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Xu Y, Liu F, Ye Y, Zhang Z, Niu L, Yao P, Wang X, Zhou X, Zhao J. Establishment of a new vault prediction formula after implantable collamer lens implantation based on factor analysis of multi-modal ophthalmic parameters of anterior and posterior chamber. Clin Exp Ophthalmol 2024. [PMID: 39119923 DOI: 10.1111/ceo.14433] [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: 02/07/2024] [Revised: 07/02/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND To establish a novel vault prediction formula after implantable collamer lens (ICL) implantation that considers both anterior and posterior chamber characteristics with multi-modal parameters. METHODS A total of 103 and 65 eyes were included in the development and validation groups, respectively. Exploratory factor analysis was performed using data from optical coherence tomography and ultrasound biomicroscopy in the development group to synthesise summative factors with different clinical significance. Dominant original metrics with heavy loadings on significant factors (absolute value of the loading coefficient >0.5) were screened for multivariate linear regression models using a stepwise method. The newly derived formula was evaluated and compared to the NK and KS formulas in the validation group. RESULTS Six factors (anterior chamber angle, horizontal width, lens, iris, iridociliary complex and ciliary body) were generated after dimension reduction via factor analysis. Factors 2 (horizontal width), 3 (lens), and 5 (iridociliary complex) had a significant influence on the vault. When dominant metrics on these factors were screened for further model building, ICL size, anterior chamber width, crystalline lens rise, iris curvature, and iris-ciliary process distance were retained in the final formula, with an adjusted R2 of 0.698, a median absolute error of 81.97 mm, and a root-mean-square error of 103.35 mm. CONCLUSIONS Multiple intraocular components, including the lens, iris, and ciliary body, play important roles in vault determination. The new formula exhibits good accuracy for vault predictions and ICL size recommendations.
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Affiliation(s)
- Yijia Xu
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Fang Liu
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Zhe Zhang
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Peijun Yao
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
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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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Wang Z, Ma H, Zhang Y, Yuan Y, Liu Y, Chen Y. Differences in anterior chamber depth in keratoconus patients with binocular very asymmetry ectasia. BMC Ophthalmol 2024; 24:87. [PMID: 38408954 PMCID: PMC10898011 DOI: 10.1186/s12886-024-03353-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/15/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To evaluate the difference in anterior chamber depth (ACD) between two eyes among keratoconus patients with binocular very asymmetric ectasia (VAE) and to explore the influencing factors. METHODS The corneal curvature and ACD in both eyes of patients with VAE were measured by Sirius (version 3.2, CSO, Italy) at the following points: corneal vertex, maximum curvature (apex), and the 1.5 mm, 2.5 mm, and 3.5 mm superior-, inferior-, nasal-, temporal-paracentral from center. The mean pupil power (MPP) and corneal morphology parameters were also measured. Correlations between ACD and curvature and morphology parameters were analyzed by linear regression. RESULTS 172 eyes of 86 patients (9 to 45 years) were classified into the VAE-N (n = 86) group and the VAE-E group (n = 86) based on the corneal morphology. The central (3.32 ± 0.27 mm versus 3.43 ± 0.29 mm, P < 0.001) and paracentral ACDs increased significantly in the VAE-E group, and the corneal morphology parameters were also significantly higher. The central ACD was significantly correlated with the MPP (r = 0.465), KVf/b (Keratoconus Vertex front/back) (r = 0.306, r = 0.327), and BCVf/b (Baiocchi Calossi Versaci front/back) (r = 0.356, r = 0.416). Linear regression showed good relationships between △ACD and △MPP (R2 = 0.429) and △KVf/b (R2 = 0.504, R2 = 0.536). CONCLUSIONS The ACD was larger in the VAE-E group. The difference in ACD between the VAE-E and VAE-N groups was significantly correlated with corneal curvature and the extent of corneal elevation, indicating the influences of both the corneal magnification effect and corneal ectasia on ACD.
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Affiliation(s)
- Zizhen Wang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
- Peking University Institute of Laser Medicine, Beijing, China
| | - Haowen Ma
- Peking University Health Science Center, 38 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Yu Zhang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
- Peking University Institute of Laser Medicine, Beijing, China
| | - Yifei Yuan
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
- Peking University Institute of Laser Medicine, Beijing, China
| | - Yan Liu
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
- Peking University Institute of Laser Medicine, Beijing, China
| | - Yueguo Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China.
- Peking University Institute of Laser Medicine, Beijing, China.
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Sánchez-Trancón A, Manito SC, Sierra OT, Baptista AM, Serra PM. Influence of anterior chamber depth and vault on anterior chamber angle morphology after phakic posterior chamber intraocular lens implantation. Int Ophthalmol 2024; 44:15. [PMID: 38321260 DOI: 10.1007/s10792-024-02924-1] [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: 01/24/2023] [Accepted: 12/17/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE This study aims to investigate the influence of anterior chamber depth (ACD) and vault on the anterior chamber angle (ACA) morphology in myopic individuals implanted with posterior chamber phakic intraocular lenses. METHODS This retrospective case series involved 231 eyes receiving a 13.2-mm implantable collamer lens (ICL). Preoperative anterior chamber anatomy was assessed using anterior segment optical coherence tomography (AS-OCT) and optical tomography, while postoperative evaluation employed AS-OCT. ACA morphology was characterized pre- and postoperatively through trabecular iris angle (TIA750), ACA distance opening (AOD750) and trabecular iris space area (TISA750). The influence of ACD and vault was examined by categorizing the sample into ACD (shallow, average and deep) and vault (low, optimal and high) groups. RESULTS Preoperative ACA morphology varied based on ACD, with shallower ACDs exhibiting narrower TIA750, smaller AOD750 and TISA750. ICL implantation induced greater ACA narrowing more in the deep ACD group (TIA750 = 20.1 degrees; AOD750 = 0.82 mm and TISA750 = 0.44 mm2) compared to the shallow ACD group (TIA750 = 15.2 degrees; AOD750 = 0.44 mm and TISA750 = 0.21 mm2). Postoperatively, deeper ACDs showed larger ACAs. Increasing vault magnitude led to increased ACA narrowing, with the low vault group exhibiting smaller closure (TIA750 = 14.3 degrees; AOD750 = 0.56 mm and TISA750 = 0.29 mm2) compared to the high vault group (TIA750 = 20.8 degrees; AOD750 = 0.73 mm and TISA750 = 0.36 mm2). The magnitude of ACA narrowing associated with the vault had a consistent effect across different ACD groups. CONCLUSIONS Posterior chamber intraocular lens implantation results in ACA narrowing, the extent of which is contingent upon preoperative anterior chamber and ACA morphology, with additional influence from vault magnitude.
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Affiliation(s)
- Angel Sánchez-Trancón
- Ophthalmology Clinic Vista Sánchez Trancón, Room 15, Calle La Violeta, 06005, Badajoz, Spain
| | - Santiago Cerpa Manito
- Ophthalmology Clinic Vista Sánchez Trancón, Room 15, Calle La Violeta, 06005, Badajoz, Spain
| | - Oscar Torrado Sierra
- Ophthalmology Clinic Vista Sánchez Trancón, Room 15, Calle La Violeta, 06005, Badajoz, Spain
| | | | - Pedro Miguel Serra
- Ophthalmology Clinic Vista Sánchez Trancón, Room 15, Calle La Violeta, 06005, Badajoz, Spain.
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Martínez-Plaza E, López-de la Rosa A, Ossa-Calderon C, Blázquez-Arauzo F, López-Miguel A, Maldonado MJ. Assessment of the iridocorneal angle pigmentation and structures after the implantation of EVO+ Visian Implantable Collamer Lens. Int Ophthalmol 2023; 43:4711-4718. [PMID: 37697080 DOI: 10.1007/s10792-023-02871-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To evaluate the effect of EVO+ Visian Implantable Collamer Lens (ICL) implantation on the iridocorneal angle pigmentation and structures. METHODS Myopic refractive surgery candidates who underwent posterior chamber EVO+ ICL implantation were evaluated preoperatively and 3 and 6 months postoperatively. High-resolution images of the iridocorneal angle (nasal, superior, temporal and inferior quadrants) were acquired during gonioscopy. A masked observer, blinded to study visits and patients' information, evaluated the angle width, apparent iris root insertion, iris configuration, and trabecular meshwork pigmentation according to the Spaeth scale in two different occasions. The intra-rater reliability was estimated using the weighted Gwet's Agreement Coefficient (AC2). Differences between visits were analyzed using the Cochran Q test or the Friedman test. RESULTS Twenty-one patients (13 females and 8 males) aging 31.3 ± 6.3 years old were recruited. The intra-rater reliability of gonioscopy assessment was excellent for every parameter assessed (AC2 ≥ 0.97). No significant differences were found among the study visits for any quadrant in the angle width (p ≥ 0.74), apparent iris root insertion (p ≥ 0.22), iris configuration (p ≥ 0.21) and trabecular meshwork pigmentation (p ≥ 0.24). Mean pigmentation of trabecular meshwork for the four quadrants did not vary either among visits (p = 0.25). CONCLUSIONS The EVO+ ICL implantation after uneventful procedures appears not to clinically affect the iridocorneal angle pigmentation and/or structures during a short-medium follow-up using gonioscopy assessment. The intra-rater reliability of glaucoma specialists assessing iridocorneal angle structures using gonioscopy images is very high.
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Affiliation(s)
- Elena Martínez-Plaza
- 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
- Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain
| | - Carolina Ossa-Calderon
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Francisco Blázquez-Arauzo
- 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.
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, 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
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Francis M, Matalia H, John AA, Matalia J, Chinnappaiah N, Bhandary P, Shetty R, Nuijts RMMA, Sinha Roy A. Minimum Corneal Diameter and Anterior Steep Axis Curvature Share the Same Meridian: A Novel Finding. Am J Ophthalmol 2023; 256:175-185. [PMID: 37669730 DOI: 10.1016/j.ajo.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE To define the external scleral sulcus (ESS) on a Scheimpflug image and use it for a morphometric analysis of corneal diameter (CD). DESIGN Retrospective, cross-sectional study of pediatric Asian-Indian eyes. METHODS One random eye of 353 subjects between 5 and 18 years underwent 25-scan Pentacam HR imaging. For all scans, densitometry values along the anterior corneal edge were recorded and differentiated. The peaks on the differentiated curve were chosen as the ESS points, and this distance between them was called CD. Vertical (vCD), maximum (maxCD), minimum (minCD) CD and their meridians were defined. Multiple regression models (MRMs) with CD and other Pentacam parameters were built to predict astigmatism and its axis, mean keratometry (Kmean), and Belin/Ambrósio enhanced ectasia display deviation (BAD-D). MRMs were validated using intraclass correlation coefficient (ICC). Estimated horizontal CD (hCD) was validated against digital caliper measurement using ICC. RESULTS The ICC (95% CI) between caliper and hCD was 0.96 (0.93, 0.97). MRM predictions (P < .001) used CD parameters, anterior chamber depth, corneal volume and distance from the corneal thinnest location to apex. These predictions achieved an ICC of 0.34 (0.18, 0.46), 0.82 (0.78, 0.86), 0.87 (0.84, 0.89), and 0.81 (0.76, 0.84), respectively. The astigmatism axis prediction depended on the minCD and maxCD meridians. Its within-subject SD (4.97°) was less than 2 consecutive Pentacam scan angles (7.2°). CONCLUSIONS The CD metric strongly correlated with the astigmatism axis, keratometry, and BAD-D. Its spatial description may be significant in corneal treatment planning and disease diagnoses.
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Affiliation(s)
- Mathew Francis
- From the Imaging, Biomechanics and Mathematical Modelling Solutions, Narayana Nethralaya Foundation (M.F., A.S.R.), Bangalore, India; Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India
| | - Himanshu Matalia
- Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India
| | - Ansu Ann John
- Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India
| | - Jyoti Matalia
- Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India
| | - Nandini Chinnappaiah
- Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India
| | - Prarthana Bhandary
- Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India
| | - Rohit Shetty
- Department of Corneal and Refractive Surgery, Narayana Nethralaya (H.M., A.A.J., J.M., N.C., P.B., R.S.), Bangalore, India; University Eye Clinic Maastricht, Maastricht University Medical Center (MUMC+) (M.F., R.S., R.M.M.A.N.), Maastricht, Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center (MUMC+) (M.F., R.S., R.M.M.A.N.), Maastricht, Netherlands
| | - Abhijit Sinha Roy
- From the Imaging, Biomechanics and Mathematical Modelling Solutions, Narayana Nethralaya Foundation (M.F., A.S.R.), Bangalore, India.
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Sánchez-Trancón A, Manito SC, Sierra OT, Baptista AM, Serra PM. Prediction model of the horizontal trabecular iris angle after phakic posterior chamber implantable intraocular lens surgery. J Cataract Refract Surg 2023; 49:732-739. [PMID: 36807205 DOI: 10.1097/j.jcrs.0000000000001171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To determine the predictors of the postoperative horizontal trabecular iris angle (TIA 750 ) after phakic posterior chamber implantable intraocular lens (IOL) surgery. SETTING Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain. DESIGN Retrospective case series. METHODS 330 eyes implanted with spherical/toric implantable collamer lens (ICL) were included in this study. From 230 eyes implanted with 13.2 mm ICL, these were divided in modeling (n = 180) and evaluation group (n = 50). Two groups implanted with 12.6 mm and 13.7 mm (n = 50 each) were also used as evaluation. Anterior-segment optical coherence tomography was used preoperatively to perform anterior chamber biometry (angle-to-angle [ATA] distance, crystalline lens rise, anterior chamber depth [ACD], cornea sagittal depth, pupil diameter, nasal/temporal TIA 750 ); postoperatively for measuring the vault, pupil diameter and nasal/temporal TIA 750 . Corneal curvature and horizontal visible iris diameter were measured using optical tomography. Bivariate correlation analysis was used to determine associations between preoperative and postoperative horizontal TIA 750 with anterior chamber biometry, ICL-related parameters and age. Finally, a multivariate linear regression model was constructed for predicting the postoperative TIA 750 . RESULTS Horizontal TIA 750 reduced from 42.9 ± 8.0 degrees preoperatively to 24.4 ± 5.6 degrees postoperatively. Postoperative TIA 750 was positively correlated with the preoperative TIA 750 , cornea sagittal depth and ACD, and negatively associated with the vault. The main predictors of the postoperative TIA 750 were the preoperative parameters, TIA 750 , ICLsize - ATA and pupil diameter (adjusted- R2 = 0.39). The limits of agreement between predicted and real TIA 750 were close to ±10 degrees. CONCLUSIONS Implantation of a phakic posterior chamber implantable IOL leads to a reduction in TIA 750 and the main factors contributing for this are the preoperative TIA 750 aperture and the vault.
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Affiliation(s)
- Angel Sánchez-Trancón
- From the Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain (Sánchez-Trancón, Manito, Sierra, Serra); Centre of Physics, University of Minho, Braga, Portugal (Baptista)
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Kilic D, Förster A, Mertens E, Dick HB, Taneri S. Rotational Stability After Implantation of Two Different Phakic Toric Intraocular Lenses. J Refract Surg 2023; 39:463-472. [PMID: 37449509 DOI: 10.3928/1081597x-20230512-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
PURPOSE To compare clinical outcomes and rotational stability of the toric implantable Collamer lens (TICL) and toric implantable phakic contact lens (TIPCL). METHODS Charts were reviewed from January 2011 to January 2023 to identify all TICLs and TIPCLs implanted by a single surgeon. Implant size was generally chosen according to the manufacturer's recommendation, but 15 TIPCLs 0.25 mm larger than recommended to increase vaulting were included. RESULTS Eighty-four TICLs and 98 TIPCLs were identified and yielded excellent refractive and visual results in eyes with high myopic astigmatism at the last follow-up visit. No case of acute glaucoma or cataract induction was observed. In total, 15 (8.2%) rotated lenses were recorded; 2 (2.4%) TICLs and 13 (13.3%) TIPCLs (P = .013). Eyes in both groups were similar in preoperative spherical equivalent, cylinder, white-to-white distance, anterior chamber depth (ACD), anterior chamber angle, and mean follow-up times (P = .925, .673, .822, .794, .358, and .873, respectively). Average TICL size was larger than TIPCL size (P < .001). Rotation of the lenses was positively correlated with cylinder and negatively correlated with ACD but not with vaulting (P = .001, r = 0.253; P = .011, r = -0.193; P = .488, r = -0.057; respectively). Vaulting was positively correlated with preoperative ACD (P ≤ .001, r = .329). In eyes with a rotated TIPCL, preoperative cylinder was higher and ACD was shallower than in eyes with a stable TIPCL (P = .001 and .007, respectively). Increasing the implant size had no significant effect on rotation rate (P = .685). CONCLUSIONS Although both implants were safe and effective in highly myopic eyes, TICL rotated less frequently than TIPCL and required fewer secondary interventions. Rotation was correlated with preoperative cylinder and ACD but not lens vaulting. [J Refract Surg. 2023;39(7):463-472.].
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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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10
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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11
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Khan MA, Tan Q, Sun W, Cai W, Zhao L, Lin D. Prediction of excessively low vault after implantable collamer lens implantation using iris morphology. Front Med (Lausanne) 2022; 9:1029350. [PMID: 36388920 PMCID: PMC9650031 DOI: 10.3389/fmed.2022.1029350] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To identify the iris morphology-related factors for prediction of outcomes of excessively low vault (< 100 μm) after Implantable Collamer Lens V4c (ICL V4c; STAAR Surgical) implantation. Methods This retrospective case-control study included 81 eyes from 2,080 patients who underwent ICL implantation. Twenty-seven eyes of 27 patients with excessively low vault (< 100 μm) constituted the case group (excessively low vault group). Patients with vault (250 to 750 μm) were selected as the optimal vault group by matching anterior chamber depth, white-to-white distance and ICL size with cases with excessive low vault (< 100 μm) at a proportion of 1:2. The preoperative biometric parameters and postoperative vault were recorded. Multiple linear regression analysis was performed to assess the relationship between the postoperative vault and various variables. Conditional logistic regression analysis was used to estimate the risk factors for excessively low vault. Results The postoperative vault was associated with preoperative pupil diameter (PD), crystalline lens rise, iris concavity and the ratio of the iris concavity to chord length (P < 0.05). The larger iris concavity increased risk of excessively low postoperative vault (< 100 μm) (OR = 81.10; 95%CI = 2.87 to 2296.58; P = 0.01). Conclusions Eyes with obviously concave iris were associated with a higher rate of excessively low vault (< 100 μm). Evaluation of iris morphology may provide significant information for predicting excessive postoperative vault.
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Affiliation(s)
- Muhammad Ahmad Khan
- Aier School of Ophthalmology, Central South University, Changsha, China
- Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China
| | - Qian Tan
- Aier School of Ophthalmology, Central South University, Changsha, China
- Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China
| | - Wei Sun
- Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China
| | - Wang Cai
- Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China
| | - Libei Zhao
- Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China
- *Correspondence: Ding Lin
| | - Ding Lin
- Aier School of Ophthalmology, Central South University, Changsha, China
- Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China
- Libei Zhao
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Silva R, Franqueira N, Faria-Correia F, Mendes J, Oliveira M, Monteiro T. Efficacy and safety after posterior chamber Implantable Collamer Lens implantation according to preoperative anterior chamber depth: Short-term comparative study. Eur J Ophthalmol 2022; 33:11206721221131889. [PMID: 36214139 DOI: 10.1177/11206721221131889] [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: 02/18/2024]
Abstract
PURPOSE To compare visual, refractive, and safety outcomes of posterior chamber Implantable Collamer Lens (ICL) implantation for the correction of myopia according to the preoperative anterior chamber depth (ACD). METHODS Retrospective, comparative study, patients submitted to implantation of myopic posterior-chamber phakic Implantable Collamer Lens (ICL), model V4C/V5, minimum follow-up of 12 months; two groups were created: Group 1 (ACD 2.80 to 2.99 mm) and Group 2 (ACD equal to or greater than 3.00 mm). The parameters evaluated were uncorrected and corrected visual acuity, subjective refraction, efficacy and safety index, predictability, endothelial cell density, central vault, anterior chamber angle and postoperative complications. A total of 558 eyes from 298 patients were evaluated: 111 eyes (19.9%) in group 1 and 447 eyes (80.1%) in group 2. RESULTS At 12 months, the efficacy index was similar in both groups (p = 0.264); the safety index was higher in group 1 (p = 0.031); the mean central Vault was significantly lower in group 1 (212.8 vs 410.6 μm; p < 0.001). Respectively, 93 (83.8%) and 366 (84.1%) eyes were within ±0.50 D of targeted refraction. Anterior chamber angle significantly decreased during follow-up in both groups (p < 0.001; p < 0.001). Intraocular pressure did not change significantly (p = 0.310 and p = 0.446, respectively). There were no significant differences in endothelial cell density loss (p = 0.278) or in the rate of complications observed (p = 0.733). CONCLUSIONS ICL implantation is an effective and safe procedure in eyes with shallow anterior chambers, with visual and refractive results and complication rates identical to those obtained in deeper anterior chambers.
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Affiliation(s)
- Rui Silva
- Department of Ophthalmology, 389794Hospital de Braga, Braga, Portugal
| | - Nuno Franqueira
- Department of Ophthalmology, 389794Hospital de Braga, Braga, Portugal
| | - Fernando Faria-Correia
- Department of Ophthalmology, 389794Hospital de Braga, Braga, Portugal
- 467460Life and Health Sciences Research Institute (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - José Mendes
- Department of Ophthalmology, 389794Hospital de Braga, Braga, Portugal
- 467460Life and Health Sciences Research Institute (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Mariana Oliveira
- Department of Ophthalmology, 389794Hospital de Braga, Braga, Portugal
| | - Tiago Monteiro
- Department of Ophthalmology, 389794Hospital de Braga, Braga, Portugal
- 467460Life and Health Sciences Research Institute (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal
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Packer M. Refractive surgery current status: expanding options. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2108405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Mark Packer
- Packer Research Associates, 1400 Bluebell Ave., Boulder, CO 80302 USA
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14
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Xu G, Wu G, Du Z, Zhu S, Guo Y, Yu H, Hu Y. Distribution of White-to-White Corneal Diameter and Anterior Chamber Depth in Chinese Myopic Patients. Front Med (Lausanne) 2021; 8:732719. [PMID: 34869427 PMCID: PMC8639187 DOI: 10.3389/fmed.2021.732719] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the distribution of white-to-white (WTW) corneal diameter and anterior chamber depth (ACD) in Chinese myopia patients. Methods: This was a cross-sectional observational study conducted at five ophthalmic centers. Anterior segment biometry was performed in 7,893 eyes of the 7,893 myopic patients using Pentacam, and the WTW and ACD were recorded. The distribution patterns of WTW and ACD were evaluated and the correlation between WTW and ACD was analyzed statistically. Results: There were 4416 (55.95%) males and 3477 (44.05%) females. The age of the study population was 25.14 ± 5.41 years. Distribution of WTW was slightly positively skewed (Skewness = 0.0076, Kurtosis = 0.3944, KS P = 0.020) with a mean of 11.65 ± 0.38 mm and a 95% normal range of 10.91-12.39 mm. A significant difference in WTW was found among different myopia groups (P < 0.001). The ACD was normally distributed (Skewness = 0.899, Kurtosis = 0.027, KS P = 0.086). The mean ACD was 3.25 ± 0.26 mm and the 95% normal range of was 2.74-3.75 mm. A significant difference in ACD was also found among different myopia groups (P = 0.030). There was a significant correlation between WTW and ACD (r = 0.460, P < 0.001). Conclusions: In our study, 95% of the Chinese myopic patients had a WTW within 10.91-12.39 mm and an ACD within 2.74-3.75 mm. ACD and WTW were significantly different among different myopia, gender and age groups. WTW was positively correlated with ACD.
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Affiliation(s)
- Guihua Xu
- Department of Ophthalmology, Huizhou Municipal Central Hospital, Huizhou, China
| | - Guanrong Wu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shanqing Zhu
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Yunxiang Guo
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China.,Aier School of Ophthalmology, Central South University, Changsha, China
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15
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Wang W, Wang L, Wang X, Zhou S, Lin S, Yang J. A Deep Learning System for Automatic Assessment of Anterior Chamber Angle in Ultrasound Biomicroscopy Images. Transl Vis Sci Technol 2021; 10:21. [PMID: 34570190 PMCID: PMC8479575 DOI: 10.1167/tvst.10.11.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To develop and assess a deep learning system that automatically detects angle closure and quantitatively measures angle parameters from ultrasound biomicroscopy (UBM) images using a deep learning algorithm. Methods A total of 3788 UBM images (2146 open angle and 1642 angle closure) from 1483 patients were collected. We developed a convolutional neural network (CNN) based on the InceptionV3 network for automatic classification of angle closure and open angle. For nonclosed images, we developed a CNN based on the EfficienttNetB3 network for the automatic localization of the scleral spur and the angle recess; then, the Unet network was used to segment the anterior chamber angle (ACA) tissue automatically. Based on the results of the latter two processes, we developed an algorithm to automatically measure the trabecular-iris angle (TIA500 and TIA750), angle-opening distance (AOD500 and AOD750), and angle recess area (ARA500 and ARA750) for quantitative evaluation of angle width. Results Using manual labeling as the reference standard, the ACA classification network's accuracy reached 98.18%, and the sensitivity and specificity for angle closure reached 98.74% and 97.44%, respectively. The deep learning system realized the automatic measurement of the angle parameters, and the mean of differences was generally small between automatic measurement and manual measurement. The coefficients of variation of TIA500, TIA750, AOD500, AOD750, ARA500, and ARA750 measured by the deep learning system were 5.77%, 4.67%, 10.76%, 7.71%, 16.77%, and 12.70%, respectively. The within-subject standard deviations of TIA500, TIA750, AOD500, AOD750, ARA500, and ARA750 were 5.77 degrees, 4.56 degrees, 155.92 µm, 147.51 µm, 0.10 mm2, and 0.12 mm2, respectively. The intraclass correlation coefficients of all the angle parameters were greater than 0.935. Conclusions The deep learning system can effectively and accurately evaluate the ACA automatically based on fully automated analysis of a UBM image. Translational Relevance The present work suggests that the deep learning system described here could automatically detect angle closure and quantitatively measure angle parameters from UBM images and enhancing the intelligent diagnosis and management of primary angle-closure glaucoma.
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Affiliation(s)
- Wensai Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Lingxiao Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Xiaochun Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Sheng Zhou
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Song Lin
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jun Yang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
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16
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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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17
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Effect of Angle Opening Parameters on Corneal Endothelial Cell Density and Intraocular Pressure after Posterior Chamber Phakic Intraocular Lens Implantation. J Clin Med 2020; 9:jcm9092704. [PMID: 32825643 PMCID: PMC7565728 DOI: 10.3390/jcm9092704] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 11/30/2022] Open
Abstract
This study aimed to investigate the time courses of angle opening parameters and the relationships of these with the corneal endothelial cell density (ECD) and the intraocular pressure (IOP) after posterior chamber phakic intraocular lens (Visian ICLTM, STAAR Surgical) implantation. We evaluated 116 eyes of 59 consecutive patients (mean age ± standard deviation, 34.0 ± 8.8 years) who underwent V5 implantable collamer lens (ICL) implantation. Preoperatively and 1 day, 1 week, and 1, 3, and 18 months postoperatively, we quantitatively measured the angle opening distance at 500 µm (AOD500), the trabecular-iris space area (TISA500), and the trabecular iris angle (TIA500), using anterior segment optical coherence tomography (CASIA 2, Tomey), and assessed the relationships of these measurements with ECD and IOP in ICL-implanted eyes. All angle parameters (AOD500, TISA500, and TIA500) significantly decreased 1 day postoperatively but remained stable thereafter. At 18 months postoperatively, we found no significant correlations of the angle parameters with ECD (Pearson correlation coefficient r = −0.108, p = 0.249 for AOD500; r = −0.162, p = 0.083 for TISA500; r = −0.022, p = 0.815 for TIA500) or between the angle parameters and IOP (r = −0.106, p = 0.256 for AOD500; r = −0.021, p = 0.826 for TISA500; r = −0.018, p = 0.850 for TIA500). The angle opening metrics significantly decreased immediately after ICL implantation but remained stable thereafter. Narrowing of the angle did not significantly affect ECD or IOP in ICL-implanted eyes during the 18-month postoperative period.
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Gargallo-Martinez B, Garcia-Medina JJ, Rubio-Velazquez E, Fernandes P, Villa-Collar C, Gonzalez-Meijome JM, Gutierrez-Ortega R. Vault changes after cyclopentolate instillation in eyes with posterior chamber phakic intraocular lens. Sci Rep 2020; 10:9646. [PMID: 32541775 PMCID: PMC7296012 DOI: 10.1038/s41598-020-66146-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/14/2020] [Indexed: 11/09/2022] Open
Abstract
Posterior chamber phakic intraocular lens (pIOL) implantation is a common option for correcting moderate-to-high ocular refractive defects. Because this pIOL is implanted on ciliary sulcus, the distance between the back surface of the pIOL and the anterior surface of the crystalline lens, that it is known as vault, should be measured in different conditions to ensure the technique's safety. Cyclopentolate is a drug that dilates the pupil and relaxes accommodation (cycloplegia). It is often used for different ocular examinations and for other medical purposes. However, there is no evidence of the effect of this drug on vault. This study quantified central vault changes associated with cyclopentolate instillation. We measured the vault under normal conditions (pre-cycloplegic instillation) and after instilling cyclopentolate on 39 eyes of 39 patients with implanted pIOL. Our results suggest that cyclopentolate instillation may induce changes to vault in eyes with implanted pIOL. These changes seem safe and are mainly associated with vault under normal conditions, but also with anterior chamber depth, pupillary diameter and pIOL size.
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Affiliation(s)
- Beatriz Gargallo-Martinez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain. .,Departament of Condensed Matter Physics, University of Sevilla, Sevilla, Spain.
| | - Jose Javier Garcia-Medina
- Departament of Ophthalmology, General University Hospital Morales Meseguer, Murcia, Spain. .,Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain.
| | - Elena Rubio-Velazquez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Departament of Ophthalmology, General University Hospital Morales Meseguer, Murcia, Spain
| | - Paulo Fernandes
- Clinical & Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal
| | - César Villa-Collar
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Faculty of Biomedicine and Health, European University of Madrid, Madrid, Spain
| | - José M Gonzalez-Meijome
- Clinical & Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal
| | - Ramón Gutierrez-Ortega
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain
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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: 37] [Impact Index Per Article: 7.4] [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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Park K, Chung JK. Result of Central Vault Depending on Lens Diameters in Patients with Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.12.1191] [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]
Affiliation(s)
- Kibum Park
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jin Kwon Chung
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Anterior Chamber Changes After Implantable Collamer Lens Implantation in High Myopia Using Pentacam: A Prospective Study. Ophthalmol Ther 2017; 6:343-349. [PMID: 28933042 PMCID: PMC5693826 DOI: 10.1007/s40123-017-0109-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION The objective of this study was to evaluate the changes of the anterior chamber (AC) of the eye after implantable Collamer lens (ICL) implantation in high myopia by using the Pentacam. METHODS The prospective study included 34 high myopic patients (34 eyes). All patients were treated with Visian implantable Collamer lens (ICL) (Staar Surgical Co.) implantation. The Pentacam (Oculus) was used for all cases preoperatively and 1, 3 and 6 months postoperatively. AC angle (ACA), AC volume (ACV), central AC depth (CACD), ICL vault, central corneal thickness (CCT), pupil diameter (PD), K readings and intraocular pressure (IOP) were recorded. RESULTS Our study included 34 eyes of 34 patients, 20 females (59%) and 14 males (41%). Mean ACA was 36.93° ± 4.75° preoperatively, 25.17° ± 5.64° and 25.23° ± 6.05° 1 and 3 months postoperatively (p < 0.001). Mean ACV was 191.24 ± 11.18 mm3 preoperatively, 141.53 ± 16.77 and 142.11 ± 15.89 mm3 1 and 3 months postoperatively (p < 0.001). Mean CACD was 3.59 ± 0.17 mm preoperatively, 2.83 ± 0.24 mm and 2.96 ± 0.25 mm 1 and 3 months postoperatively (p < 0.001). The ICL vault decreased from 0.556 ± 0.033 mm 1 month postoperatively to 0.431 ± 0.056 mm 3 months postoperatively (p < 0.001). There were no statistically significant differences for any of the AC parameters among measurements taken 3, 6 and 12 months postoperatively. There were no statistically significant differences between preoperative and any postoperative measurements of CCT, PD and K readings. CONCLUSIONS ICL implantation for correction of high myopia leads to significant changes in the anterior chamber angle, volume and depth and insignificant changes in the pupil diameter, CCT and K readings.
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Fernández-Vigo JI, Macarro-Merino A, Fernández-Vigo C, Fernández-Vigo JÁ, De-Pablo-Gómez-de-Liaño L, Fernández-Pérez C, García-Feijóo J. Impacts of Implantable Collamer Lens V4c Placement on Angle Measurements Made by Optical Coherence Tomography: Two-Year Follow-up. Am J Ophthalmol 2017; 181:37-45. [PMID: 28662940 DOI: 10.1016/j.ajo.2017.06.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/14/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine iridocorneal angle changes produced after 2 years of implantable collamer lens (ICL) V4c (STAAR Surgical AG, Nidau, Switzerland) placement by Fourier-domain optical coherence tomography (FD-OCT). DESIGN Prospective interventional case series. METHODS In 54 eyes of 27 myopic subjects FD-OCT iridocorneal angle measurements were made before and 1 month, 3 months, 1 year, and 2 years after ICL implant. Trabecular-iris angle (TIA), angle opening distance 500 μm from the scleral spur (AOD500), and iridotrabecular contact length (TICL) were compared among these time points and the nasal, temporal, and inferior quadrants. RESULTS Preoperative TIAs were 49.5 ± 8.7, 48.3 ± 9.6, and 49.1 ±8.6 degrees for the nasal, temporal and inferior quadrants (P < .001). Corresponding values were 29.9 ± 10.4, 28.4 ± 10.8, and 28.8 ± 9.7 degrees at 1 month and 27.3 ± 8.8, 26.8 ± 8.1, and 28.9 ± 7 degrees at 2 years of follow-up, indicating angle narrowing of 39%-45% and no further narrowing beyond 1 month in the nasal (P = .133), temporal (P = .376), and inferior (P = 1.000) quadrants. Trabecular-iris contact (TIC) was observed in 8 eyes of 8 subjects, mostly only in the temporal quadrant. Mean TICL failed to vary during follow-up (307 ± 288 μm at 3 months and 225 ± 142 μm at 2 years, P = .159). CONCLUSIONS In response to ICL V4c implant, considerable angle narrowing was detected at 1 month but this narrowing remained stable at 2 years. In the 8 cases of TIC, no progression of contact was observed beyond 3 months postimplant.
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Coskunseven E, Kavadarli I, Sahin O, Kayhan B, Pallikaris I. Refractive Outcomes of 20 Eyes Undergoing ICL Implantation for Correction of Hyperopic Astigmatism. J Refract Surg 2017; 33:604-609. [DOI: 10.3928/1081597x-20170504-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/18/2017] [Indexed: 11/20/2022]
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A comparison of visual outcome and rotational stability of two types of toric implantable collamer lenses (TICL) : V4 versus V4c. PLoS One 2017; 12:e0183335. [PMID: 28846701 PMCID: PMC5573270 DOI: 10.1371/journal.pone.0183335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the efficacy and rotational stability after implantation of two types of toric implantable collamer lenses (Toric ICL™(TICL);V4 and V4c, STAAR Surgical Co.). STUDY DESIGN Retrospective case series. METHODS This retrospective study evaluated total 48 eyes of 48 patients who underwent the implantation with V4 and V4c TICL with a central hole; A twenty-four eyes of 24 patients with V4 TICL and 24 eyes of 24 patients with V4c TICL with a central hole. Visual acuity, manifest refraction, and intraocular pressure were evaluated before and after surgery. Rotational stability (disparity between the intended axis and achieved axis) was assessed in both groups using digital anterior segment photographs, and vector analysis was also performed. RESULTS Uncorrected visual acuity improved in both groups without significant difference (P = .111). There were no statistical differences between two groups in postoperative SE and cylindrical errors (P = .067 and .384, respectively). The mean value of rotation was 4.17±3.31° and 3.39±2.36° in the V4 and V4c TICL groups, respectively without significant difference (P = .364). Vector analysis of astigmatic correction showed no significant diffrence between two groups. CONCLUSION V4 and V4c TICL have similar efficacy with regard to visual acuity and refractive outcomes and rotational stability.
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Abstract
PURPOSE The objective of this study was to review the advances in the field of refractive surgery as reported in the peer-reviewed literature during the previous year. DESIGN A literature review. METHODS In this review, we highlight the most pertinent articles in the field from June 2014 to the end of July 2015. RESULTS This past year has seen a growing body of research on small-incision lenticule extraction, presbyopic inlays, and phakic intraocular lenses, as more clinicians are adopting these techniques into their armamentarium. CONCLUSIONS Laser-assisted in situ keratomileusis and photorefractive keratectomy continue to dominate the keratorefractive literature, as they remain the most frequently performed refractive surgeries.
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Affiliation(s)
- Angelique Pillar
- From the Department of Refractive Surgery, Cole Eye Institute, Cleveland Clinic, Cleveland, OH
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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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Zhang J, Luo HH, Zhuang J, Yu KM. Comparison of anterior section parameters using anterior segment optical coherence tomography and ultrasound biomicroscopy in myopic patients after ICL implantation. Int J Ophthalmol 2016; 9:58-62. [PMID: 26949611 DOI: 10.18240/ijo.2016.01.10] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 04/20/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the agreement of anterior chamber depth (ACD) and central vault measurements obtained by anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) of post surgical high myopic eyes with posterior chamber phakic intraocular lens (Visian ICL; STAAR Surgical) implantation. METHODS Fifty-two phakic eyes of 28 high myopic patients who underwent implantable Collamer lens (ICL) surgery for the correction of high myopia were studied. The postoperative ACD, the distance between the corneal endothelium and the anterior surface of ICL (cornea-ICL) and the central vault were measured with the AS-OCT system and the UBM system. Intraclass correlation coefficient (ICC) and the Bland-Altman plot were used to evaluate the repeatability and agreement of two devices. RESULTS The mean ACD, cornea-ICL and central vault in the 52 phakic eyes after ICL surgery was 3.19±0.28 mm, 2.47±0.28 mm, 0.50±0.19 mm by AS-OCT and 3.13±0.25 mm, 2.49±0.25 mm, 0.44±0.19 mm by UBM, respectively. Pairwise comparison of ACD and central vault measurements showed significant differences between AS-OCT and UBM (P<0.05). However, no statistically significant difference was found between these imaging techniques in cornea-ICL (P>0.05). The Pearson correlation coefficient (r) between AS-OCT and UBM measurements for ACD, cornea-ICL and vault was 0.88, 0.80 and 0.89, respectively (P<0.001). The ICC was 0.89-0.94 for the measurements of AS-OCT and UBM. Bland-Altman analysis showed the 95% limits of agreement of ACD, cornea-ICL, central vault measurements between these two devices were -0.20 to 0.32 mm, -0.36 to 0.32 mm and -0.12 to 0.24 mm, respectively. CONCLUSION Central ACD and vault measurements using AS-OCT demonstrated a slight significantly higher value than using UBM in phakic eyes after ICL surgery. These two devices should not be used interchangeably for measurements of central ACD and vault in patients after phakic intraocular lens implantation.
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Affiliation(s)
- Jing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hui-Hui Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Ke-Ming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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