the implantation of ICL V4c were followed up for 3 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective scattering index (OSI), modulation transfer function cutoff frequency (MTF cutoff), strehl ratio (S/R), OV100%, OV20% and OV9% were measured pre- and postoperatively. Meantime, the Pseudophakic Dysphotopsia Questionnaire (PDQ) was scored to evaluate the subjective satisfaction of intraocular scattering pre- and postoperatively. Results The UCVA were − 0.02 ± 0.06, − 0.03 ± 0.07 and − 0.04 ± 0.07 logMAR at 1 week, 1 month and 3 months postoperatively which were significantly better than those preoperatively (P < 0.05). The BCVA were − 0.09 ± 0.09, − 0.09 ± 0.1 and − 0.1 ± 0.11 logMAR at 1 week, 1 month and 3 months after surgery, which were better than those before surgery significantly (t = 15.64, P < 0.05). The mean OSI were 2.37 ± 1.6, 1.63 ± 0.94, 1.5 ± 0.86 and 1.43 ± 1.05 preoperatively, 1 week, 1 month and 3 months postoperatively which was found significant difference (F = 12.92 P < 0.05). No significant differences were found in MTF cut off (F = 0.61, P = 0.62), S/R (F = 0.58, P = 0.36), OV100% (F = 0.966, P = 0.65), OV20% (F = 0.121, P = 0.96) and OV9% (F = 1.01, P = 0.30) between pre- and postoperatively. The PDQ results indicated that intraocular scattering reduced at 3 months after surgery significantly (P < 0.05). Conclusions The ICL V4c implantation for correcting high myopia induced less intraocular scattering and visual disorder than spectacle correction.
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Affiliation(s)
- Zhe Yu
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin, People's Republic of China
| | - Jun Li
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin, People's Republic of China.
| | - Hui Song
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin, People's Republic of China.
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24
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Sachdev GS, Singh S, Ramamurthy S, Rajpal N, Dandapani R. Comparative analysis of clinical outcomes between two types of posterior chamber phakic intraocular lenses for correction of myopia and myopic astigmatism. Indian J Ophthalmol 2019; 67:1061-1065. [PMID: 31238411 PMCID: PMC6611309 DOI: 10.4103/ijo.ijo_1501_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: To compare clinical outcomes following implantation of two types of posterior chamber phakic intraocular lenses: Visian™ Implantable Collamer Lens with Centraflow (ICL, V4C Staar Surgical, Nidau, Switzerland) and Implantable Phakic Contact Lens (IPCL, V1, Caregroup Sight Solution, India) for the correction of myopia and myopic astigmatism. Methods: This retrospective case series included eyes which underwent phakic intraocular lens implantation with a minimum follow-up period of 1 year. Visual outcomes including safety, efficacy, refractive predictability, and stability were compared at 1 week and at 1, 6, and 12 months’ postoperative visit. Complications and adverse events were analyzed. Results: The study included 119 and 203 eyes in the IPCL and ICL groups, respectively. At 1-year postoperative visit, median corrected distance visual acuity was 0.10 (interquartile range [IQR] 0,0.10) and 0 (IQR 0,0) in the IPCL and ICL cohorts, respectively (P = 0.066). An uncorrected visual acuity of 20/32 or better was achieved in 86.5% and 88.67% of the eyes, respectively (P = 0.574). Ninety and 94% of the eyes achieved a postoperative manifest spherical equivalent within ± 0.5D (P = 0.169, χ2 test). Three eyes (2.52%) in the IPCL group versus one eye (0.49%) in the ICL group developed visually significant cataract requiring surgical intervention (P = 0.113). No vision-threatening complications were noted in either cohort. The mean follow-up period was 94.69 ± 32.45 and 102.67 ± 61.82 weeks, respectively. Conclusion: Both groups demonstrated similar efficacy and safety profile. The IPCL is an effective and economically viable option for the correction of myopia.
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Affiliation(s)
| | - Shivangi Singh
- Refractive Services, The Eye Foundation, RS Puram, Coimbatore, Tamil Nadu, India
| | - Shreyas Ramamurthy
- Refractive Services, The Eye Foundation, RS Puram, Coimbatore, Tamil Nadu, India
| | - Narayan Rajpal
- Refractive Services, The Eye Foundation, RS Puram, Coimbatore, Tamil Nadu, India
| | - Ramamurthy Dandapani
- Refractive Services, The Eye Foundation, RS Puram, Coimbatore, Tamil Nadu, India
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25
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Chen M, Long Q, Gu H, Hong J. Accommodation changes after visian implantable collamer lens with central hole for high myopia: A STROBE-compliant article. Medicine (Baltimore) 2019; 98:e16434. [PMID: 31305467 PMCID: PMC6641841 DOI: 10.1097/md.0000000000016434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To characterize the accommodative changes in high-myopic patients after the implantation of the Visian implantable collamer lens with a central hole (ICL V4c).This prospective study enrolled 30 patients (60 eyes) with uneventful surgery of ICL V4c implantation. Parameters including amplitude of accommodation (AA), monocular and binocular facility of accommodation (FA), positive relative accommodation (PRA), negative relative accommodation (NRA), near point convergence (NPC), accommodative response, and accommodation convergence/accommodation (AC/A) ratio were assessed before surgery, at 1 and 3 months postoperatively.Mean preoperative SE was -10.86 ± 3.87 diopter (D) (range, -6.5D to -22D), which improved to 0.27 ± 0.51D at 1 month and 0.09 ± 0.47D at 3 months after surgery (P <.001). Significant improvements in AA, NRA, PRA, NPC, monocular, and binocular FA were seen at 1 month and 3 months postoperatively compared to the values before surgery (P <.05), but the difference between 1 month and 3 months were not obvious (P >.05) except for binocular FA (P = .002). However, no significant changes were seen in either AC/A ratio or accommodative response at any postoperative follow-ups in contrast to those before surgery (P >.05). Similar changes in accommodative function were found in patients with less myopia (> -10.00D) and those with more myopia (≤10.00D) (P >.05).The accommodative function of eyes after the implantation of ICL V4c is enhanced and stabilizes at 1 month, except for the AC/A ratio and accommodative response. The clearer vision and increased amount of accommodation for near target account for the majority of the improvement.
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Affiliation(s)
- Minjie Chen
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou
| | - Qiurong Long
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Hao Gu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou
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Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses. Cornea 2019; 38:873-879. [PMID: 31170105 DOI: 10.1097/ico.0000000000001914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the temporal effect of toric implantable collamer lens (TICL) implantation and location on corneal endothelial cell density (ECD) over a period of 36 months after surgery. METHODS ECD [number of cells per square millimeter estimated using the Specular Microscope SP-1P (Topcon Europe Medical B.V., Netherlands)] data were collected from cases deemed suitable for the TICL (VTICMO, VTICM5; STAAR Surgical, Nidau, Switzerland). The preoperative refractive error (sphere and cylinder) ranged from -1.00 to -22.25 diopter sphere and from -0.50 to -5.50 diopter cylinder. ECD was evaluated at preoperative and all postoperative sessions. RESULTS Key findings were as follows: the mean ECD (±SD, 95% confidence interval) was 2720 cells/mm (±272, 2620-2820 cells/mm) preoperatively, which was reduced to 2372 cells/mm (±325, 2250-2490 cells/mm) at 36 months postoperatively (P < 0.001). Linear regression revealed the following significant correlations between the (1) log of the change in ECD (y1) and log of preoperative ECD (x1) at 2 years postoperatively, y1 = 2.513x1-6.2816 (n = 62, r= 0.3503, P = 0.005); (2) mean ECD (y2) and log time (in months, x2), y2= 2543.7-36.997x2-38.99x2 (r=-0.9654, n = 7, P = 0.0004); and (3) mean axial distance between the front surface of the crystalline lens and the TICL back surface (y3) and time postoperatively (in months, x3), y3 = 0.1035x3-5.2808x3 +473.18 (r = 0.8512, n = 7, P = 0.015). CONCLUSIONS Expected ECD loss after TICL implantation by 2 years postoperatively is predictable. On average, over 3 years after implantation, there is (1) an initial rapid decline in ECD, followed by a gradual fall in the rate of cell loss, and (2) a gradual fall in the distance between the TICL and the crystalline lens by 2 years postoperatively, followed by a reversal by the third year.
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Niu L, Miao H, Han T, Ding L, Wang X, Zhou X. Visual outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth. BMC Ophthalmol 2019; 19:121. [PMID: 31142292 PMCID: PMC6542118 DOI: 10.1186/s12886-019-1132-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background High myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare. This observational study aims to evaluate visual outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. Methods A prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for at least 12 months (average 15.35 ± 4.90 months, rangers from 12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after surgery. Results All surgeries were performed safely and no complication was observed during the follow-ups. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ±1.0 D and 35 eyes (69%) were within ±0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 μm (90 to 700 μm). The ECD was reduced by 8.38 ± 0.06% as compared to the preoperative value (p < 0.001). No significant change was observed in IOP (p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed. Conclusions In this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation. Trial registration This trial was retrospectively registered on 05/08/2018 under the number (ChiCTR1800017594).
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Affiliation(s)
- Lingling Niu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, 200031, China.,Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, 83 Fen Yang Road, Shanghai, 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, 83 Fen Yang Road, Shanghai, 200031, China
| | - Huamao Miao
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, 200031, China.,Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, 83 Fen Yang Road, Shanghai, 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, 83 Fen Yang Road, Shanghai, 200031, China
| | - Tian Han
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, 200031, China.,Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, 83 Fen Yang Road, Shanghai, 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, 83 Fen Yang Road, Shanghai, 200031, China
| | - Lan Ding
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, 200031, China.,Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, 83 Fen Yang Road, Shanghai, 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, 83 Fen Yang Road, Shanghai, 200031, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, 200031, China.,Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, 83 Fen Yang Road, Shanghai, 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, 83 Fen Yang Road, Shanghai, 200031, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, 200031, China. .,Key NHC Key Laboratory of Myopia (Fudan University), 83 Fen Yang Road, Shanghai, 200031, China. .,Laboratory of Myopia, Chinese Academy of Medical Sciences, 83 Fen Yang Road, Shanghai, 200031, China. .,Shanghai Research Center of Ophthalmology and Optometry, 83 Fen Yang Road, Shanghai, 200031, China.
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Jadidi K, Mosavi SA, Nejat F, Mohammadi N, Aghamolaei H, Daryabari SH, Torabi H, Alishiri A. Use of low-vault posterior chamber collagen copolymer phakic intraocular lenses for the correction of myopia: a 3-year follow-up. Graefes Arch Clin Exp Ophthalmol 2019; 257:1555-1560. [DOI: 10.1007/s00417-019-04336-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 11/28/2022] Open
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Chen X, Guo L, Han T, Wu L, Wang X, Zhou X. Contralateral eye comparison of the long-term visual quality and stability between implantable collamer lens and laser refractive surgery for myopia. Acta Ophthalmol 2019; 97:e471-e478. [PMID: 30187653 PMCID: PMC6585688 DOI: 10.1111/aos.13846] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Purpose To investigate the long‐term visual quality and stability of implantable collamer lens (ICL) and laser refractive surgery (LRS) for myopia. Methods This study comprised 52 eyes of 26 high‐myopia anisometropia patients who were suitable for surgical treatment. In each patient, the higher‐myopia eye was implanted with ICL and the lower‐myopia eye was treated with LRS. The patients were followed for 3 years. During that time period, uncorrected (UDVA) and corrected distance visual acuity (CDVA), refraction, wavefront aberration and visual quality were evaluated. Results The spherical equivalent refractive error changed from −14.11 ± 3.39 D preoperatively to −1.27 ± 1.05 D 3 years after ICL implantation and from −8.75 ± 2.76 D to −1.12 ± 1.30 D after LRS. The changes in refractive error from 1 month to 3 years were −0.52 and −0.77 D for the ICL and LRS groups, respectively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.84 ± 1.00 and 1.32 ± 0.40, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.40 ± 1.10 and 1.11 ± 0.44, respectively. The postoperative coma, spherical and total higher‐order aberrations in the ICL group were lower than those in the LRS group. Conclusion Both ICL implantation and LRS are safe and effective procedures for myopia with suitable indications, but ICL implantation is more stable. Fewer induced aberrations are gained after ICL implantation.
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Affiliation(s)
- Xun Chen
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
| | - Lin Guo
- Department of Ophthalmology Xi'an No. 4 Hospital of Xi'an Jiao Tong University Xi'an China
| | - Tian Han
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
| | - Liangcheng Wu
- Department of Ophthalmology Jing'an District Centre Hospital of Fudan University Shanghai China
| | - Xiaoying Wang
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
| | - Xingtao Zhou
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
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Rizk IM, Al-Hessy AAA, El-Khouly SE, Sewelam AM. Visual performance after implantation of two types of phakic foldable intraocular lenses for correction of high myopia. Int J Ophthalmol 2019; 12:284-290. [PMID: 30809486 DOI: 10.18240/ijo.2019.02.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 11/12/2018] [Indexed: 02/07/2023] Open
Abstract
AIM To compare Visian lens (model V4c) and Artiflex lens regarding quality (contrast sensitivity) and quantity (efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and analysis of complications. METHODS The comparative prospective study included 39 eyes of 23 patients with high myopia, 19 eyes had Visian lens implantation (model V4c) and 20 eyes had Artiflex lens implantation. The inclusion criteria were high myopia (higher than 6.0 D) and stable refraction (<0.5 D change over one year). Outcomes included assessment of safety and efficacy indices, predictability, stability, contrast sensitivity and analysis of complications at postoperative 1d, 1wk and 1, 3, 6 and 12mo. Selection of the type of phakic intraocular lens for patients was based on surgeons' preferences, which was no specific selection criteria. RESULTS After 12mo of follow up, difference in uncorrected and corrected distant visual acuity (CDVA) between both groups was statistically insignificant (UDVA for VisianV4c and Artiflex lens were 0.33±0.2 logMAR and 0.37±0.2 logMAR respectively, P=0.59, CDVA for VisianV4c and Artiflex lens were 0.155±0.1 logMAR and 0.147± 0.1 logMAR respectively, P=0.87). The efficacy index was 1.25 for VisianV4c lens and 0.8 for Artiflex lens, 78.9% of eyes were within one diopter spherical equivalent in Visian V4c lens group compared to 70% in the Artiflex lens group. No eye lost lines of CVDA proving a good safety index for both lenses (safety index was 1.67 for VisianV4c lens and 1.34 for Artiflex lens). Difference in contrast sensitivity between both groups was statistically insignificant (P=0.15, 0.88, 0.27, 0.32 and 0.82 at five spatial frequencies). CONCLUSION Both Visian ICL V4c and Artiflex lenses are safe and effective with stable and predictable refraction and they have comparable contrast sensitivity outcomes with no vision threatening complications.
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Affiliation(s)
- Islam M Rizk
- Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Abd-Almonem A Al-Hessy
- Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Sherief E El-Khouly
- Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ashraf M Sewelam
- Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
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Sachdev G, Ramamurthy D. Long-term safety of posterior chamber implantable phakic contact lens for the correction of myopia. Clin Ophthalmol 2019; 13:137-142. [PMID: 30662257 PMCID: PMC6327895 DOI: 10.2147/opth.s185304] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To review the safety of the implantable phakic contact lens (IPCL V1, Caregroup Sight Solutions, India) for correction of myopia and myopic astigmatism. Methods Retrospective interventional case series including 134 eyes which underwent IPCL implantation for correction of myopia and myopic astigmatism at a tertiary eye care hospital in South India. Intraoperative and postoperative complications were analyzed. The following parameters were analyzed at preoperative and 1, 6 and 12 month postoperative visits: visual acuity (in logMAR) and manifest refraction, slit lamp bio microscopy, dilated fundus examination, IOP and endothelial cell density measurement. Results No intraoperative complications were noted. Cataract was the most common postoperative complication, wherein three eyes (2.2%) underwent observation for visually insignificant anterior subcapsular cataract and one eye (0.7%) required surgical intervention. Four eyes developed transient increased IOP due to steroid response (3 eyes) and pupillary block glaucoma (1 eye). The endothelial cell loss noted over a 1-year follow-up was 2.01%±4.12% (P=0.71). One eye developed hypopyon on the third postoperative day, which resolved subsequently with an unaided vision of 20/20. No vision threatening complications were noted. The mean follow-up in the cohort was 25.66±16.45 months. Conclusion The IPCL is a safe and effective treatment modality for correction of myopia and myopic astigmatism.
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Fernández-Vega-Cueto L, Lisa C, Esteve-Taboada JJ, Montés-Micó R, Alfonso JF. Implantable collamer lens with central hole: 3-year follow-up. Clin Ophthalmol 2018; 12:2015-2029. [PMID: 30349185 PMCID: PMC6188208 DOI: 10.2147/opth.s171576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the long-term predictability, stability, safety, and efficacy of the V4c Visian implantable collamer lens (ICL) with central hole to correct myopia. Patients and methods One hundred and eighty-four eyes of 92 patients were evaluated during 3 years after implantation of the V4c ICL. The refraction, uncorrected distance visual acuity, best-corrected distance visual acuity, IOP, endothelial cell count, vault, and adverse effects were evaluated every 12 months during the whole follow-up. Results The mean spherical equivalent dropped from -8.30±2.98 D preoperatively to −0.37±0.47 D at 36 months post-surgery, with 91.8% eyes being within ±1.00 D of emmetropia. With respect to the astigmatic components J0 and J45, 98.4% and 99.5% of eyes, respectively, were within ±0.50 D of the desired refraction. At 36 months, 78.8% of eyes had no change in the Snellen lines of best-corrected distance visual acuity, while 8.7% gained one line and 6.5% gained two or more lines; mean safety and efficacy indexes were 1.03 and 0.90, respectively. Mean endothelial cell count was 2,742±340 cells/mm2 before and 2,663±366 cells/mm2 at 36 months post-surgery. Mean IOP reduced from 13.7±1.9 mmHg preoperatively to 12.8±1.7 mmHg at 36 months post-surgery. Mean vault varied from 409±196 µm at 12 months to 349±165 µm at 36 months. Conclusion The visual and refractive outcomes were very good and highly stable throughout the follow-up period, indicating that this ICL model may be predictable, stable, safe, and effective to correct myopia in the long term.
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Affiliation(s)
| | - Carlos Lisa
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain,
| | - José J Esteve-Taboada
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - José F Alfonso
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain, .,School of Medicine, University of Oviedo, Oviedo, Spain,
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Analysis of pre-operative factors affecting range of optimal vaulting after implantation of 12.6-mm V4c implantable collamer lens in myopic eyes. BMC Ophthalmol 2018; 18:163. [PMID: 29980187 PMCID: PMC6035463 DOI: 10.1186/s12886-018-0835-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate clinical factors affecting postoperative vaulting in eyes that had achieved optimal vaulting within the range of 250–750 μm following implantation of 12.6-mm V4c implantable collamer lenses (ICL). Methods A total of 236 eyes of 236 patients that had achieved optimal vaulting following implantation of a 12.6-mm V4c ICL were retrospectively analyzed. Associations between postoperative vaulting and age, preoperative anterior chamber depth (ACD), preoperative axial length (AL), preoperative white-to-white diameter, preoperative pupil size, preoperative sulcus-to-sulcus diameter, and preoperative manifest refraction spherical equivalent were investigated using simple regression, stepwise multiple regression, and multinomial logistic regression analyses. Results Mean central vaulting at the 6-month follow-up was 519.0 ± 112.8 μm. Variables relevant to postoperative vaulting were, in order of influence, preoperative ACD (β = 0.305, p < 0.001), preoperative pupil size (β = 0.218, p < 0.001), and preoperative AL (β = 0.171, p = 0.006). Low preoperative pupil size was associated with low optimal vaulting (250 to 450 μm), relative to that observed in the mid optimal vaulting group (451 to 550 μm) (odds ratio = 0.532, P = 0.021). Increasing preoperative ACD was associated with high optimal vaulting (551 and 750 μm), relative to that observed the mid optimal vaulting group (odds ratio = 6.340, P = 0.034). Conclusions Myopic eyes with greater preoperative ACD, larger pupil size, and longer AL are predisposed to higher postoperative vaulting following 12.6-mm V4c ICL implantation. Therefore, the extremes of these parameters should be considered when choosing V4c ICL size.
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Two-Year Outcomes of Visian Implantable Collamer Lens with a Central Hole for Correcting High Myopia. J Ophthalmol 2018; 2018:8678352. [PMID: 30057804 PMCID: PMC6051026 DOI: 10.1155/2018/8678352] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/21/2018] [Accepted: 05/30/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose To investigate two-year outcomes of Visian Implantable Collamer Lens with a central hole (ICL V4c) implantation for correcting high myopia. Methods Sixty-one eyes of 32 patients went through ICL V4c implantation. Safety, efficacy, predictability, and intraocular pressure were evaluated 2 years postoperatively. Anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle width (ACAW), and vault were measured using a Scheimpflug tomography imaging system. Results At 2 years, the spherical equivalent refraction decreased from preoperative −14.62 ± 4.29 D to −0.90 ± 0.95 D, with 79% of the eyes within ±0.50 D and 98% within ±1.00 D of the intended correction. The efficacy index was 1.03 ± 0.23, and the safety index was 1.24 ± 0.26. Corrected distance visual acuity (CDVA) remained unchanged in 23% of the eyes, 75% gained one or more lines of CDVA, and 2% lost one line. The ACV, ACD, and ACAW, respectively, decreased from 193.28 ± 29.15 mm3, 3.15 ± 0.23 mm, and 36.51 ± 6.54 degree to 112.48 ± 17.01 mm3, 2.99 ± 0.23 mm, and 22.54 ± 5.27 degree (p=0.0008, 0.008, and 0.0003, resp.). Intraocular pressure was 15.39 ± 2.88 mmHg before surgery and was 15.86 ± 4.11 mmHg at 2 years (p=0.11). Conclusion Implantation of ICL V4c is a safe, effective, and predictable procedure for correcting high myopia. Reduction of anterior chamber space after surgery did not induce intraocular pressure increase during the 2-year follow-up.
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Long-Term Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation in Young Population. Eye Contact Lens 2018; 44 Suppl 2:S365-S369. [PMID: 29944497 DOI: 10.1097/icl.0000000000000497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the clinical outcomes and vision-related quality of life after implantable collamer lens (ICL) implantation for younger patients (17 years ≤ age ≤21 years) and for older patients (age >21 years). METHODS Design: Retrospective observational study. This study-enrolled patients underwent ICL implantation and finished 5-year follow-up who were divided into two groups based on age. Uncorrected distance visual acuity and corrected distance visual acuity (CDVA), refractions for the evaluation of efficacy, safety, stability, and predictability, intraocular pressure, corneal endothelial cell, ICL vaults, higher-order aberration (HOA), contrast sensitivity (CS) functions, adverse events, and quality of life were evaluated on 1, 3, 7, 14 days, 1, 3, 6 months and 1, 3, 5 years after surgery. RESULTS The study enrolled 164 eyes (82 patients), 84 in younger group (17 years ≤ age ≤21 years) and 80 in older group (age >21 years). The mean postoperative log of minimal angle of resolution CDVA of younger group was better than those of older group. The mean spherical equivalent values were more myopic in younger group than older group. As for CS and HOA, the younger and older groups showed similar data. The NEI-RQL scores of dependence on correction, worry, suboptimal correction, appearance, and satisfaction of older group were higher, whereas the score of symptom and near vision was worse. Both groups showed similar results in vaults, endothelial cell density and adverse events. CONCLUSIONS The ICL performed well for the ametropia correction of both younger and older patients throughout the 5-year period. In the younger group, the visual quality was even better, but the myopic shift was quicker.
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Rodríguez-Una I, Rodríguez-Calvo PP, Fernández-Vega Cueto L, Lisa C, Fernández-Vega Cueto A, Alfonso JF. Intraocular Pressure After Implantation of a Phakic Collamer Intraocular Lens With a Central Hole. J Refract Surg 2018; 33:244-249. [PMID: 28407164 DOI: 10.3928/1081597x-20170110-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/08/2016] [Indexed: 11/20/2022]
Abstract
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.].
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Changes in Objective Vault and Effect on Vision Outcomes after Implantable Collamer Lens Implantation: 1-Year Follow-up. Eur J Ophthalmol 2018; 22:153-60. [PMID: 21607932 DOI: 10.5301/ejo.2011.8359] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2011] [Indexed: 11/20/2022]
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Long-Term Endothelial Cell Loss in Patients with Artisan Myopia and Artisan Toric Phakic Intraocular Lenses: 5- and 10-Year Results. Ophthalmology 2017; 125:486-494. [PMID: 28935401 DOI: 10.1016/j.ophtha.2017.08.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/10/2017] [Accepted: 08/08/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the long-term change in endothelial cell density (ECD) after the implantation of 2 types of rigid iris-fixated phakic intraocular lenses (pIOLs) for the treatment of myopia and astigmatism. DESIGN Prospective, clinical cohort study. PARTICIPANTS A total of 507 eyes of 289 patients receiving the Artisan Myopia or Artisan Toric (Ophtec B.V., Groningen, The Netherlands) iris-fixated pIOL for the treatment of myopia or astigmatism at the University Eye Clinic Maastricht as of January 1998. METHODS A total of 381 myopic and 126 toric pIOLs were implanted. Five- and 10-year follow-ups were completed by 193 and 127 eyes implanted with the myopic pIOL and by 40 and 20 eyes implanted with the toric pIOL, respectively. MAIN OUTCOME MEASURES Chronic endothelial cell (EC) loss, percentage of eyes with a decrease of ≥25% in ECD, and percentage of eyes with an ECD <1500 cells/mm2. RESULTS Chronic EC loss was calculated from 6 months postoperatively to the end of follow-up and showed an annual ECD decline of 48 cells/mm2 (standard error, 3.14) and 61 cells/mm2 (standard error, 6.30) in the myopic (P < 0.001) and toric (P < 0.001) groups, respectively, resulting in a total EC loss of 16.6% and 21.5% from 6 months to 10 years postoperatively, respectively. Ten years after implantation, ECD had decreased by ≥25% in 7.9% and 6.3%, whereas ECD was <1500 cells/mm2 in 3.9% and 4.0% in the myopic and toric groups, respectively. Explantation of the pIOL occurred in 6.0% in the myopic group and 4.8% in the toric group. Risk factors for increased EC loss were a shallow anterior chamber depth (ACD) (P ≤ 0.005) and a smaller distance between the central and peripheral pIOL edge to the endothelium (P ≤ 0.005). CONCLUSIONS A significant linear chronic EC loss was reported after implantation with myopic or toric iris-fixated pIOLs. A smaller ACD and smaller distance between pIOL edge and endothelium were risk factors for EC loss. Modification of preoperative age-related ECD thresholds is indicated to maintain an ECD that warrants safe future combined pIOL explantation and cataract surgery.
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Lu Y, Yang N, Li X, Kong J. Four-year Follow-up of the Changes in Anterior Segment After Phakic Collamer Lens Implantation. Am J Ophthalmol 2017; 178:140-149. [PMID: 28342721 DOI: 10.1016/j.ajo.2017.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the changes and relationship in central vaulting, flare intensity, and crystalline lens thickness during a follow-up period of 4 years after implantable collamer lens (ICL) implantation in eyes with high myopia. DESIGN Retrospective observational study. METHODS Ninety-eight eyes of 50 patients were followed up with routine measurements of central vaulting, crystalline lens thickness, endothelial cell density, and aqueous flare postoperatively. Data were analyzed by repeated-measures analysis of variance. The relationship between the annual change in crystal lens thickness after surgery and age was evaluated by Pearson correlation coefficient and linear regression. RESULTS There was a continuous reduction in central vaulting and endothelial cell density as well as an increase in crystalline lens thickness in ICL eyes from 1 month onward to 5 years postoperatively (P < .001). Although the trend of variation during the individual visit period was accentuated, the variation turned out to be smaller between 12 and 36 months or 60 months postoperatively (P = .42, P = .65). Aqueous flare intensity increased significantly after surgery and returned to normal 1 year later. Additionally, a positive correlation between patient age and crystalline lens thickness (r = 0.617, P < .0001) was observed in eyes with ICL implantation. CONCLUSIONS The changes in central vaulting, endothelial cell density, and crystalline lens thickness are more prominent during the first year after ICL implantation, tending to be relatively stable afterwards. The anterior inflammation during the early postoperative period synchronizes with the sharp progression of crystalline lens changes within the first year.
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Meier PG, Majo F, Othenin-Girard P, Bergin C, Guber I. Refractive outcomes and complications after combined copolymer phakic intraocular lens explantation and phacoemulsification with intraocular lens implantation. J Cataract Refract Surg 2017; 43:748-753. [DOI: 10.1016/j.jcrs.2017.03.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/14/2017] [Accepted: 03/07/2017] [Indexed: 11/26/2022]
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Esteve-Taboada JJ, Domínguez-Vicent A, Ferrer-Blasco T, Alfonso JF, Montés-Micó R. Posterior chamber phakic intraocular lenses to improve visual outcomes in keratoconus patients. J Cataract Refract Surg 2017; 43:115-130. [DOI: 10.1016/j.jcrs.2016.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/06/2016] [Accepted: 05/25/2016] [Indexed: 12/01/2022]
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Senthil S, Choudhari NS, Vaddavalli PK, Murthy S, Reddy J, Garudadri CS. Etiology and Management of Raised Intraocular Pressure following Posterior Chamber Phakic Intraocular Lens Implantation in Myopic Eyes. PLoS One 2016; 11:e0165469. [PMID: 27855172 PMCID: PMC5113895 DOI: 10.1371/journal.pone.0165469] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/12/2016] [Indexed: 11/18/2022] Open
Abstract
AIM To evaluate the etiology and management of elevated intraocular pressure (IOP) following posterior chamber phakic implantable collamer lens (ICL) surgery. METHODS Between 2009 and 2015, 638 eyes of 359 subjects with refractive myopia, underwent V4b and V4c (CentraFLOW) model ICL implantation. Ocular hypertension (OHT) was defined as IOP of ≥ 22 mm Hg on two separate occasions and elevated IOP with corresponding optic disc or visual field damage was defined as glaucoma. RESULTS Elevated IOP ≥ 22 mm Hg was noted in 33 eyes of 30 subjects (33/638; 5.17%). Median age of subjects with raised IOP was 26 years (Inter quartile range (IQR):22, 29) and median refarctive error was -16 diopters (-19.5, -13). The median follow up was 7.8 months (IQR:0.3, 17.6) and median time for postoperative IOP rise was 12 days, (IQR:2, 24). The various etiologies for elevated IOP were steroid response in 21 eyes (64%; 10 eyes with V4b, 11 eyes with V4c), retained viscoelastic in 5 eyes (15%) (3 with V4b, 2 with V4c), pupillary block in four eyes (12%; 3 with V4b, 1 with V4c), malignant glaucoma in one eye (3%, V4b), and missed pre-existing Juvenile open angle glaucoma (JOAG) in two eyes (6% with V4b). Elevated IOP in 31 eyes resolved with conservative management. One eye (centraFLOW design) with central aquaport block by viscoelastic, needed AC wash and one eye with malignant glaucoma needed parsplana vitrectomy and hyaloidotomy. Ten eyes required longterm (>2 months) antiglaucoma medications (AGM) for IOP control. Except the two eyes with JOAG, none had disc and field damage. CONCLUSION In our series, OHT was seen in 4.85% and glaucoma in 0.3% eyes that underwent V4b and V4c model ICL implantation. Multiple etiologies were noted and steroid induced ocular hypertension was the most common cause of elevated IOP followed by retained viscoelastic and pupillary block. One third of these eyes required longterm AGM for IOP control.
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Affiliation(s)
- Sirisha Senthil
- VST Glaucoma Center, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- * E-mail:
| | - Nikhil S. Choudhari
- VST Glaucoma Center, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Pravin K. Vaddavalli
- Tej Kohli Cornea Services, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Somasheila Murthy
- Tej Kohli Cornea Services, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Jagadesh Reddy
- Tej Kohli Cornea Services, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
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Chen X, Miao H, Naidu RK, Wang X, Zhou X. Comparison of early changes in and factors affecting vault following posterior chamber phakic Implantable Collamer Lens implantation without and with a central hole (ICL V4 and ICL V4c). BMC Ophthalmol 2016; 16:161. [PMID: 27604229 PMCID: PMC5015244 DOI: 10.1186/s12886-016-0336-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/23/2016] [Indexed: 12/04/2022] Open
Abstract
Background To objectively compare the early changes in vault over time following implantation of an Implantable Collamer Lens without (ICL V4) and with (ICL V4c) a central hole and the respective factors affecting vault change in moderate to high myopia. Methods This prospective study comprised of 38 eyes of 38 patients implanted with ICL V4 and 39 eyes of 39 patients implanted with ICL V4c intraocular lenses. We quantitatively assessed the postoperative values of vault and pupil size at 1 day, 1 week, and 1 month following implantation using a rotating Scheimpflug camera (Pentacam). We compared these postoperative values within and between the two groups and identified the factors affecting vault change. Results The mean vaults at 1 day, 1 week, and 1 month following ICL V4 implantation were 303.68 ± 185.11, 517.89 ± 160.07 and 521.32 ± 155.72 μm respectively, and those following ICL V4c were 316.67 ± 186.89, 495.13 ± 180.84 and 510.77 ± 175.51 μm, respectively. There was a significant difference in vault between 1 day and 1 week postoperatively. There was a significant association between the vault change and the pupil size change in both groups from 1 day to 1 month postoperatively (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001; ICL V4c: r = 0.588, P <0.001). The vault value 1 month after implantation of ICL V4 and ICL V4c was associated with the preoperative anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus. Conclusions Pupil movement is a critical factor in vault change, with increasing vault observed postoperatively from 1 day to 1 week associated with the declining effects of pharmacological miosis and increasing pupil size. The anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus show some correlation with vault. Electronic supplementary material The online version of this article (doi:10.1186/s12886-016-0336-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xun Chen
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Huamao Miao
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | | | - Xiaoying Wang
- Key Lab of Myopia, Ministry of Health, Shanghai, China. .,EYE & ENT Hospital of Fudan University, Shanghai, China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Eye and ENT Hospital of Fudan University, No. 19 BaoQing Road, Shanghai, 200031, China.
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
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Cao X, Wu W, Wang Y, Xie C, Tong J, Shen Y. Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia: First experience in China. Medicine (Baltimore) 2016; 95:e4641. [PMID: 27603356 PMCID: PMC5023878 DOI: 10.1097/md.0000000000004641] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this article is to evaluate the clinical outcomes of a posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens V4c) for the correction of moderate to high myopia in Chinese eyes.The article is designed as a retrospective case series.This study included the first consecutive eyes that had implantation of a new pIOL design with a central hole, at our department by the same surgeon. The safety, efficacy, predictability, stability, and adverse events of the surgery were evaluated over 6 months.The study enrolled 63 eyes (32 patients). The mean spherical equivalent decreased from -12.81 ± 3.11 diopters (D) preoperatively to -0.05 ± 0.27 D 6 months postoperatively; 96.8% of eyes were within ±0.50 D of the target and 100% of eyes were within ±1.00 D. All eyes had a decimal uncorrected distance visual acuity of 0.5 (20/40) or better at every follow-up visit. The safety and efficacy indices were 1.42 ± 0.34 and 1.11 ± 0.19, respectively. Postoperatively, the intraocular pressure (IOP) remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 505.2 ± 258.9 μm (range 120-990 μm), and the mean endothelial cell loss was 2.0%.Implantation of the pIOL was safe, effective, predictable, and stable in the correction of moderate-to-high myopia in Han Chinese patients, even without peripheral iridectomy.
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Affiliation(s)
- Xinfang Cao
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China. Department of Orthopedics, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China
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Zheng QY, Xu W, Liang GL, Wu J, Shi JT. Preoperative Biometric Parameters Predict the Vault after ICL Implantation: A Retrospective Clinical Study. Ophthalmic Res 2016; 56:215-221. [DOI: 10.1159/000446185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/13/2016] [Indexed: 11/19/2022]
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Lee J, Kim Y, Park S, Bae J, Lee S, Park Y, Lee J, Lee JE. Long-term clinical results of posterior chamber phakic intraocular lens implantation to correct myopia. Clin Exp Ophthalmol 2016; 44:481-7. [PMID: 26661832 DOI: 10.1111/ceo.12691] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/28/2015] [Accepted: 12/05/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to determine whether implantable collamer lens (ICL) implantation to correct myopia is an effective and safe surgical option even after long-term follow up. DESIGN A retrospective observational study was carried out. PARTICIPANTS A total of 281 eyes of 145 myopic patients were included in the study. METHODS Patients underwent ICL implantation and had the follow-up period of at least 5 years (87 ± 18.9 months). MAIN OUTCOME MEASURES Outcome measures included uncorrected and corrected distance visual acuities, refraction for the evaluation of efficacy, safety, stability and predictability, ICL vault and adverse events. RESULTS The final mean logMAR uncorrected and corrected distance visual acuities were 0.02 ± 0.19 and -0.12 ± 0.13, respectively. The mean efficacy and safety indices were 1.04 ± 0.32 and 1.20 ± 0.26. The mean spherical equivalent decreased from -8.74 ± 2.27 diopter (D) to -0.58 ± 0.72 D, and there was high predictability with 69.8% and 87.2% having a postoperative refraction within 0.5 D and 1.0 D, respectively. The mean postoperative vault was changed from 2.53 ± 0.6 to 2.00 ± 0.7. Six (2.1%) eyes developed cataract, and the mean endothelial cell loss was 7.8 ± 8.3%. Increased intraocular pressure was found in two (0.7%) eyes that required the exchange of lenses with different sizes. CONCLUSIONS Implantable collamer lens implantation to correct myopia was an effective and safe surgery with high predictability and stability during long-term follow up. Slight myopic shift and cataract formation related with change in vault should be further evaluated.
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Affiliation(s)
- Jongsoo Lee
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | | | | | | | - Seunguk Lee
- The Department of Ophthalmology, School of Medicine, Kosin University, Pusan, Korea
| | - Youngmin Park
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jonghun Lee
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea
| | - Ji-Eun Lee
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Effects of Implantable Collamer Lens V4c Placement on Iridocorneal Angle Measurements by Fourier-Domain Optical Coherence Tomography. Am J Ophthalmol 2016; 162:43-52.e1. [PMID: 26582312 DOI: 10.1016/j.ajo.2015.11.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess by Fourier-domain optical coherence tomography (FDOCT) changes produced in iridocorneal angle measurements in patients undergoing Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG) placement. DESIGN Prospective interventional case series. METHODS In 50 eyes of 25 myopic subjects consecutively scheduled for ICL implant, FDOCT (RTVue; Optovue Inc) iridocorneal angle measurements were made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA) and angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared among the quadrants nasal, temporal, and inferior, and correlations with ocular variables including lens vault were examined. RESULTS Preoperative TIA was 48.7 ± 8.7, 48.2 ± 8.7, and 48.7 ± 9.3 degrees for the nasal, temporal, and inferior quadrants, with no differences (P = 1.000). Following ICL implant, corresponding values fell to 31.2 ± 11.5, 30.0 ± 10.7, and 29.7 ± 8.1 degrees at 1 month postsurgery, indicating angle narrowing of 34%-42%, and to 30.6 ± 12.3, 30.1 ± 11.9, and 29.8 ± 12.3 degrees, respectively, at 3 months postsurgery. Angle measurements failed to vary between 1 month and 3 months postsurgery (P = .481). In 8 eyes, iridotrabecular contact attributable to surgery was observed. One month after surgery, vault measurements correlated with TIA (R = -.309; P = .048). Six variables were identified as predictors of TIA at 1 month postsurgery (R(2) = .907). CONCLUSIONS Although considerable angle narrowing was detected 1 month after ICL V4c implant, this narrowing remained stable at 3 months postsurgery. Factors predictive of TIA could serve to identify suitable candidates for ICL placement.
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Lisa C, Baamonde B, Pérez-Vives C, Montés-Micó R, Alfonso JF. Five-year functional outcomes and vault of -20 diopter myopic phakic intraocular lens implantation. J Cataract Refract Surg 2016; 41:2724-30. [PMID: 26796453 DOI: 10.1016/j.jcrs.2015.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 07/09/2015] [Accepted: 07/15/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate refractive and visual outcomes and complications associated with phakic intraocular lens (pIOL) implantation to correct high myopia. SETTINGS Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective observational case series. METHODS Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction, vault, and adverse effects were evaluated after 5 years with Visian ICMV4 pIOL. RESULTS Mean spherical equivalent (SE) dropped from -18.32 ± 2.37 diopters (D) preoperatively to -0.88 ± 0.52D 5 years postoperatively; 61% of eyes were within ±0.75 D of the target. The mean Snellen decimal CDVA and UDVA were 0.73 ± 0.23 and 0.55 ± 0.26, respectively. More than 50% of eyes achieved 20/25 or better CDVA postoperatively. Four eyes had lost 2 or 1 lines of CDVA, 10 eyes had not lost any lines from preoperatively, and 46 eyes had gained 1 or more lines of CDVA 5 years postoperatively. The safety index was 1.26 ± 0.32. Forty eyes had UDVA of 20/40 or better postoperatively. The efficacy index was 0.99 ± 0.42. At 5-year follow-up, the mean central vault was 475.28 ± 216.38 μm. No eyes showed central contact between the pIOL and crystalline lens. Nevertheless, 10 eyes showed peripheral contact with a central vault between 150 and 260 μm. Two eyes developed anterior subcapsular cataract, although only 1 eye required cataract surgery. CONCLUSIONS Predictability, safety and effective outcomes of posterior pIOL of (- were good, as well as postoperative complications over the long term. A central vault of 260 μm was enough to prevent the peripheral contact between the pIOL and crystalline lens in eyes with high myopia. FINANCIAL DISCLOSURE The authors have no proprietary interest in any of the materials mentioned in this article.
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Affiliation(s)
- Carlos Lisa
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Begoña Baamonde
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Cari Pérez-Vives
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Robert Montés-Micó
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - José F Alfonso
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
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Lee SC, Chung HJ, Chung YS, Choi JY, Choi KY, Kim MJ. Pigment Dispersion Syndrome and Reverse Pupillary Block after Implantable Collamer Lens with Central Hole Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.10.1661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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