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Zhao H, Tang T, Lu Y, Li X, Sun L, Chen S, Ma L, Luo Y, Wang K, Zhao M. Development and Validation of Data-Level Innovation Data-Balancing Machine Learning Models for Predicting Optimal Implantable Collamer Lens Size and Postoperative Vault. Ophthalmol Ther 2024; 13:267-286. [PMID: 37943481 PMCID: PMC10776515 DOI: 10.1007/s40123-023-00841-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION There are only four sizes of implantable collamer lens (ICL) available for selection, which cannot completely fit all patients as a result of the discontinuity of ICL sizes. Sizing an optimal ICL and predicting postoperative vault are still unresolved problems. This study aimed to develop and validate innovative data-level data-balancing machine learning-based models for predicting ICL size and postoperative vault. METHODS The patients were randomly assigned to training and internal validation sets in a 4:1 ratio. Feature selection was performed using analysis of variance (ANOVA) and Kruskal-Wallis feature importance methods. Traditional linear regression model and machine learning-based models were used. The accuracy of models was assessed using the area under the curve (AUC) and confusion matrix. RESULTS A total of 564 patients (1127 eyes) were eligible for this study, consisting of 808 eyes in the training set, 202 eyes in the internal validation set, and 117 eyes in the external validation set. Compared with the traditional linear regression method, the machine learning model bagging tree showed the best performance for ICL size selection, with an accuracy of 84.5% (95% confidence interval (CI) 83.2-85.8%), and the AUC ranged from 0.88 to 0.99; the prediction accuracy of 12.1 mm and 13.7 mm ICL sizes was improved by 49% and 59%, respectively. The bagging tree model achieved the best accuracy [90.2%, (95% CI 88.9-91.5%)] for predicting the postoperative vault, and the AUC ranged from 0.90 to 0.94. The prediction accuracies of internal and external validation dataset for ICL sizing were 82.2% (95% CI 81.1-83.3%) and 82.1% (95% CI 81.1-83.1%), respectively. CONCLUSIONS The innovative data-level data balancing-based machine learning model can be used to predict ICL size and postoperative vault more accurately, which can assist surgeons in choosing optimal ICL size, thus reducing risks of postoperative complications and secondary surgery.
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Affiliation(s)
- Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yuchang Lu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Liyuan Sun
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Sitong Chen
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lu Ma
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.
- College of Optometry, Peking University Health Science Center, Beijing, China.
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Martínez-Plaza E, López-de la Rosa A, López-Miguel A, Holgueras A, Maldonado MJ. EVO/EVO+ Visian Implantable Collamer Lenses for the correction of myopia and myopia with astigmatism. Expert Rev Med Devices 2023; 20:75-83. [PMID: 36708714 DOI: 10.1080/17434440.2023.2174429] [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: 01/30/2023]
Abstract
INTRODUCTION Intraocular lens implantation in phakic eyes for the correction of refractive error is currently a widespread procedure. The EVO and EVO+ Visian Implantable Collamer Lenses (ICL) are two of the most prevalent lenses implanted. They incorporate a central orifice to avoid the need for iridotomy. The main difference between both ICL is the higher optical diameter zone provided by the EVO+, allowing a better quality of vision at night. This review aims to provide an overview of the current ICL models available for correcting myopia and myopic astigmatism. AREAS COVERED During the last decade, more than 100 scientific papers analyzing the performance of EVO and EVO+ lenses have been published. This review describes the objective visual performance achieved with the implantation of central hole ICL lenses and the subjective perception of the patients implanted with these lenses. In addition, the safety and the potential complications associated with undergoing an EVO and EVO+ ICL implantation have been addressed. EXPERT OPINION Refractive surgeons and candidates to undergo ICL implantation should be aware of the excellent safety and visual outcomes provided by the implantation of central hole ICL lenses. However, future research could address minor issues currently not resolved.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | | | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Alfredo Holgueras
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
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Amer AA, Ahmed Ghanem Abu El Wafa Ali E, Sayed Ahmed E, Ateto Hamed M, el Shazly Eata W, Amer I. Posterior-Chamber Phakic Implantable Collamer Lenses with and without a Central Hole: A Comparative Study. Clin Ophthalmol 2023; 17:887-895. [PMID: 36942086 PMCID: PMC10023812 DOI: 10.2147/opth.s405689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Purpose This study aimed to compare the short-term outcome of implanting the Visian implantable collamer lens V4 ICL versus the Visian V4c ICL in patients with moderate and high myopia. Patients and Methods This is a retrospective that was conducted on patients with moderate or high myopia who were scheduled for ICL implantation at our institution, Patients who underwent V4 ICL implantation with peripheral iridectomy were assigned to group A, and those who underwent V4c ICL implantation without peripheral iridectomy were assigned to group B. In group A, a preoperative peripheral iridectomy was performed. In group B, the patients received cycloplegic and dilating agents. The patients underwent a complete ocular examination preoperatively and during the follow-up visits that were conducted at 3, 6, and 12 months postoperatively. Results This study included 214 eyes from 107 patients; group A included 110 eyes, and group B included 104 eyes. Postoperatively, the UCVA and BCVA showed statistically significant improvement across the follow-up time points (p<0.001), with no significant difference between the two groups. No statistically significant difference was found between the two groups in the mean achieved correction or the residual refraction. Both groups showed a strong correlation between the target and the achieved correction, with R2 = 0.99 in the two groups. No significant difference was found between the two groups in the IOP across all time measures. However, the intraocular pressure showed a statistically significant postoperative increase in group A (p=0.004), and no significant change in group B (p=0.817). There was a downward slope in the vaults of both groups across time, with significant variation in the last follow-up measure compared to the 3-month measure in the two groups (p<0.001). No significant difference was found between the two groups across all time measures. Conclusion The current study adds new evidence concerning the feasibility, safety, and efficacy of ICL V4c implantation for the treatment of moderate and high myopia, with safer postoperative IOP.
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Affiliation(s)
- Ahmed Ali Amer
- Ophthalmology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
- Correspondence: Ahmed Ali Amer, Tel +20 101 182 7000, Email
| | | | | | | | - Wael el Shazly Eata
- Ophthalmology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ibrahim Amer
- Ophthalmology Department, Al Azhar University, Assuit, Egypt
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Martínez-Plaza E, López-Miguel A, López-de la Rosa A, Maldonado MJ. Inter-eye and postoperative prediction of vault after implantation of EVO + Visian phakic implantable collamer lens. Int Ophthalmol 2022; 43:1501-1510. [PMID: 36260197 DOI: 10.1007/s10792-022-02546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess whether the postoperative outcomes of the implantation of an EVO + implantable collamer lens (ICL) in one eye can be used as a predictor of the vault of the fellow eye, and to evaluate the vault changes of the implantation in both eyes during the postoperative period. METHODS A prospective study including 40 eyes of 20 patients with a bilateral EVO + ICL implantation was performed. Subjects were evaluated before the surgery and 1 day, 1 week and 1, 3 and 6 months postoperatively. Central vault was assessed using spectral-domain optical coherence tomography. The inter-eye and follow-up analyses were performed using lineal models and the Bland-Altman method. RESULTS The vault of the first implanted eye at the 1-day visit highly predicts the vault of the second eye (R2 = .87; P < .001); the mean inter-eye difference was - 0.95 μm, and the superior and inferior limits of agreement were -50.27 μm and 148.37 μm, respectively. This relationship was maintained during the medium-term follow-up, not finding differences in the slopes among visits (P ≥ .09). A progressive decrease of vault was found during the follow-up (P < .001). Larger vault change 6 months after the surgery was associated with higher vault 1 day after the ICL implantation (R2 = .19;P = .005). CONCLUSION One-day postoperative vault in the first eye can help to predict the optimal ICL sizing in the second eye. Vault tends to decrease during the first 6 months after EVO + ICL implantation. Eyes with higher initial vaults will also show larger reductions during the medium-term follow-up.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain.
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
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Factors leading to realignment or exchange after implantable collamer lens implantation in 10 258 eyes. J Cataract Refract Surg 2022; 48:1190-1196. [PMID: 35351844 PMCID: PMC9514736 DOI: 10.1097/j.jcrs.0000000000000950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/24/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the incidence, causes, and outcomes of implantable collamer lens (ICL) realignment or exchange after implantation of the EVO-ICL. SETTING Eye and ENT Hospital of Fudan University, China. DESIGN Retrospective study. METHODS The study included 10 258 consecutive eyes after ICL implantation. Preoperative refractive and biometric measurements were compared between eyes with and without realignment or exchange. For eyes with ICL realignment or exchange, visual and biometric outcomes were also compared before and after ICL realignment or exchange. RESULTS The overall incidence of ICL realignment or exchange was 0.21% 22 eyes. 12 eyes (0.12%) underwent ICL realignment by axis rotation (10 eyes) or ICL exchange (2 eyes) due to toric ICL (TICL) misalignment. After realignment, uncorrected distance visual acuity improved, and residual cylinder decreased from -1.75 ± 0.48 diopters (D) to -0.87 ± 0.59 D ( P = .01). 10 eyes (0.10%) underwent vertical rotation of ICL (3 eyes) or ICL exchange (7 eyes) due to excessive vault. After either vertical rotation or ICL exchange, vault decreased significantly ( P < .05). CONCLUSIONS The incidence of ICL realignment or exchange after ICL implantation is low. TICL misalignment and excessive vault are 2 main causes. Implant exchange may be performed for excessive vault or misalignment with an insufficient vault. In addition, vertical rotation of an ICL may be a less invasive method to treat excessive vault in certain cases.
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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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Montés‐Micó R, Ruiz‐Mesa R, Rodríguez‐Prats JL, Tañá‐Rivero P. Posterior-chamber phakic implantable collamer lenses with a central port: a review. Acta Ophthalmol 2021; 99:e288-e301. [PMID: 32841517 PMCID: PMC8246543 DOI: 10.1111/aos.14599] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023]
Abstract
We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow‐up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time‐points post‐surgery. In addition, adverse events and other parameters such as endothelial cell density, intraocular pressure and vault measurements—which were evaluated in some of the studies—were also compared. This review encompassed a total of 2904 eyes. The outcomes reported in this review lead us to conclude that ICL V4c implantation for myopia correction is a safe and efficient procedure, with stable visual and refractive outcomes and low adverse event rates. The patient’s anterior segment should be thoroughly characterized, and the ICL parameters should be carefully selected so as to achieve good outcomes and avoid complications.
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Affiliation(s)
- Robert Montés‐Micó
- Oftalvist Alicante Spain
- Optics and Optometry and Vision Sciences Department University of Valencia Valencia Spain
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Zhou T, Jiang H, Wang Y, Xie C, Xia J, Shen Y. Comparison of anterior chamber angle changes following phakic intraocular lens with and without a central hole implantation for moderate to high myopic eyes. Medicine (Baltimore) 2020; 99:e23434. [PMID: 33285737 PMCID: PMC7717800 DOI: 10.1097/md.0000000000023434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The aim of this study was to compare the anterior chamber angle changes after implantation of phakic intraocular lens with and without a central hole for moderate to high myopic eyes in Chinese people.This study enrolled 106 eyes of 54 people with intraocular lens V4 implantation and 105 eyes of 53 people with intraocular lens V4c implantation. Postoperative vault, intraocular pressure, and anterior chamber angle changes were assessed using noncontract tonometer and ultrasound biomicroscope, respectively, at 1, 3, 6, and 12months after the surgery.There were no significant differences (all P > .05) between the 2 groups in the depth of the central vault, intraocular pressure, or the width of anterior chamber angle at any time point post-surgery. The anterior chamber angle width in degree had a baseline of 54.40 ± 10.51 in V4c group, and decreased to 27.80 ± 5.62, 26.95 ± 5.56, 27.32 ± 5.66, 27.04 ± 5.47 at 1, 3, 6, and 12 months post-surgery, respectively. Mean preoperative value of 50.62 ± 11.77 decreased to 27.28 ± 6.53, 26.82 ± 6.03, 26.61 ± 5.80, 26.83 ± 5.76 at 1, 3, 6, 12 months, respectively, in V4 group. It had sufficient evidence (P < .001) that anterior chamber angle will narrow done after surgery, but there were no statistically significant differences within groups at any time point after surgery.The anterior chamber angle changes of the V4c group was essentially equivalent to that of conventional V4 group, although implantation of both models will lead to the decrease in anterior chamber angle width.
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Zhu Y, Yue Y, Zhu H, Chen J, Zhou J. Influence of refractive error on pupil diameters in highly myopic eyes with implantable collamer lenses. Eur J Ophthalmol 2019; 30:1328-1334. [PMID: 31304777 DOI: 10.1177/1120672119863716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To investigate the influence of refractive error on pupil diameters in highly myopic eyes with implantable collamer lenses. SETTING Shanghai, China. DESIGN A prospective consecutive observational study. METHODS Sixty-six eyes of 66 patients that underwent ICL V4c implantation were included. Pupil diameters before and 1 week, 1 month, and 3 months after surgery were measured using an automatic pupillometry system (MonCv3; Metrovision, Pérenchies, France) under four standardized illumination conditions: 0, 1, 10, and 100 cd/m2. The correlations between changes in pupil diameter and spherical equivalent values and patient age were investigated. RESULTS Based on preoperative spherical equivalent values, included eyes were divided into a high-myopia group (-6.3 to -9.9 D (diopters)) and a super-high-myopia group (-10 to -20 D). Pupil sizes remained unchanged after surgery in the high-myopia group and decreased at 1 and 10 cd/m2 in the super-high-myopia group. A between-group comparison showed that pupils were significantly smaller in the super-high-myopia group 1 week postoperatively under all illumination conditions and remained smaller at 1 month and 3 months under 1 and 10 cd/m2 lighting conditions. Preoperative spherical equivalent values were significantly correlated with the percent decrease in pupil diameter 1 week postoperatively under 0, 1, and 10 cd/m2 illumination conditions; the greater the degree of myopia, the greater the reduction in pupil diameter. CONCLUSION Preoperative refractive error significantly affects pupil diameter in highly myopic eyes after implantable collamer lens implantation. Pupils of super highly myopic eyes remained smaller than preoperative levels under mesopic conditions after implantable collamer lens implantation.
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Affiliation(s)
- Yi Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yu Yue
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Haobin Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jili Chen
- Department of Ophthalmology, Shibei Hospital, Shanghai, China
| | - Jibo Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Zhu Y, He T, Zhu H, Chen J, Zhou J. Static and dynamic pupillary characteristics in high myopic eyes with two implantable collamer lenses. J Cataract Refract Surg 2019; 45:946-951. [DOI: 10.1016/j.jcrs.2019.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 11/27/2022]
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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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12
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Zhu Y, Zhang J, Zhu H, Chen J, Zhou J. The effect of mydriasis on moderate-to-high myopic eyes with implantable collamer lenses V4 and V4c. Eur J Ophthalmol 2019; 30:462-468. [PMID: 30845836 DOI: 10.1177/1120672119831218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the vault change and anterior segment movement induced by mydriasis in moderate-to-high myopic eyes with implantable collamer lenses (ICL). SETTING Shanghai, China. DESIGN A prospective consecutive observational study. METHODS A total of 45 eyes of 24 patients with ICL V4 implantation and 128 eyes of 65 patients with ICL V4c implantation were included and analyzed. Anterior chamber depth, posterior corneal endothelium-to-ICL distance, and vault before and after mydriasis were measured by Pentacam (Oculus, Wetzlar, Germany) at 1, 3, and 6 months after surgery. RESULTS Significant vault increases and anterior chamber depth increases induced by mydriasis were noted in both ICL V4 and V4c groups at 1, 3, and 6 months postoperatively. The corneal endothelium-ICL distance increased significantly in eyes with implanted ICL V4c after mydriasis at 3 and 6 months. Moreover, mydriasis-induced vault increases were greater in the ICL V4 group than in the ICL V4c group at 3 and 6 months. In eyes with implanted ICL V4c, mydriasis-induced vault increases were significantly greater at 1 month than at 3 and 6 months. CONCLUSION Mydriasis results in a general vault increase in eyes with implanted ICLs. The adjustment of the pressure equilibrium via the central hole of the ICL V4c has an important role in vault change. The mydriasis-induced vault increases tend toward stability after 3 months postoperatively. Mydriasis is relatively safe in eyes with ICL implantation.
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Affiliation(s)
- Yi Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jing Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Haobin Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jili Chen
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Ophthalmology, Shibei Hospital, Shanghai, China
| | - Jibo Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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13
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Park K, Chung JK. Result of Central Vault Depending on Lens Diameters in Patients with Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.12.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kibum Park
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jin Kwon Chung
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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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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15
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Chen SY, Xie C, Wang Y, Shen Y. Full-vision maintenance in extra-high myopia from implantable collamer lens to trifocal intraocular lens implantation. Int J Ophthalmol 2018; 11:1239-1242. [PMID: 30046546 DOI: 10.18240/ijo.2018.07.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 03/12/2018] [Indexed: 11/23/2022] Open
Affiliation(s)
- Shu-Yang Chen
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Chen Xie
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Yang Wang
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Ye Shen
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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16
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Nam SW, Lim DH, Hyun J, Chung ES, Chung TY. Buffering zone of implantable Collamer lens sizing in V4c. BMC Ophthalmol 2017; 17:260. [PMID: 29273016 PMCID: PMC5741871 DOI: 10.1186/s12886-017-0663-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/13/2017] [Indexed: 02/01/2023] Open
Abstract
Background The purpose of this study was to identify factors related to the unexpected vault in V4c implantable collamer lens (ICL; STAAR Surgical) implantation. Methods V4c ICLs were implanted in 43 eyes of 43 patients for the correction of myopia. The implanted V4c ICL sizes were determined individually with our previous V4 ICL sizing nomogram based on the sulcus-to-sulcus diameter (STS), and the V4 ICL sizes were then converted to V4c ICL sizes with a size-converting table. We defined the “normal-sizing group” as having a pre-converted ICL size larger than the STS, and the “under-sizing group” as having a pre-converted ICL size smaller than the STS. Refractive outcomes, safety and parameters related to postoperative vault were compared between the two groups. Results The value of “actual ICL size – STS” differed significantly between the normal-sizing and under-sizing groups (p < 0.001), but postoperative vault did not differ significantly (p = 0.442). The demographics, implanted ICL characteristics, effectiveness indexes, safety indexes, and parameters related to postoperative vault did not differ significantly between the two groups (p > 0.05). Two patients in the normal-sizing group exhibited over-vaulting; these patients had shallow anterior chambers and were implanted with high-dioptric-power ICLs. Conclusions The achievement of acceptable vault in both normal-sizing and under-sizing groups indicates the existence of a buffering zone in V4c ICL sizing. The smaller size of V4c ICLs should be considered in patients susceptible to over-vaulting, such as those with shallow anterior chambers and high-dioptric-power ICLs.
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Affiliation(s)
- Seung Wan Nam
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Preventive Medicine, Graduate School, The Catholic University of Korea, Seoul, South Korea
| | - Joo Hyun
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Saevit Eye Hospital, Goyang, South Korea
| | - Eui-Sang Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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