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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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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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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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ICL Postimplantation Decentration and Tilt in Myopic Patients with Primary Iridociliary Cysts. J Ophthalmol 2023; 2023:3475468. [PMID: 36700115 PMCID: PMC9870672 DOI: 10.1155/2023/3475468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/09/2022] [Accepted: 10/25/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose To observe the decentration and tilt of implantable collamer lens (ICL) as well as possible visual effects postimplantation in primary iridociliary cysts. Methods The present investigation was a retrospective cohort study. All 48 patients (91 eyes) who underwent ICL surgery at the Center of Refraction Surgery of Tianjin Medical University Eye Hospital between July 2018 and May 2020 were split into two groups based on the absence or presence of primary iridociliary cysts established by ultrasonic biological microscopy (UBM) examination. Intraocular pressure (IOP), corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), anterior chamber angle (ACA), anterior chamber volume (ACV), and anterior chamber depth (ACD) were recorded preoperatively and postoperatively at 1, 6, and 12 months. Additionally, we performed an analysis of the ICL vault, decentration, and tilt using a rotating Scheimpflug Oculus Pentacam camera system at 1, 6, and 12 months after surgery. Results No serious complications were observed. Significant postoperative improvement (P < 0.05) of UDVA was established in the two studied groups; however, we did not observe statistically significant intergroup differences (P > 0.05) throughout the entire research period. In each group, the preoperative ACA, ACV, and ACD were statistically significantly reduced (P < 0.05), but no such decrease was established between their postoperative values (P > 0.05). We observed no statistical differences between both groups with regard to their values of IOP, ACA, ACV, ACD, ICL vault, ICL decentration, and tilt at 1, 6, and 12 months after surgery. Similarly, no statistically significant within-group correlation (P > 0.05) of the decentration of ICL and the tilt and the CDVA values was established. Conclusion No postimplantation effect of ICL with a central hole on vision was established in myopia patients with primary iridociliary cysts, within certain limits of ICL decentration and tilt values.
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Choi H, Kim T, Kim SJ, Sa BG, Ryu IH, Lee IS, Kim JK, Han E, Kim HK, Yoo TK. Predicting Postoperative Anterior Chamber Angle for Phakic Intraocular Lens Implantation Using Preoperative Anterior Segment Metrics. Transl Vis Sci Technol 2023; 12:10. [PMID: 36607625 PMCID: PMC9836008 DOI: 10.1167/tvst.12.1.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose The anterior chamber angle (ACA) is a critical factor in posterior chamber phakic intraocular lens (EVO Implantable Collamer Lens [ICL]) implantation. Herein, we predicted postoperative ACAs to select the optimal ICL size to reduce narrow ACA-related complications. Methods Regression models were constructed using pre-operative anterior segment optical coherence tomography metrics to predict postoperative ACAs, including trabecular-iris angles (TIAs) and scleral-spur angles (SSAs) at 500 µm and 750 µm from the scleral spur (TIA500, TIA750, SSA500, and SSA750). Data from three expert surgeons were assigned to the development (N = 430 eyes) and internal validation (N = 108 eyes) datasets. Additionally, data from a novice surgeon (N = 42 eyes) were used for external validation. Results Postoperative ACAs were highly predictable using the machine-learning (ML) technique (extreme gradient boosting regression [XGBoost]), with mean absolute errors (MAEs) of 4.42 degrees, 3.77 degrees, 5.25 degrees, and 4.30 degrees for TIA500, TIA750, SSA500, and SSA750, respectively, in internal validation. External validation also showed MAEs of 3.93 degrees, 3.86 degrees, 5.02 degrees, and 4.74 degrees for TIA500, TIA750, SSA500, and SSA750, respectively. Linear regression using the pre-operative anterior chamber depth, anterior chamber width, crystalline lens rise, TIA, and ICL size also exhibited good performance, with no significant difference compared with XGBoost in the validation sets. Conclusions We developed linear regression and ML models to predict postoperative ACAs for ICL surgery anterior segment metrics. These will prevent surgeons from overlooking the risks associated with the narrowing of the ACA. Translational Relevance Using the proposed algorithms, surgeons can consider the postoperative ACAs to increase surgical accuracy and safety.
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Affiliation(s)
- Hannuy Choi
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Taein Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Su Jeong Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Beom Gi Sa
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Ik Hee Ryu
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Jin Kuk Kim
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Eoksoo Han
- Electronics and Telecommunications Research Institute (ETRI), Daejeon, South Korea
| | - Hong Kyu Kim
- Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Tae Keun Yoo
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
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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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Nassar GA, Abbas EN, Khalil MMAA, Tharwat E, Mohammed AR. Evaluation of Higher Order Aberrations and Anterior Segment Parameters Changes After Implantable Collamer Lens Implantation for High Myopia. Clin Ophthalmol 2023; 17:1097-1107. [PMID: 37064961 PMCID: PMC10103779 DOI: 10.2147/opth.s405182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/17/2023] [Indexed: 04/18/2023] Open
Abstract
Purpose To evaluate changes in higher order aberrations (HOAs) induced by implantable collamer lens (ICL) implantation in correction of high myopia and to compare the anterior segment parameters before and after surgery. Also, to correlate these parameters with HOAs, the best corrected visual acuity (BCVA) and intraocular pressure (IOP). Methods This prospective interventional cohort case series study included 40 eyes with high myopia that underwent ICL V4c implantation. They were evaluated pre-operatively and post-operatively at 1st and 3rd month HOAs using Scheimpflug Sirius Camera. The anterior segment parameters were evaluated by optical biometry. Correlations between HOAs, BCVA and anterior segment parameters were evaluated. Results The mean pre-operative BCVA was 0.67 ± 0.17, while post-operative BCVA was 0.74 ± 0.16 (p-value < 0.001). The spherical equivalent was -13.66 ± 2.23 pre-operatively, while post-operatively it was -0.77 ± 0.65 (p-value < 0.001). The mean pre-operative root mean square (RMS) of HOAs was 0.62 ± 0.11 µm, while mean post-operative RMS in the 1st month was 0.82 ± 0.29 µm (p-value < 0.001). At 3rd month, it was 0.63 ± 0.17 µm (p-value = 0.685). The mean pre-operative anterior chamber depth (ACD) was 3.66 ± 0.26 mm. It decreased in the post-operative 1st month to 3.46 ± 0.30 mm, while in 3rd month 3.45 ± 0.24 mm (p-value < 0.001, < 0.001) respectively. The mean pre-operative anterior chamber angle (ACA) 45.98 ± 8.39 o while, the mean ACA was 31.65 ± 4.14, 31.03 ± 3.74 post-operatively (p-value < 0.001, < 0.001) respectively. There was significant increase in IOP (p-value < 0.001). Conclusion ICL implantation is safe and effective in correction of high myopia, as HOAs increase at first month post-operatively then, return to the pre-operative level by 3rd month. However, anterior segment parameters show significant changes which may need longer follow up.
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Affiliation(s)
- Ghada A Nassar
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Correspondence: Ghada A Nassar, 10 Said Street, Heliopolis, Cairo, 11757, Egypt, Tel +2 01222397300, Fax +20223636504, Email
| | - Ezzat N Abbas
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Ehab Tharwat
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed R Mohammed
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Sánchez Trancón A, Cerpa Manito S, Torrado Sierra O, Baptista AM, Serra PM. Vault differences in eyes implanted with spherical and toric implantable collamer lenses: an inter-eye analysis. BMC Ophthalmol 2022; 22:435. [PMCID: PMC9664806 DOI: 10.1186/s12886-022-02653-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose
To determine the influence of implantable collamer lenses (ICL) geometry, i.e. spherical and toric on the vault, and report the refractive and visual outcomes of patients bilaterally implanted with the two ICL geometries.
Methods
This retrospective case series analysed 41 patients implanted with a spherical ICL (sICL) in one eye and an equal sized toric ICL (tICL) in the fellow eye. The anatomical and ICL-related parameters were assessed using anterior-segment optical coherence tomography (AS-OCT Visante, Zeiss Meditec AG) and optical tomography (Pentacam, OCULUS). The influence of the anatomical and ICL-related parameters on the vault was determined using generalised estimating equations (GEE) to incorporate inter-eye correlations.
Results
Postoperative spherical equivalent was within ± 0.50D in 66% and 83% of the eyes, respectively implanted with sICL and tICL. The efficacy index in the sICL group was 1.06 and 1.14 in the tICL group. The mean inter-eye vault difference was -1.46 µm, anatomical and ICL-related parameters showed similar associations with the vault for sICL and tICL. The GEE identified the ICL size minus the anterior chamber width, the ICL spherical power and ICL central thickness as significant factors influencing the vault.
Conclusions
Spherical and toric ICL showed good efficacy for the correction of myopia and astigmatism. Patients implanted bilaterally with sICL and tICL tend to present similar vaults. The vault produced by both types of ICL was mainly regulated by the oversizing of the ICL. This suggests that the ICL geometry (spherical vs toric) is a factor with limited influence on the vault, thus the sizing method of a sICL and tICL should be similar.
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Liu F, Xia F, Niu L, Zhao J, Wang X, Zhou X. Early Assessment of Circumferential Anterior Segment Structures Following Implantable Collamer Lens V4c Implantation Via SS-OCT. Transl Vis Sci Technol 2022; 11:4. [PMID: 36331273 PMCID: PMC9645365 DOI: 10.1167/tvst.11.11.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose To explore early changes in circumferential anterior segment structures following Implantable Collamer Lens (ICL) V4c implantation via swept-source optical coherence tomography (SS-OCT). Methods In 103 eyes of 56 myopic patients undergoing ICL V4c surgery, anterior segments were measured via SS-OCT to compute local anterior chamber angle (ACA) parameters on the nasal–temporal (0°–180°), superior–inferior (90°–270°), and superior nasal–inferior temporal (80°–260°) meridians, including angle-opening distance at 500 µm (AOD500), trabecular–iris space area at 500 µm (TISA500), trabecular–iris angle at 500 µm (TIA500), and circumferential ACA parameters, including AOD area at 500 µm (AODA500), trabecular–iris circumference volume at 500 µm (TICV500), and the index and area of iris–trabecular contact (ITC). ACA parameters were compared preoperatively and at 1 week, 1 month, and 3 months postoperatively and compared among quadrants. Mixed-effects model was used to evaluate the parameters correlated with the post-ITC parameters. Results The mean AOD500, TISA500, TIA500, AODA500, and TICV500 were decreased by 65.4% to 71%, 64.1% to 69.3%, 53.8% to 61.5%, 69.9%, and 69.2%, respectively, at 1 week postoperatively. The ITC index and area values rose from 1.436% ± 4.427% and 0.070 ± 0.254 mm2 to 12.343% ± 13.216% and 0.903 ± 1.304 mm2 (all P < 0.05). No further decreases in ACA parameters were observed beyond 1 week postoperatively (all P > 0.05). Significant differences were observed among quadrants, with the narrowest in the superior–nasal quadrant, followed by the superior quadrant. The 3-month vault was significantly correlated with the ITC index and area at 3 months postoperatively. Conclusions Anterior segment structures were significantly shallow at 1 week with no further decreases thereafter. In light of anatomical variability, we recommend circumferential meridian scan to assess angle status, with special attention to the superior–nasal and superior quadrants. Translational Relevance We investigated the early changes in circumferential anterior segment structures following ICL V4c implantation, thus providing a better perspective for understanding anterior segment structural characteristics after ICL V4c surgery.
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Affiliation(s)
- Fang Liu
- Department of Ophthalmology and Optometry, Eye and 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
| | - Fei Xia
- Department of Ophthalmology and Optometry, Eye and 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
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Eye and 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
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye and 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
- Department of Ophthalmology and Optometry, Eye and 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
- Department of Ophthalmology and Optometry, Eye and 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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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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Chen X, Chen F, Wang X, Xu Y, Cheng M, Han T, Wang X, Zhou X. Safety and anterior chamber structure of evolution implantable Collamer lens implantation with short white-to-white corneal diameters. Front Med (Lausanne) 2022; 9:928245. [PMID: 36059823 PMCID: PMC9428310 DOI: 10.3389/fmed.2022.928245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To evaluate the safety and anterior chamber structure of implantation of the Evolution (EVO) implantable Collamer lens (EVO-ICL) in patients with short white-to-white (WTW) corneal diameters. Materials and methods The study population was divided into two groups: the experimental group (34 eyes of 34 patients) with WTW corneal diameters of ≤10.6 mm and the control group (59 eyes of 59 patients) with WTW corneal diameters of >10.6 mm. The outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, refractive power, intraocular pressure (IOP), anterior chamber angle, depth, volume, and vault. Results The safety indices of the experimental and control groups were 1.17 ± 0.30 and 1.12 ± 0.14, respectively (P > 0.05); the effectiveness indices were 1.16 ± 0.31 and 1.07 ± 0.17, respectively (P > 0.05). The simulation curves of the expected and actual corrections in the experimental and control groups were y = 0.9876x – 0.0927 and y = 0.9799x + 0.0343, respectively. There were no significant differences between the IOPs and anterior chamber structures of the two groups (P > 0.05). The average vaults of the experimental and control groups were 395.76 ± 155.32 and 389.49 ± 135.01 μm, respectively (P > 0.05). Conclusion EVO-ICL implantation in patients with short WTW corneal diameters (≤ 10.6 mm) was determined to be a safe, effective, and predictable method for correcting myopia. The changes in the anterior chamber structure were still within normal limits after the surgery, the IOP remained stable, and the ideal vault was achieved after the surgery.
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Affiliation(s)
- Xun Chen
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fang Chen
- The First People's Hospital of Zhaoqing, Zhaoqing, China
| | - Xuanqi Wang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Prediction of the trabecular iris angle after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg 2021; 48:604-610. [PMID: 34486579 DOI: 10.1097/j.jcrs.0000000000000804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To create an equation for predicting the trabecular iris angle (TIA) and to verify its accuracy after implantable collamer lens (ICL) implantation. SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Retrospective evaluation of a screening approach. METHODS The subjects included 174 eyes (174 patients) that underwent ICL implantation. Patients were randomly assigned to the prediction equation group (116 eyes) or verification group (58 eyes). Anterior segment optical coherence tomography (AS-OCT; CASIA2 TOMEY) was performed before and 3 months after ICL surgery. For the prediction group, a prediction equation was created with the preoperative AS-OCT parameters and ICL size as independent variables and the postoperative anterior chamber depth (ACD) as dependent variables. Then, by applying the predicted post-ACD and preoperative AS-OCT parameters as independent variables and TIA after ICL surgery as the dependent variable, a prediction equation was created to predict the postoperative TIA (post-TIA) after ICL surgery. Each prediction equation was created using stepwise multiple regression analysis, and its accuracy was verified by a Bland-Altman plot in the verification group. RESULTS The explanatory variables (standardized partial regression coefficient) selected in the post-TIA prediction equation were post-ACD (0.629), TIA750 (0.563), iris curvature (0.353), pupil diameter (-0.281), iris area (-0.249), and trabecular iris space area 250 (-0.171) (R2 = 0.646). There were no clinically significant systematic errors between measured and predictive post-TIA values in the verification group. The average absolute prediction error was 3.43° ± 2.22°. CONCLUSIONS Post-TIA can be accurately predicted from the predicted post-ACD and other preoperative AS-OCT parameters.
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Determining vault size in implantable collamer lenses: preoperative anatomy and lens parameters. J Cataract Refract Surg 2021; 46:728-736. [PMID: 32358268 DOI: 10.1097/j.jcrs.0000000000000146] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine patient preoperative anatomical features and the parameters of implantable collamer lenses (ICLs) relevant in explaining vault variability. SETTING Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain. DESIGN Retrospective case series. METHODS This study comprised 360 eyes of 360 patients implanted with myopic or toric ICLs. Pentacam imaging was used for assessing white-to-white (WTW) diameter, central keratometry, and central corneal thickness. Anterior-segment optical coherence tomography was used to measure the horizontal anterior chamber angle distance (ATA), internal anterior chamber (ACQ), crystalline lens rise (CLR), anterior chamber angle (ACA), and vault. The sample was divided according to the implanted lens size (12.6 mm, 13.2 mm, and 13.7 mm). Vault predictors were identified from the variables above using multivariate regression analysis. RESULTS The groups showed significant statistical differences for WTW, ATA, ACQ, ACA, and vault (P < .007 for all). In general, bigger lenses were implanted in eyes with larger transverse sizes (WTW and ATA) and deeper ACQ. Also, larger ICL diameters were associated with higher vaults. Multivariate regression analysis identified the lens size (13.2 mm as reference; 12.6 mm: β [standardized coefficients] = -0.33; 13.7 mm: β = 0.42), ATA (β = -0.42), and CLR (β = -0.25), ICL spherical equivalent (β = -0.22) and patient age (β = -0.12) as predictors of the vault size (adjusted-R = 0.34 P < .001). CONCLUSIONS The multivariate model explained 34% of vault variability. The predictors indicated the presence of different mechanisms regulating the vault. These involved the difference between the transverse size of the eye and the ICL, the crystalline lens protrusion, and the ICL properties, such as power and size.
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Cerpa Manito S, Sánchez Trancón A, Torrado Sierra O, Baptista AM, Serra PM. Biometric and ICL-related risk factors associated to sub-optimal vaults in eyes implanted with implantable collamer lenses. EYE AND VISION 2021; 8:26. [PMID: 34225809 PMCID: PMC8256545 DOI: 10.1186/s40662-021-00250-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/30/2021] [Indexed: 12/05/2022]
Abstract
Background To identify biometric and implantable collamer lens (ICL)-related risk factors associated with sub-optimal postoperative vault in eyes implanted with phakic ICL. Methods This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL. Preoperatively, white-to-white (WTW), central keratometry (Kc) and central corneal thickness (CCT) were measured using the Pentacam. Anterior-segment optical coherence tomography (AS-OCT, Visante) was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance (ATA), internal anterior chamber depth (ACD), crystalline lens rise (CLR), anterior-chamber angle (ACA) and postoperatively the vault. Eyes were divided into three vault groups: low (LVG: ≤ 250 μm), optimal (OVG: > 250 and < 1000 μm) and high (HVG: ≥ 1000 μm). Multinomial logistic regression (MLR) was used to find the sub-optimal vault predictors. Results MLR showed that CLR, ICL size minus the ATA (ICL size-ATA), age, ICL spherical equivalent (ICLSE) and ICL size as contributing factors for sub-optimal vaults (pseudo-R2 = 0.40). Increased CLR (OR: 1.01, CI: 1.00–1.01) and less myopic ICLSE (OR: 1.22, CI: 1.07–1.40) were risk factors for low vaults. Larger ICL size-ATA (OR: 41.29, CI: 10.57–161.22) and the 13.7 mm ICL (OR: 7.08, CI: 3.16–15.89) were risk factors for high vaults, whereas less myopic ICLSE (OR: 0.85, CI: 0.76–0.95) and older age (OR: 0.92, CI: 0.88–0.98) were protective factors. Conclusion High CLR and low ICLSE were the major risk factors in eyes presenting low vaults. In the opposite direction, ICL size-ATA was the major contributor for high vaults. This relationship was more critical in higher myopic ICLSE, younger eyes and when 13.7 mm ICL were used. The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault (low, optimal or high). Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00250-6.
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Affiliation(s)
- Santiago Cerpa Manito
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain
| | - Angel Sánchez Trancón
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain
| | - Oscar Torrado Sierra
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain
| | | | - Pedro Miguel Serra
- Research and Development Department, Ophthalmology Clinic Vista Sánchez Trancón, Building Tecnolaser, Room 14 Calle La Violeta, 06005, Badajoz, Spain. .,Optics and Optometry Department, Instituto Superior de Educação e Ciências, Lisbon, Portugal.
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Singh R, Vanathi M, Kishore A, Tandon R, Singh D. An anterior segment optical coherence tomography study of the anterior chamber angle after implantable collamer lens-V4c implantation in Asian Indian Eyes. Indian J Ophthalmol 2021; 68:1418-1423. [PMID: 32587181 PMCID: PMC7574076 DOI: 10.4103/ijo.ijo_1540_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: To quantitatively assess anterior chamber and angle parameters by anterior segment optical coherence tomography (AS-OCT) in myopic eyes undergoing Implantable Collamer Lens (ICL V4c) implantation. Methods: Prospective noncomparative observational case series. Pre and postoperative (1st and 3rd month) AS-OCT angle parameters (anterior chamber depth [ACD], anterior chamber angle [ACA], Angle opening distance [AOD], trabecular iris space area [TISA], scleral spur angle [SSA]) were evaluated in 32 eyes (16 patients). SPSS version 20 with paired t-test for intragroup and Mann-Whitney U value test for intergroup comparisons. Results: It included 6 (37.5%) males and 10 (62.5%) females. Preoperative ACA of 34.6 ± 2.3° reduced to 32.2 ± 2.4°, 31.9 ± 2.5° at 1 and 3 months postoperatively (P = 0.001). Preoperative mean AOD500, AOD750, TISA500, TISA750, SSA of 0.34 ± 0.06 mm, 0.52 ± 0.15 mm, 0.09 ± 0.02 mm2, 0.20 ± 0.04 mm2, 34.27 ± 4.6° decreased to 0.32 ± 0.06 mm, 0.48 ± 0.15 mm, 0.08 ± 0.02 mm2, 0.17 ± 0.05 mm2, 32.5 ± 4.3° at 1-month (P = 0.001); 0.32 ± 0.06 mm, 0.47 ± 0.13 mm, 0.08 ± 0.02 mm2, 0.17 ± 0.05 mm2 and 32.4 ± 4.6° (P = 0.001) at 3-months, respectively. Correlation analysis between preoperative ACD/intraocular pressure (IOP) was − 0.62 (P = 0.0002) [1st month], −0.40 (0.024) [third month]; between IOP/postoperative ACA, AOD500, AOD750, TISA500, TISA750, SSA was − 0.04 (0.81), −0.03 (0.85), −0.08 (0.64), −0.12 (0.48), −0.10 (0.57), −0.06 (0.73) at 1 month; −0.09 (0.58), 0.04 (0.78), 0.12 (0.48), −0.02 (0.9), −0.04 (0.79), 0.02 (0.88) at 3 months; between ICL vault/ACA, AOD500, AOD750, TISA500, TISA750, SSA was 0.38 (0.02), 0.24 (0.17), 0.21 (0.25), 0.05 (0.75), 0.15 (0.41), 0.27 (0.13) at 1st month; 0.19 (0.28), 0.06 (0.71), −0.03 (0.85), 0.005 (0.97), 0.05 (0.78), 0.07 (0.68) at 3rd month. Conclusion: Postoperatively significant angle narrowing was noted. There was a negative correlation between IOP and preoperative ACD. There was no significant correlation between IOP and ICL vault with postoperative AS-OCT angle parameters.
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Affiliation(s)
- Rashmi Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Murugesan Vanathi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Alisha Kishore
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Radhika Tandon
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Zhao J, Zhao J, Yang W, Miao H, Niu L, Shang J, Wang X, Zhou X. Peripheral Anterior Chamber Depth and Angle Measurements Using Pentacam After Implantation of Toric and Non-toric Implantable Collamer Lenses. Front Med (Lausanne) 2021; 8:610590. [PMID: 33585524 PMCID: PMC7873523 DOI: 10.3389/fmed.2021.610590] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose: To evaluate the characteristics of peripheral anterior chamber measurements by Pentacam after posterior implantable collamer lenses (ICL) and toric ICL (TICL) with central hole (V4c) implantation. Methods: Prospective, non-randomized consecutive case series. Forty-six patients undergoing ICL implantation in one eye (Group A) and identically sized TICL in the contralateral eye (Group B) in the Refractive Surgery Center of Eye and ENT Hospital of Fudan University were prospectively included. According to ICL/TICL size, these eyes were further divided into four subgroups. Peripheral anterior chamber depth (PACD) and angle (ACA) in nasal and temporal sides were measured using Pentacam pre-operatively and 12-month post-operatively. Results: The safety indices were 1.34 ± 0.32 and 1.25 ± 0.16 and the efficacy indices were 1.20 ± 0.24 and 1.19 ± 0.19 for ICL and TICL groups, respectively. There was no significant difference in pre-operative PACD or ACA between the two groups. Post-operative PACD and ACA were significantly lower than pre-operative values. Variations of PACD and ACA of TICL group were significantly larger than those of ICL group. The change of ACA for 13.2 mm lenses was significantly larger than that of 12.6 mm lenses. Pre-operative CACD and vault were significantly associated with post-operative PACD, while pre-operative ACA and vault were significantly associated with post-operative ACA. Conclusions: Variations of PACD and ACA were greater in eyes after TICL (V4c) implantation compared with identically sized ICL (V4c) implantation and with larger size than smaller size lens implantation. Pre-operative anterior chamber structure and vault affect post-operative PACD and ACA.
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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, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
| | - Huamao Miao
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
| | - Jianmin Shang
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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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18
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Takagi Y, Kojima T, Nishida T, Nakamura T, Ichikawa K. Prediction of anterior chamber volume after implantation of posterior chamber phakic intraocular lens. PLoS One 2020; 15:e0242434. [PMID: 33196664 PMCID: PMC7668562 DOI: 10.1371/journal.pone.0242434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To predict the anterior chamber volume (ACV) after implantable collamer lens (ICL) implantation based on ICL size and parameters of anterior segment optical coherence tomography (AS-OCT). DESIGN Retrospective study. METHODS This study included 222 eyes of 222 patients who underwent ICL implantation at Nagoya Eye Clinic. The patients were divided into two groups: prediction group, for creating the prediction equation (148 eyes, mean age: 32.11 ± 8.04 years), and verification group, for verifying the equation (74 eyes, mean age: 33.03 ± 6.74 years). The angle opening distance (AOD), anterior chamber width (ACW), ACV, anterior chamber depth, lens vault, angle-to-angle distance, angle recess area, and trabecular iris space area were calculated using AS-OCT. A stepwise multiple regression analysis was performed. After the creation of the prediction equation, its accuracy was verified in the verification group. RESULTS The ACV, AOD750, ACW, and ICL size were selected as explanatory variables to predict postoperative ACV. Mean predicted (114.2 ± 21.83 mm3) and actual postoperative ACVs (116.1 ± 25.41 mm3) were not significantly different (P = 0.269); absolute error was 10.59 ± 9.13 mm3. In addition, there was high correlation between actual and predictive ACV (adjusted R2 = 0.6996, p < 0.0001). Bland-Altman plot revealed that there was no addition or proportional error between predicted and actual postoperative ACV. CONCLUSION Postoperative ACV was accurately predicted using AS-OCT parameters and ICL size. This prediction equation may be useful for making decisions regarding ICL size.
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Affiliation(s)
- Yuki Takagi
- Department of Ophthalmology, Iida Municipal Hospital, Nagano, Japan
| | - Takashi Kojima
- Nagoya Eye Clinic, Nagoya, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail:
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Cerpa Manito S, Sánchez Trancón A, Torrado Sierra O, Baptista AMG, Serra PM. <p>Inter-Eye Vault Differences of Implantable Collamer Lens Measured Using Anterior Segment Optical Coherence Tomography</p>. Clin Ophthalmol 2020; 14:3563-3573. [PMID: 33154615 PMCID: PMC7605967 DOI: 10.2147/opth.s258817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/12/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | | | | | - Pedro Miguel Serra
- Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain
- Optics and Optometry Department, Instituto Superior de Educação e Ciências, Lisbon, Portugal
- Correspondence: Pedro Miguel Serra Email
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He F, Liu Y, Jia R, Zhang J. Evaluation of changes in choroidal thickness after implantable collamer lens surgery in high myopia patients with graves' Ophthalmopathy (inactive phase). BMC Ophthalmol 2020; 20:344. [PMID: 32842970 PMCID: PMC7446171 DOI: 10.1186/s12886-020-01612-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/14/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND To evaluate the safety and effectiveness of the Visian Implantable Collamer Lens (ICL) implantation in high myopic patients with inactive Graves' ophthalmopathy (GO) by observing the changes of choroidal thickness (CT). METHODS Eight patients (16 eyes) with high myopia accompanied with inactive GO were selected as the experimental group (group A) and 18 high myopic patients (36 eyes) without GO were selected as a control group (group B). The outcomes of uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), safety index, efficacy index, intraocular pressure (IOP), vault, corneal endothelial count, and choroidal thickness (CT) were observed. The values of CT were measured using swept-source optical coherence tomography (SS-OCT) scans. RESULTS The UCVA and BCVA in all operated eyes were better than that before surgery. The postoperative safety index and efficacy index were 1.23 and 1.19 in the group A, respectively, and 1.26 and 1.21 in the group B, respectively. In both groups, foveal CT increased significantly in high myopic patients at 2 h and at 3 months after surgery, compared to preoperative values. The same tendencies were observed in the inner nasal and outer nasal regions. Compared with patients without GO, the increase of CT was more obvious in GO patients, 2 h postoperatively (P = 0.006) and 3 months postoperatively (P = 0.011). CONCLUSIONS The ICL implantation is safe and effective in high myopic patients with inactive GO. Subfoveal and nasal CT may be useful parameters for monitoring the activity of GO patients.
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Affiliation(s)
- Fanglin He
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai, China
| | - Yan Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai, China
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai, China.
| | - Jing Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai, China.
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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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The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation. J Ophthalmol 2020; 2020:4014512. [PMID: 32774903 PMCID: PMC7391088 DOI: 10.1155/2020/4014512] [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: 03/14/2020] [Revised: 06/11/2020] [Accepted: 06/24/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP ≥ 21 mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (χ2 = 7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher (p < 0.001) in the right eyes, and TIA and AOD were significantly lower (p < 0.05) in the right eyes than in the left eyes. There was no significant difference at 24 h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (β = −23.707 and 1.731, respectively; p = 0.013 and 0.002, respectively). Conclusion The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes.
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Yang W, Zhao J, Sun L, Zhao J, Niu L, Wang X, Zhou X. Four-year observation of the changes in corneal endothelium cell density and correlated factors after Implantable Collamer Lens V4c implantation. Br J Ophthalmol 2020; 105:625-630. [PMID: 32546550 PMCID: PMC8077217 DOI: 10.1136/bjophthalmol-2020-316144] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 11/23/2022]
Abstract
Background To evaluate the changes in corneal endothelium cell density (ECD) and the correlated factors after Implantable Collamer Lens (ICL) V4c implantation. Methods In this retrospective, consecutive study, 48 eyes of 25 patients with myopia who underwent ICL V4c implantation were enrolled. Patients were followed up for at least 4 years, during which manifest refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, ECD, anterior chamber depth, anterior chamber volume (ACV), anterior chamber angle (ACA), vault and distance from the corneal endothelium to the central ICL (C-ICL) were measured. Spearman’s correlation analysis was used to identify variables correlated with changes in ECD, and generalised estimating equation model adjusting within-patient intereye correlations was used to predict changes in ECD. Results All surgeries were performed safely with no complications during follow-up (average 52±2.9 months). Safety and efficacy indices were 1.23±0.22 and 1.04±0.16, respectively. No eyes had decreased CDVA, and 67% gained one or more lines. Further, 79% were within ±0.50 D, and 100% were within ±1.0 D of the attempted refraction. Additionally, a 4.03%±2.2% reduction in ECD compared with the preoperative value was observed at the last follow-up visit. Changes in ECD were significantly correlated with vault, C-ICL, change in ACA and change in ACV. Vault was the most significant factor for changes in ECD. Conclusions ICL V4c implantation is safe and effective for myopia correction. Anterior segment biometric parameters including the vault, ACA and C-ICL may influence changes in ECD; specifically, the vault plays a major role.
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Affiliation(s)
- Wen Yang
- Department of Ophthalmology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jing Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ling Sun
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jiao Zhao
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
| | - Lingling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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He F, Yang J, Jia R, Zhang J. Evaluation of changes in choroidal thickness after surgical implantation of collamer lens in patients with different degrees of high myopia. Exp Ther Med 2019; 18:2599-2607. [PMID: 31572508 PMCID: PMC6755434 DOI: 10.3892/etm.2019.7831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/05/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to investigate the potential changes in the choroidal thickness (CT) after surgical implantation of collamer lens (ICL) and to determine whether the variations in CT were associated with the degree of myopia. In the study, 98 eyes from 98 myopia patients were divided into two groups according to the degree of myopia: High myopia and super-high myopia. All eyes were measured using the swept-source optical coherence tomography (SS-OCT) technique. CT and CT variations were also recorded. The foveal CT increased significantly in high-myopia patients at 2 h after surgery and 3 months after surgery; the same tendency was observed in the inner nasal CT and outer nasal CT at the same time-points. In patients with super-high myopia, the subfoveal CT increased significantly at 2 h and 3 months after surgery compared with the pre-operative values. No statistically significant differences were obtained in any of the nine different choroidal regions evaluated at post-operative week 1 and post-operative month one. Furthermore, the increase in the subfoveal CT in the super-myopia group was significantly higher than that in the high-myopia group at 2 h and at 3 months after ICL. The results of the present study indicated that the CT significantly increased 2 h after the surgery and then reached a peak at 3 months, particularly in the subfoveal and nasal areas. A higher degree of myopia was associated with greater subfoveal choroidal changes.
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Affiliation(s)
- Fanglin He
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, P.R. China
| | - Jie Yang
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, P.R. China
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, P.R. China
| | - Jing Zhang
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, P.R. China
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Kudsieh B, Fernández-Vigo JI, Vila-Arteaga J, Urcola JA, Martínez-de-la-Casa JM, García-Feijóo J, Ruiz-Moreno JM, Fernández-Vigo JÁ. Update on the usefulness of optical coherence tomography in assessing the iridocorneal angle. ACTA ACUST UNITED AC 2019; 94:478-490. [PMID: 31371112 DOI: 10.1016/j.oftal.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
The iridocorneal angle, due to its implications in the physiopathology of aqueous humour drainage, is a fundamental structure of the anterior chamber. Anterior segment optical coherence tomography is a rapid and non-invasive technique that obtains images in vivo. The high resolution allows it to analyse the normal anatomy of the angle, any alterations, and the changes that occur after different therapeutic interventions. Anterior segment optical coherence tomography technology has evolved to provide images that allow the identification and quantification of the angular structures in healthy subjects and in glaucoma patients, and especially the trabecular meshwork and the Schlemm's canal. It also enables the angle width to be quantified, with some objective parameters that have been standardised in recent years, such as the trabecular-iris angle, the angle opening distance, and the trabecular-iris area. This technique has multiple uses in the study of the different mechanisms of angle closure, the evaluation of changes after a laser peripheral iridotomy or iridoplasty after cataract surgery, as well as after the implantation of phakic lenses.
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Affiliation(s)
- B Kudsieh
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España; Centro Internacional de Oftalmología Avanzada, Madrid, España.
| | - J I Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, España; Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J Vila-Arteaga
- Hospital La Fe, Valencia, España; Clínica Vila-Innova Ocular, Valencia, España
| | - J Aritz Urcola
- Departamento de Oftalmología, Hospital Universitario de Álava, Vitoria, España; Begitek Clínica Oftalmológica, Innova Ocular, Donostia-San Sebastián, España
| | - J M Martínez-de-la-Casa
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J M Ruiz-Moreno
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, España; Departamento de Oftalmología, Universidad de Extremadura, Badajoz, España
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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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Abstract
The purpose of this review is to summarize preclinical and clinical data from publications appearing in the peer-reviewed scientific literature relevant to the safety and effectiveness of the EVO Implantable Collamer Lens (ICL) posterior chamber phakic refractive lens with a central port (V4c Visian ICL with KS Aquaport, STAAR Surgical, Inc.). A literature search was conducted using PubMed.gov to identify all articles relating to the EVO ICL. Articles were examined for their relevance, and the references cited in each article were also searched for additional relevant publications. On the basis of a total of 67 preclinical studies and clinical reports, including effectiveness data on 1,905 eyes with average weighted follow-up of 12.5 months and safety data on 4,196 eyes with weighted average follow up of 14.0 months, the EVO ICL is safe and effective for the correction of a broad range of refractive errors. High levels of postoperative uncorrected visual acuity, refractive predictability, and stability demonstrate the effectiveness of the EVO ICL. Safety data suggest reduced rates of anterior subcapsular cataract and pupillary block compared with earlier models. Improved safety and proven effectiveness make EVO an attractive option for surgeons and patients.
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Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA,
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Kamiya K, Shimizu K, Igarashi A, Kitazawa Y, Kojima T, Nakamura T, Ichikawa K. Posterior Chamber Phakic Intraocular Lens Implantation in Eyes with an Anterior Chamber Depth of Less Than 3 mm: A Multicenter Study. Sci Rep 2018; 8:13322. [PMID: 30190562 PMCID: PMC6127101 DOI: 10.1038/s41598-018-31782-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022] Open
Abstract
This study was aimed to assess the clinical outcomes of Visian ICL (hole ICL; STAAR Surgical, Inc.) implantation for the correction of myopic refractive errors in eyes having an anterior chamber depth (ACD) below the current manufacturer's recommendation (<3.0 mm). We comprised 365 eyes of 201 consecutive patients (mean age ± standard deviation, 35.7 ± 7.5 years) with spherical equivalents of -8.66 ± 3.54 D. We evaluated the safety, efficacy, predictability, stability, intraocular pressure (IOP), endothelial cell density (ECD), and complications. The safety and efficacy indices were 1.12 ± 0.22 and 0.98 ± 0.22. At 1 year, 90% and 98% of eyes were within ± 0.5 and 1.0 D of the attempted correction, respectively. Changes in the manifest refraction from 1 week to 1 year postoperatively were -0.08 ± 0.34 D. The mean ECD loss was 0.2 ± 8.7%. No eyes showed a significant ECD loss (≥30%). We found no significant correlation between the ACD and the change in ECD (Pearson correlation coefficient r = -0.048, p = 0.360). No significant IOP rise or vision-threatening complication occurred at any time. These findings indicate that the surgical indication of ICL implantation should be reconsidered in terms of ACD.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Sagamihara, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | | | - Takashi Kojima
- Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan
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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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Zhao J, Luo D, Sun Y, Niu L, Zhao F, Wang X, Wang H, Chen Q, Zhou X. Implanting a posterior chamber phakic intraocular lens in highly myopic eyes with peripheral primary iris and ciliary body cysts. Eur J Ophthalmol 2018; 29:171-177. [PMID: 29607656 DOI: 10.1177/1120672118766445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: To investigate the safety and efficacy of implanting a posterior chamber implantable collamer lens with a central hole in cases of high myopia with peripheral primary iris or ciliary body cysts. METHODS: A total of 37 eyes of 19 patients with primary iris or ciliary body cysts detected by ultrasonic biological microscope were included, with spherical powers of -10.26 ± 3.28 D and cylinder powers of -1.71 ± 1.18 D. Each patient received ultrasonic biological microscope and a routine examination before implantation of the implantable collamer lens. A routine postoperative follow-up was performed to observe changes in the iris or ciliary body cyst, ranging from 3 to 18 months. RESULTS: There were no complications. At the last follow-up, 56.8% (21/37) of eyes achieved the same corrected distance visual acuity as their preoperative measurements, 43.2% of eyes were enhanced by ≥1 line, and no patients' corrected distance visual acuity declined. The efficacy index and safety index were 0.95 and 1.11, respectively. After 18 months, 66.7% of the spherical equivalents were between ±0.5 D with 100% between ±1.0 D. The postoperative mean spherical equivalents at 1, 3, 6, 12, and 18 months were -0.45 ± 0.31 D, -0.39 ± 0.29 D, -0.36 ± 0.30 D, -0.39 ± 0.38 D, and -0.48 ± 0.23 D (p = 0.789). The vaults were 516 ± 140, 548 ± 124, 498 ± 133, 582 ± 161, and 557 ± 110 μm (p = 0.355). There were no changes in size (p > 0.05), number, or position of the iris or ciliary body cysts. CONCLUSION: Implantable collamer lens implantation is safe and effective for highly myopic patients with peripheral primary iris and ciliary body cysts. The cysts did not change after operation in this study.
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Affiliation(s)
- Jing Zhao
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Dongqiang Luo
- 2 Center of Ophthalmology and Optometric, People's Hospital of Hunan Province, Changsha, China
| | - Yong Sun
- 3 Department of Ophthalmology, The People's Hospital of Shajin in Baoan District, Shenzhen, China
| | - Lingling Niu
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Feng Zhao
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaoying Wang
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Hua Wang
- 2 Center of Ophthalmology and Optometric, People's Hospital of Hunan Province, Changsha, China
| | - Qian Chen
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xingtao Zhou
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Impacts of Implantable Collamer Lens V4c Placement on Angle Measurements Made by Optical Coherence Tomography: Two-Year Follow-up. Am J Ophthalmol 2018; 186:171-172. [PMID: 29221822 DOI: 10.1016/j.ajo.2017.10.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 11/20/2022]
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Fernández-Vigo JI, De-Pablo-Gómez-de-Liaño L, Almorín-Fernández-Vigo I, Fernández-Vigo C, Macarro-Merino A, García-Feijóo J, Fernández-Vigo JÁ. Agreement between Pentacam and optical coherence tomography in the assessment of iridocorneal angle width in a large healthy population. J Fr Ophtalmol 2018; 41:14-20. [PMID: 29295793 DOI: 10.1016/j.jfo.2017.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the agreement between Pentacam and optical coherence tomography (OCT) in the assessment of trabecular-iris angle (TIA) width in a large population of normal subjects. METHODS A cross-sectional study was performed in 989 right eyes of 989 healthy subjects. The trabecular-iris angle (TIA) was measured in the temporal and nasal quadrants using the Pentacam (Oculus, Wetzlar, Germany), a device based on Scheimpflug technology and RTVue 100 OCT (Optovue, Fremont, CA, USA). Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to evaluate agreement between these devices. RESULTS Mean age was 49.1±15.2 years (18-84); 61% were women and spherical error range was -14 to 8.25. TIA could be measured by OCT in 94.9% and 94.1% in the temporal and nasal quadrants, with a mean value of 35.8±13.2 degrees (2.5-78.7) and 35.7±12.9 degrees (2.2-76.8) respectively. TIA was able to be measured by Pentacam in 95.2% and 95% in the temporal and nasal quadrants and means were 35.7±7.3 degrees (11-74.2) and 36.4±8.2 degrees (14.5-64) respectively. An ICC of 0.378 (95% confidence interval [CI], 0.322-0.431) and 0.589 (95% CI 0.546-0.629) for the temporal and nasal quadrants was obtained, showing moderate agreement between the devices. Bland-Altman plots revealed that, compared with OCT, Pentacam tends to overestimate measurements in narrow angles and underestimate these in open angles. CONCLUSIONS Agreement between OCT and Pentacam was mediocre, indicating the two devices are not interchangeable when used to measure angle width.
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Affiliation(s)
- J I Fernández-Vigo
- Ophthalmology department, hospital universitario clínico San-Carlos, instituto de investigación sanitaria del hospital clínico San-Carlos (IdISSC), Madrid, Spain; Centro internacional de oftalmología Avanzada, Madrid, Spain.
| | - L De-Pablo-Gómez-de-Liaño
- Centro internacional de oftalmología Avanzada, Madrid, Spain; Ophthalmology department, hospital universitario 12 de Octubre. Madrid, Spain
| | | | | | | | - J García-Feijóo
- Ophthalmology department, hospital universitario clínico San-Carlos, instituto de investigación sanitaria del hospital clínico San-Carlos (IdISSC), Madrid, Spain
| | - J Á Fernández-Vigo
- Centro internacional de oftalmología Avanzada, Madrid, Spain; Ophthalmology department, facultad de medicina, universidad de Extremadura, Badajoz, Spain
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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: 11] [Impact Index Per Article: 1.6] [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: 23] [Impact Index Per Article: 3.3] [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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Garcia-De la Rosa G, Olivo-Payne A, Serna-Ojeda JC, Salazar-Ramos MS, Lichtinger A, Gomez-Bastar A, Ramirez-Miranda A, Navas A, Graue-Hernandez EO. Anterior segment optical coherence tomography angle and vault analysis after toric and non-toric implantable collamer lens V4c implantation in patients with high myopia. Br J Ophthalmol 2017; 102:544-548. [PMID: 28729370 DOI: 10.1136/bjophthalmol-2017-310518] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/12/2017] [Accepted: 06/25/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions. METHODS Longitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up. RESULTS Seventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001). CONCLUSION There is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.
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Affiliation(s)
- Guillermo Garcia-De la Rosa
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Andrew Olivo-Payne
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Juan Carlos Serna-Ojeda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Maria Sandra Salazar-Ramos
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Alejandro Lichtinger
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Arturo Gomez-Bastar
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
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Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol 2016; 10:1059-77. [PMID: 27354760 PMCID: PMC4907705 DOI: 10.2147/opth.s111620] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks.
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Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA
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