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Kırgız A, Yalçınkaya Çakır G, Çakır İ, Yıldırım Y, Ağca A. Seven-Year clinical outcomes after implantation of Eyecryl posterior chamber phakic intraocular lenses for high myopia. Eur J Ophthalmol 2024; 34:1424-1431. [PMID: 38297492 DOI: 10.1177/11206721241229311] [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] [Indexed: 02/02/2024]
Abstract
PURPOSE To evaluate the long-term clinical outcomes, safety and efficacy of Eyecryl posterior-chamber phakic intraocular lens implantation (pIOL) implantation in patients with high myopia. METHODS Patients with myopia between -6.00 and -20.00 dioptres and with endothelial cell density (ECD) was ≥2300 cells/mm2 were included. Preoperative and postoperative first, fourth, and seventh years of refraction, uncorrected/corrected distance visual acuity (UDVA/CDVA), ECD, central vault were detected. RESULTS Thirty-six eyes were analyzed. The mean UDVA and CDVA in postoperative seventh years were 0.25 ± 0.31 and 0.13 ± 0.24 logMAR, respectively. The safety and efficacy indices were 1.55 ± 0.54 and 1.24 ± 0.53, respectively. The mean cumulative ECD loss was 6.96% (p < 0.001). The central vault at the 1st and the 7th year were 0.52 ± 0.14 and 0.49 ± 0.14 mm, respectively (p = 0.25). CONCLUSIONS These findings supported the long-term stability, efficacy, safety of the Eyecryl pIOL for high myopia. Eyecryl posterior chamber pIOL is one of the effective refractive options in correcting high myopia.
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Affiliation(s)
- Ahmet Kırgız
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Gülay Yalçınkaya Çakır
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - İhsan Çakır
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Yusuf Yıldırım
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Alper Ağca
- Atakoy World Eye Hospital, Istanbul, Turkey
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Ni Y, Wu Y, Dong Y, Jin H, Zhang K, Hong C, Qiu P, Shen T. Lens height paraments comparison according to ciliary sulcus width (CSW): a pilot study of the predictive role of CLR and STSL for vault after ICL implantation. BMC Ophthalmol 2024; 24:355. [PMID: 39164617 PMCID: PMC11334505 DOI: 10.1186/s12886-024-03631-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND To assess the relationship between postoperative implantable collamer lens (ICL) vault and lens height obtained from two different measurements. METHODS A retrospective case series study enrolled eyes with horizontally implanted ICL. Crystal lens rise (CLR) and the distance between STS plane and anterior crystalline lens surface (STSL) were measured in the horizontal and vertical directions using ultrasound biomicroscopy (UBM). We compared the differences in the parameters measured in both horizontal and vertical directions. The participants were categorized into three groups according to ciliary sulcus width (CSW) which is defined as the distance between the posterior angle of the iris and the anterior angle of the ciliary process: narrow CSW group (NSG); medium CSW group (MSG); and wide CSW group (WSG). The correlations between CLR/STSL and vault were examined in each of the three groups. Biased correlation analysis was used further to contrast the correlation between CLR/STSL and vault. RESULTS This retrospective study included 223 myopic eyes. Vertical STSL (VSTSL) and vertical CLR (VCLR) exhibited significantly greater values compared to their horizontal counterparts (both P < 0.05). None of the indicators were statistically different between the three groups. In both NSG and MSG, STSL/CLR correlated with vault, while in WSG, only STSL correlated with vault (r=-0.316, P = 0.013). In contrast to HCLR, the correlation between HSTSL and vault remained after controlling for HCLR (r=-0.162, P = 0.015). CONCLUSIONS STSL should deserve more attention in the preoperative evaluation of ICL compared to CLR especially when CSW is large.
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Affiliation(s)
- Yingjie Ni
- The Second Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China
| | - Yuanpeng Wu
- Department of Ophthalmology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, 310014, China
| | - Yi Dong
- Department of Ophthalmology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, 310014, China
| | - Huihui Jin
- The Second Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China
| | - Kailei Zhang
- Postgraduate Training Base Alliance of Wenzhou Medical University (Affiliated People's Hospital), Hangzhou, zhejiang province, China
| | - Chaoyang Hong
- Department of Ophthalmology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, 310014, China
| | - Peijin Qiu
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.1 West Lake Avenue, Hangzhou, zhejiang province, 310009, China
| | - Ting Shen
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.1 West Lake Avenue, Hangzhou, zhejiang province, 310009, China.
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Zeng Z, Zhu M, Zhang G. Accuracy of intraocular lens calculation formulas based on swept-source OCT biometer in cataract patients with phakic intraocular lens. BMC Ophthalmol 2024; 24:326. [PMID: 39103785 DOI: 10.1186/s12886-024-03605-4] [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: 05/01/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024] Open
Abstract
PURPOSE To research the accuracy of intraocular lens (IOL) calculation formulas and investigate the effect of anterior chamber depth (ACD) and lens thickness (LT) measured by swept-source optical coherence tomography biometer (IOLMaster 700) in patients with posterior chamber phakic IOL (PC-pIOL). METHODS Retrospective case series. The IOLMaster 700 biometer was used to measure axial length (AL) and anterior segment parameters. The traditional formulas (SRK/T, Holladay 1 and Haigis) with or without Wang-Koch (WK) AL adjustment, and new-generation formulas (Barret Universal II [BUII], Emmetropia Verifying Optical [EVO] v2.0, Kane, Pearl-DGS) were utilized in IOL power calculation. RESULTS This study enrolled 24 eyes of 24 patients undergoing combined PC-pIOL removal and cataract surgery at Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China. The median absolute prediction error in ascending order was EVO 2.0 (0.33), Kane (0.35), SRK/T-WKmodified (0.42), Holladay 1-WKmodified (0.44), Haigis-WKC1 (0.46), Pearl-DGS (0.47), BUII (0.58), Haigis (0.75), SRK/T (0.79), and Holladay 1 (1.32). The root-mean-square absolute error in ascending order was Haigis-WKC1 (0.591), Holladay 1-WKmodified (0.622), SRK/T-WKmodified (0.623), EVO (0.673), Kane (0.678), Pearl-DGS (0.753), BUII (0.863), Haigis (1.061), SRK/T (1.188), and Holladay 1 (1.513). A detailed analysis of ACD and LT measurement error revealed negligible impact on refractive outcomes in BUII and EVO 2.0 when these parameters were incorporated or omitted in the formula calculation. CONCLUSION The Kane, EVO 2.0, and traditional formulas with WK AL adjustment displayed high prediction accuracy. Furthermore, the ACD and LT measurement error does not exert a significant influence on the accuracy of IOL power calculation formulas in highly myopic eyes implanted with PC-pIOL.
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Affiliation(s)
- Zongsheng Zeng
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Meiyi Zhu
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Guangbin Zhang
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China.
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China.
- Fujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China.
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China.
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Sánchez-Ventosa Á, Cano-Ortiz A, González Cruces T, Villalba González M, Membrillo A, Villarrubia A. Analysis after posterior chamber phakic intraocular lens implantation: 17- to 19-year follow-up study. J Cataract Refract Surg 2024; 50:816-821. [PMID: 39083408 DOI: 10.1097/j.jcrs.0000000000001469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/21/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE To evaluate the clinical outcomes of the Visian implantable collamer lens (ICL) in eyes with ≥17 years of follow-up. SETTING Single-center. DESIGN Retrospective observational study. METHODS 70 eyes from 38 patients who underwent surgery between 2002 and 2006 with V4 ICL implantation were analyzed. Preintervention data included corrected distance visual acuity (CDVA), refraction, and intraocular pressure (IOP). At the 19-year mark, CDVA, refraction, IOP, endothelial count, and vault were measured using Tomey Casia 2 anterior pole tomography, along with recording long-term events. RESULTS The operated patients had a spherical correction between -4 diopters (D) and -21 D and a cylinder up to 7.5 D. The mean CDVA (decimal) at the 17-year check-up was 0.89 ± 0.18, with a spherical equivalent of -1.05 ± 1.36 D. IOP has remained stable because mean measurements before surgery and currently were 15.16 ± 2.54 mm Hg and 16.19 ± 3.29 mm Hg, respectively. The endothelial cell count showed values of 2191 ± 386 cells/mm2, with a maximum of 2804 cells and a minimum of 1125 cells. Finally, the vault obtained was 348.53 ± 234.58 mm. Over the years, 2 eyes developed angle-closure glaucoma and 9 eyes were operated on for the development of anterior subcapsular cataracts. CONCLUSIONS Visian ICL implantation demonstrated long-term visual and refractive stability, indicating it as a low-risk procedure. The ICL V4 model yielded satisfactory results for myopia and astigmatism correction after 17 years.
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Naujokaitis T, Auffarth GU, Łabuz G, Khoramnia R. Endothelial Cell Loss in Patients with Phakic Intraocular Lenses. Klin Monbl Augenheilkd 2024; 241:923-943. [PMID: 38242162 DOI: 10.1055/a-2209-5251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Although the safety of phakic intraocular lenses (pIOLs) has been continuously improved over 70-years of development, high endothelial cell losses can occur even with current pIOL models. Numerous studies have demonstrated that the distance of a pIOL to the corneal endothelium plays a crucial role in the extent of endothelial cell loss. For this reason alone, higher endothelial cell loss tends to be observed with anterior chamber lenses than with posterior chamber lenses. Adequate preoperative anterior chamber depth is essential, at least for iris-fixed pIOLs, in order to ensure a safe distance from the endothelium. However, the anterior chamber becomes shallower with age and therefore it may be useful to consider patient age in the safety criteria. Although endothelial cell loss is generally low with current pIOL models, regular monitoring of the endothelial cell density remains essential due to large interindividual differences in patients with pIOLs. If the endothelial cell loss is greater than expected and the follow-up visits confirm the trend, the pIOL should be explanted without delay. The endothelial reserve should be considered on an individual basis by taking into account patient age, physiological endothelial cell loss, and loss due to further surgery. With careful indication and long-term patient care, pIOLs remain a safe treatment option.
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Affiliation(s)
- Tadas Naujokaitis
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
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Cardoza NJ, Murthy SI, Senthil S. Reverse pupillary block with pigment dispersion and elevated intraocular pressure following bilateral phakic intraocular lens implantation. BMJ Case Rep 2024; 17:e256010. [PMID: 38782424 DOI: 10.1136/bcr-2023-256010] [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] [Indexed: 05/25/2024] Open
Abstract
The authors describe a case of reverse pupillary block with pigment dispersion following sequential phakic intraocular lens (pIOL) implantation for high myopia, in a young female patient. The intraocular pressure (IOP) elevation began 3 weeks postoperatively, for which Nd-YAG laser peripheral iridotomies (PIs) were attempted elsewhere. Despite maximum medical therapy, the IOP was uncontrolled. She was referred to our institute for further management. Examination showed anteriorly displaced iris-pIOL diaphragm, iris pigment dispersion and raised IOP. The PIs were incomplete. Based on clinical evaluation and investigations, we concluded that the excess area of contact of the posterior iris over the pIOL caused a reverse pupillary block and pigment dispersion. The IOPs were controlled by repeating laser iridotomies and with medical therapy. Subsequently, the patient developed a low lens vault leading to bilateral cataract. Sequential explantation of the pIOL along with cataract extraction was performed and her vision was restored.
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Affiliation(s)
| | - Somasheila I Murthy
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sirisha Senthil
- VST Center for Glaucoma, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
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Thompson V, Cummings AB, Wang X. Implantable Collamer Lens Procedure Planning: A Review of Global Approaches. Clin Ophthalmol 2024; 18:1033-1043. [PMID: 38601168 PMCID: PMC11005927 DOI: 10.2147/opth.s456397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
More than 2 million implantable collamer lenses (ICLs) have been implanted worldwide. With a central port to improve aqueous flow through the ICL, the latest iteration of this phakic intraocular lens (pIOL) has been shown to have stable outcomes with very low rates of adverse events. However, correct planning and ICL size selection continue to be important to achieve an optimal vault. Shallow or excessive vaults are not complications in and of themselves but may increase the risk of complications. Historically, surgeons have relied on measurements of anterior chamber depth (ACD) and manual, caliper-measured white-to-white (WTW) distance to select the ICL size. New diagnostic and imaging technologies such as optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) provide additional opportunities for visualization and measurement of the intraocular dimensions involved in phakic intraocular lens implantation, including sulcus-to-sulcus (STS) and angle-to-angle (ATA) diameters. This paper reviews various approaches to ICL planning and sizing that have been published in the peer-reviewed literature, all of which produce acceptable results for predicting vault and size selection. Surgeons may also want to identify a methodology for patient evaluation and ICL size selection that best aligns with their personal preferences, diagnostic technology, and familiarity with analytical optimization tools.
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Affiliation(s)
- Vance Thompson
- Vance Thompson Vision, Sioux Falls, SD, USA
- Department of Ophthalmology, University of South Dakota Sanford School of Medicine, Vermillion, SD, USA
| | | | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People’s Republic of China
- Shanghai Research Center of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China
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9
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Jiang Y, Shen Y, Wang L, Chen X, Tang J, Liu L, Ma T, Ju L, Chen Y, Ge Z, Zhou X, Wang X. Effect of vault on predicting postoperative refractive error for posterior chamber phakic intraocular lens based on a machine learning model. J Cataract Refract Surg 2024; 50:319-327. [PMID: 37938020 DOI: 10.1097/j.jcrs.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To investigate how vault and other biometric variations affect postoperative refractive error of implantable collamer lenses (ICLs) by integrating artificial intelligence and modified vergence formula. SETTING Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN Artificial intelligence and big data-based prediction model. METHODS 2845 eyes that underwent uneventful spherical ICL or toric ICL implantation and with manifest refraction results 1 month postoperatively were included. 1 eye of each patient was randomly included. Random forest was used to calculate the postoperative sphere, cylinder, and spherical equivalent by inputting variable ocular parameters. The influence of predicted vault and modified Holladay formula on predicting postoperative refractive error was analyzed. Subgroup analysis of ideal vault (0.25 to 0.75 mm) and extreme vault (<0.25 mm or >0.75 mm) was performed. RESULTS In the test set of both ICLs, all the random forest-based models significantly improved the accuracy of predicting postoperative sphere compared with the Online Calculation & Ordering System calculator ( P < .001). For ideal vault, the combination of modified Holladay formula in spherical ICL exhibited highest accuracy ( R = 0.606). For extreme vault, the combination of predicted vault in spherical ICL enhanced R values ( R = 0.864). The combination of predicted vault and modified Holladay formula was most optimal for toric ICL in all ranges of vault (ideal vault: R = 0.516, extreme vault: R = 0.334). CONCLUSIONS The random forest-based calculator, considering vault and variable ocular parameters, illustrated superiority over the existing calculator on the study datasets. Choosing an appropriate lens size to control the vault within the ideal range was helpful to avoid refractive surprises.
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Affiliation(s)
- Yinjie Jiang
- From the Eye and ENT Hospital, Fudan University, Shanghai, China (Jiang, Shen, X. Chen, Tang, Liu, Zhou, X. Wang); National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China (Jiang, Shen, X. Chen, Tang, Liu, Zhou, X. Wang); Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China (Jiang, Shen, X. Chen, Tang, Liu, Zhou, X. Wang); Beijing Airdoc Technology Co., Ltd., Beijing, China (L. Wang, Ma, Ju, Y. Chen, Ge); Monash Medical AI Group, Monash University, Clayton, Australia (L. Wang, Ju, Ge)
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Lorger A, Luft N, Mayer WJ, Priglinger SG, Dirisamer M. One-stage versus two-stage bilateral implantable collamer lens implantation: a comparison of efficacy and safety. Sci Rep 2024; 14:5648. [PMID: 38453996 PMCID: PMC10920801 DOI: 10.1038/s41598-024-54101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/08/2024] [Indexed: 03/09/2024] Open
Abstract
Implantable collamer lens implantation (ICL) represents a safe and effective treatment for myopia and myopic astigmatism. To compare the outcomes of a bilateral one-stage same day approach to a two-stage approach, the databases of the University Eye Hospital Munich, Ludwig Maximilians-University and Smile Eyes Linz, Austria were screened for eyes that had undergone ICL implantation. Two-stage surgery was performed at an interval of 1 day (17 patients), 2 days (19 patients) and 1 week (2 patients). Variables analyzed were preoperative, 1-day and last follow-up uncorrected distance (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, refractive spherical equivalent (SEQ), astigmatism, age, endothelial cell count (ECD), intraocular pressure (IOP) and ICL vaulting. In total, 178 eyes (100 eyes one-stage, 78 eyes two-stage) of 89 patients were included in this study. Mean follow-up was 1.1 ± 0.8 and 1.3 ± 0.5 years. Mean preoperative SEQ was - 7.9 ± 2.6 diopters (D) in the one-stage and - 8.0 ± 1.7 D in the two-stage group (p = 0.63) and improved to 0.00 ± 0.40 and - 0.20 ± 0.40 D at end of follow-up, showing slightly better stability in the one-stage group (p = 0.004). There was no difference in the efficacy (1.1 vs. 1.2, p = 0.06) and the safety index (1.2 vs. 1.2, p = 0.60) between the two groups. No eye (0%) in either group lost 2 lines or more of UDVA (p > 0.99). Refraction within ± 0.50 D and ± 1.00 D around target was achieved comparably often (89 vs. 86%, p = 0.65; 99 vs. 99%, p > 0.99). Endothelial cell loss was slightly higher in the two-stage group (1.3 vs. 4.3%). Vaulting at the final follow up was higher in the one-stage group (373.8 ± 205.4 µm vs. 260.3 ± 153.5 µm, p = 0.00007). There were no serious intraoperative complications in either group. In conclusion, this study demonstrates that both the one- and two-stage approaches are equally effective, predictable and safe. Regarding endothelial cell loss, vaulting and SEQ stability, the one-stage group showed slightly better outcomes, but these results are clinically questionable because they are so small. Larger studies are needed to quantitatively evaluate a potential benefit.
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Affiliation(s)
- Anna Lorger
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
| | - Nikolaus Luft
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
- SMILE Eyes Linz, Linz, Austria
| | - Wolfgang J Mayer
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
| | - Siegfried G Priglinger
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
- SMILE Eyes Linz, Linz, Austria
| | - Martin Dirisamer
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany.
- SMILE Eyes Linz, Linz, Austria.
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Yang Y, Long Z, Lei B, Liu W, Ye J. Clinical decision support system based on deep learning for evaluating implantable collamer lens size and vault after implantable collamer lens surgery: a retrospective study. BMJ Open 2024; 14:e081050. [PMID: 38365302 PMCID: PMC10875548 DOI: 10.1136/bmjopen-2023-081050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/23/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVES To aid doctors in selecting the optimal preoperative implantable collamer lens (ICL) size and to enhance the safety and surgical outcomes of ICL procedures, a clinical decision support system (CDSS) is proposed in our study. DESIGN A retrospective study of patients after ICL surgery. SETTING China Tertiary Myopia Prevention and Control Center. PARTICIPANTS 2772 eyes belonging to 1512 patients after ICL surgery. Data were collected between 2018 and 2022. OUTCOME MEASURES A CDSS is constructed and used to predict vault at 1 month postoperatively and preoperative ICL dimensions using various artificial intelligence methods. Accuracy metrics as well as area under curve (AUC) parameters are used to determine the CDSS prediction methods. RESULTS Among the ICL size prediction models, conventional neural networks (CNNs) achieve the best prediction accuracy at 91.37% and exhibit the highest AUC of 0.842. Regarding the prediction model for vault values 1 month after surgery, CNN surpasses the other methods with an accuracy of 85.27%, which has the uppermost AUC of 0.815. Thus, we select CNN as the prediction algorithm for the CDSS. CONCLUSIONS This study introduces a CDSS to assist doctors in selecting the optimal ICL size for patients while improving the safety and postoperative outcomes of ICL surgery.
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Affiliation(s)
- Yixuan Yang
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
| | - Zhengqin Long
- Chongqing University Qianjiang Hospital, Chongqing, China
| | - Bo Lei
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
| | - Wei Liu
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
| | - Jian Ye
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
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Jiang F, Yang Y, Ni Y, Qin Y, Yuan F, Ju R, Wu M. Smurf1 Modulates Smad Signaling Pathway in Fibrotic Cataract Formation. Invest Ophthalmol Vis Sci 2024; 65:18. [PMID: 38324299 PMCID: PMC10854413 DOI: 10.1167/iovs.65.2.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
Purpose TGF-β/BMP signaling pathway plays a significant role in fibrotic cataract. Smurf1, a ubiquitin protein ligase, regulates the TGF-β/BMP signaling pathway through the ubiquitin-proteasome system (UPS). This study aims to investigate the role of Smurf1 in the progression of fibrotic cataract and its underlying mechanism. Methods We used a mouse model of injury-induced anterior subcapsular cataract (ASC) and administered the Smurf1 inhibitor A01 for in vivo investigations. RNA sequencing was performed to examine global gene expression changes. Protein levels were assessed by Simple Western analysis. The volume of subcapsular opacity was determined using whole-mount immunofluorescence of lens anterior capsules. Lentivirus was utilized to establish cell lines with Smurf1 knockdown or overexpression in SRA01/04. Lens epithelial cell (LEC) proliferation was evaluated by CCK8 and EdU assays. Cell cycle profile was determined by flow cytometry. LEC migration was measured using Transwell and wound healing assays. Results The mRNA levels of genes associated with cell proliferation, migration, epithelial-mesenchymal transition (EMT), TGF-β/BMP pathway, and UPS were upregulated in mouse ASC model. Smurf1 mRNA and protein levels were upregulated in lens capsules of patients and mice with ASC. Anterior chamber injection of A01 inhibited ASC formation and EMT. In vitro, Smurf1 knockdown reduced proliferation, migration and TGF-β2-induced EMT of LECs, concomitant with the upregulation of Smad1, Smad5, and pSmad1/5. Conversely, overexpression of Smurf1 showed opposite phenotypes. Conclusions Smurf1 regulates fibrotic cataract progression by influencing LEC proliferation, migration, and EMT through the modulation of the Smad signaling pathway, offering a novel target for the fibrotic cataract treatment.
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Affiliation(s)
- Fanying Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yuanfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yan Ni
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yingyan Qin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Fa Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Rong Ju
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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Zhao H, Tang T, Lu Y, Li X, Sun L, Chen S, Ma L, Luo Y, Wang K, Zhao M. Development and Validation of Data-Level Innovation Data-Balancing Machine Learning Models for Predicting Optimal Implantable Collamer Lens Size and Postoperative Vault. Ophthalmol Ther 2024; 13:267-286. [PMID: 37943481 PMCID: PMC10776515 DOI: 10.1007/s40123-023-00841-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION There are only four sizes of implantable collamer lens (ICL) available for selection, which cannot completely fit all patients as a result of the discontinuity of ICL sizes. Sizing an optimal ICL and predicting postoperative vault are still unresolved problems. This study aimed to develop and validate innovative data-level data-balancing machine learning-based models for predicting ICL size and postoperative vault. METHODS The patients were randomly assigned to training and internal validation sets in a 4:1 ratio. Feature selection was performed using analysis of variance (ANOVA) and Kruskal-Wallis feature importance methods. Traditional linear regression model and machine learning-based models were used. The accuracy of models was assessed using the area under the curve (AUC) and confusion matrix. RESULTS A total of 564 patients (1127 eyes) were eligible for this study, consisting of 808 eyes in the training set, 202 eyes in the internal validation set, and 117 eyes in the external validation set. Compared with the traditional linear regression method, the machine learning model bagging tree showed the best performance for ICL size selection, with an accuracy of 84.5% (95% confidence interval (CI) 83.2-85.8%), and the AUC ranged from 0.88 to 0.99; the prediction accuracy of 12.1 mm and 13.7 mm ICL sizes was improved by 49% and 59%, respectively. The bagging tree model achieved the best accuracy [90.2%, (95% CI 88.9-91.5%)] for predicting the postoperative vault, and the AUC ranged from 0.90 to 0.94. The prediction accuracies of internal and external validation dataset for ICL sizing were 82.2% (95% CI 81.1-83.3%) and 82.1% (95% CI 81.1-83.1%), respectively. CONCLUSIONS The innovative data-level data balancing-based machine learning model can be used to predict ICL size and postoperative vault more accurately, which can assist surgeons in choosing optimal ICL size, thus reducing risks of postoperative complications and secondary surgery.
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Affiliation(s)
- Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yuchang Lu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Liyuan Sun
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Sitong Chen
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lu Ma
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.
- College of Optometry, Peking University Health Science Center, Beijing, China.
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Shiga S, Kojima T, Horai R, Nakamura T. Evaluation of long-term clinical outcomes after toric implantable collamer lens implantation. J Cataract Refract Surg 2023; 49:964-969. [PMID: 37395497 DOI: 10.1097/j.jcrs.0000000000001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To evaluate the long-term (8-10 years) outcomes of toric implantable collamer lens (TICL) surgery. SETTING Nagoya Eye Clinic, Nagoya, Aichi, Japan. DESIGN Retrospective observational study. METHODS Patients who underwent TICL surgery from 2005 to 2009 to correct myopia and myopic astigmatism were enrolled. The safety, efficacy, predictability, astigmatism correction efficacy, and complications were evaluated using preoperative, 1-year postoperative, and final examination data. RESULTS 133 eyes of 77 patients were included. At the final visit, the mean uncorrected and corrected visual acuities were -0.01 ± 0.2 and -0.17 ± 0.05, respectively. The mean safety and efficacy indices were 0.91 ± 0.26 and 0.68 ± 0.21, respectively. The manifest astigmatism was -0.45 ± 0.43 diopters (D). The mean corneal astigmatism change from 1 year postoperatively to the final visit was 0.40 ± 0.26 D. Of the 38 eyes with a change in corneal astigmatism ≥0.5 D, 30 eyes (78.9%) changed to against-the-rule (ATR) astigmatism, 1 (2.6%) changed to oblique astigmatism, and 7 (18.4%) changed to with-the-rule (WTR) astigmatism. The mean manifest astigmatism change from 1 year postoperatively to the final visit was 0.43 ± 0.52 D. Of the 60 eyes with a change in manifest astigmatism ≥0.5 D, 25 (41.7%) changed to ATR astigmatism, 18 (30.0%) changed to oblique astigmatism, and 17 (28.3%) changed to WTR astigmatism. During follow-up, 8 (6.0%) of 133 eyes developed anterior subcapsular cataracts, among which 4 (3.0%) underwent TICL removal and phacoemulsification and aspiration. No vision-threatening complications occurred. CONCLUSIONS TICL surgery showed good long-term astigmatism-correcting effects, although the long-term uncorrected visual acuity decreased. The procedure was effective in correcting myopia and astigmatism.
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Affiliation(s)
- Suguru Shiga
- From the Japanese Red Cross Gifu Hospital, Gifu, Japan (Shiga, Kojima); Nagoya Eye Clinic, Nagoya, Japan (Kojima, Horai, Nakamura)
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Zhang J, Chen F, Han X, Qiu X, Liu Z, Chen X, Jin G, Qu B, Yao H, Ye Y, Yu K, Tan X, Luo L. Vault Height Is a Key Predictive Factor for Anterior Segment Measurement Error by IOLMaster 700 in Eyes With Phakic Intraocular Lens. Transl Vis Sci Technol 2023; 12:16. [PMID: 37738056 PMCID: PMC10519433 DOI: 10.1167/tvst.12.9.16] [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: 03/14/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose To identify risk factors of ocular anterior segment measurement error by the IOLMaster 700 in eyes implanted with an implantable Collamer lens (ICL). Methods In total, 152 patients with clear lens (152 eyes, group 1) and another 32 cataract patients (57 eyes, group 2) who underwent ICL implantation were included, and the presence of measurement error by the IOLMaster 700 was determined based on B-scan images. The risk factors for measurement error were evaluated by logistic regression, and the optimal threshold was determined using receiver operating characteristic analysis. Results The ICL was misidentified as the anterior surface of the crystalline lens in 51.97% of eyes (79/152) in group 1 and 80.70% of eyes (46/57) in group 2. For every 100-µm decrease in the vault height, a 3.57- and 5.78-fold increase in the risk of measurement error was observed in group 1 and group 2, respectively. We identified an optimal threshold of the vault height at 389.47 µm for predicting biometric measurement error in eyes implanted with ICL, which showed an area under the curve of 0.93 (95% confidence interval, 0.90-0.97), a sensitivity of 0.87, and a specificity of 0.86. Conclusions Patients with ICL implantation, particularly those with a vault height less than 389.47 µm, are at a greater risk of anterior segment biometric measurement error by the IOLMaster 700. Translational Relevance The threshold of vault height can help to identify high-risk patients and further optimize biometric measurement.
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Affiliation(s)
- Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaozhang Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Bo Qu
- Peking University Third Hospital, Peking, China
| | - Huan Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yiming Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Naujokaitis T, Auffarth GU, Łabuz G, Kessler LJ, Khoramnia R. Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses. Diagnostics (Basel) 2023; 13:2503. [PMID: 37568866 PMCID: PMC10417808 DOI: 10.3390/diagnostics13152503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell loss rate and the endothelial reserve in accordance with the patient's age when deciding whether to explant a pIOL. The anterior chamber morphometrics, including the anterior chamber depth and the distance between the pIOL and the endothelium, measured using Scheimpflug tomography and anterior segment optical coherence tomography (AS-OCT), can help to assess the risk of the endothelial cell loss. In patients undergoing posterior chamber pIOL implantation, accurate prediction of the vault and its postoperative measurements using AS-OCT or Scheimpflug tomography are important when assessing the risk of anterior subcapsular cataract and secondary glaucoma. Novel approaches based on ultrasound biomicroscopy and AS-OCT have been proposed to increase the vault prediction accuracy and to identify eyes in which prediction errors are more likely. Careful patient selection and regular postoperative follow-up visits can reduce the complication risk and enable early intervention if a complication occurs.
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Affiliation(s)
| | | | | | | | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
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Cakir I, Sonmez O, Pehlivanoglu S, Cakir GY, Yildiz BK, Yildirim Y, Agca A. Long-term results of a new posterior chamber phakic intraocular lens in patients with high myopia: 5-year results. J Cataract Refract Surg 2023; 49:409-415. [PMID: 36888565 DOI: 10.1097/j.jcrs.0000000000001110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/27/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change. SETTING Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN Retrospective. METHODS Eyes that were not suitable for corneal refractive surgery, had high myopia between -6.00 diopters (D) and -20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm 2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded. RESULTS 36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% ( P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye. CONCLUSIONS Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.
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Affiliation(s)
- Ihsan Cakir
- From the Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey (I. Cakir, Sonmez, Pehlivanoglu, G.Y. Cakir, Yildiz, Yildirim); Atakoy World Eye Hospital, Istanbul, Turkey (Agca)
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Zhang W, Li F, Li L, Zhang J. A quantitative study of the effect of ICL orientation selection on post-operative vault and model-assisted vault prediction. Front Neurol 2023; 14:1136579. [PMID: 36937516 PMCID: PMC10020497 DOI: 10.3389/fneur.2023.1136579] [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: 01/03/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Background Appropriate vault height of implantable collamer lens (ICL) implantation matters for it has risks of corneal endothelial cell loss, cataract formation and intraocular pressure elevation, which could lead to irreversible damage to optic nerve. Therefore, pre-operative prediction for an ideal vault height is a hotspot. However, few data exist regarding quantitative effect of ICL orientation on vault height. This study is aimed to quantitatively investigate the effect of ICL implantation orientation on vault height, and built a machine-learning (ML)-based vault prediction model taking implantation orientation into account. Methods 473 consecutive case series treated with ICL implantation were retrospectively analyzed (408 were horizontally implanted, and 65 were vertically implanted). Multivariable logistic regression analysis was performed to determine the association between ICL orientation and achieved vault. ML was performed to develop a new vault height prediction model taking ICL orientation into account. Receiver operating characteristic curve (ROC) and net reclassification index (NRI) were obtained to assess the prediction ability. Results 95% of all the patients achieved 20/20 uncorrected distance visual acuity (UDVA) or better. No complications including cataract formation, dispersion or optic nerve injury were observed in any cases. Sex, sphere power, cylinder power, axis, ICL size and ICL orientation were all significant risk factors associated to vault height, and age was positively co-related. Of note, ICL size and ICL orientation were the top-ranking risk factors. Comparing to conventional horizontal implantation, vertical implantation could reduce the achieved vault by 81.187 μm (p < 0.001). In regarding to different ICL sizes, vertical implantation had no good to vault reduction when using ICL of 12.1 mm. However, it could reduce the vault by 59.351 μm and 160.992 μm respectively when ICL of 12.6mm and 13.2 mm were implanted (p = 0.0097 and p = 0.0124). For prediction of vault height, ML based model significantly outperformed traditional multivariable regression model. Conclusion We provide quantitative evidence that vertical implantation of ICL could effectively reduce the achieved vault height, especially when large size ICL was implanted, comparing to traditional horizontal implantation. ML is extremely applicable in development of vault prediction model.
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Affiliation(s)
- Weijie Zhang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Fang Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Lin Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
- Lin Li
| | - Jing Zhang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
- *Correspondence: Jing Zhang
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19
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Fraenkel D, Hamon L, Weinstein I, Seitz B, Daas L. Urrets-Zavalia Syndrome after Implantation of a Phakic Intraocular Lens. Klin Monbl Augenheilkd 2023; 240:77-79. [PMID: 34571548 DOI: 10.1055/a-1610-9239] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Doris Fraenkel
- Ophthalmology, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Loïc Hamon
- Ophthalmology, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Isabel Weinstein
- Ophthalmology, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Berthold Seitz
- Ophthalmology, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Loay Daas
- Ophthalmology, Universitätsklinikum des Saarlandes, Homburg, Germany
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20
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Zhu QJ, Xing XY, Zhu MH, Ma L, Yuan Y, Song E. Validation of the vault prediction model based on the sulcus-to-sulcus diameter and lens thickness: a 925-eye prospective study. BMC Ophthalmol 2022; 22:463. [PMID: 36451125 PMCID: PMC9714062 DOI: 10.1186/s12886-022-02698-z] [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: 04/24/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND To verify the accuracy and stability of the prediction formula based on the ciliary sulcus diameter and lens thickness and to analyse factors influencing the prediction results. METHODS In total, 925 eyes from 506 subjects were enrolled in this prospective study between July 1, 2020, and June 30, 2021. Subjects were divided into four seasons, each spanning three months. The target vault was set to be between 300 μm and 700 μm according the prediction formula. The actual vault was measured one month postoperatively. The Bland-Altman test, 95% confidence intervals (95% CI) and 95% limits of agreement (95% LoA) were used to evaluate the agreement between the predicted vault and the actual vault. Eyes with absolute prediction errors greater than 300 μm were further analysed. RESULTS The mean predicted vaults for the four seasons were 503 ± 99, 494 ± 96, 481 ± 92 and 502 ± 93 μm, while the mean actual vaults were 531 ± 189, 491 ± 179, 464 ± 179 and 529 ± 162 μm, respectively. The predicted and actual vaults of the overall subjects were 493 ± 95 and 500 ± 180 μm, respectively. Of the 925 eyes, 861 eyes (93.08%), 42 eyes (4.54%), and 22 eyes (2.38%) showed a normal vault, high vault, and low vault, respectively. Bland-Altman plots showed that the mean difference between the actual vault and predicted vault overall (± 95% LoA) was 6.43 ± 176.2 μm (-339 to 352 μm). Three UBM features may lead to large prediction errors (more than 300 μm): wide iris-ciliary angle (ICA), iris concavity and anteriorly positioned ciliary body. CONCLUSIONS This study demonstrated the accuracy and stability of the prediction formula through the validation of a large sample size and a long time span. Wide ICA, iris concavity and anteriorly positioned ciliary body may have an effect on vault.
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Affiliation(s)
- Qiu-Jian Zhu
- grid.452666.50000 0004 1762 8363Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou, China ,grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | | | - Man-Hui Zhu
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | - Lie Ma
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | - You Yuan
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | - E. Song
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
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21
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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22
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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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23
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Wang Y, Yang R, Huang Y, Zhang C, Liu H, Jia Z, Zhao S. Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique. BMC Ophthalmol 2022; 22:381. [PMID: 36151534 PMCID: PMC9502894 DOI: 10.1186/s12886-022-02603-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Implantable collamer lens (ICL) surgery techniques are constantly progressing. The purpose of this study was to investigate the application effect of the modified technique and its impact on the change in corneal astigmatism in EVO-ICL surgery. Methods The analysis of retrospective cohort data included 153 eyes of 81 patients with myopia from July 2018 to May 2020. An EVO-ICL was inserted by modified surgical skills, including a single 3.0 mm corneal incision and no ophthalmic viscosurgical device (OVD) before the insertion of the ICL (modified technique group: 41 cases, 80 eyes) and standard procedure (standard technique group: 40 cases, 73 eyes). Early postoperative intraocular pressure (IOP) was monitored at 2 and 24 h. IOP, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), vault, and anterior chamber depth (ACD) were measured 1, 6, and 12 months following the initial examination. The corneal endothelial cell density (ECD) was monitored at 6 and 12 months after the operation. Surgically induced astigmatism (SIA) in the total, anterior, and posterior corneal surfaces was analysed 1 month after the operation. Results No serious complications were detected. The two groups had no difference in visual outcomes, ICL vaults, or ACD at any time point (P > 0.05). Two hours postoperatively, IOP was significantly lower in the modified technique group (16.22 ± 2.22 vs. 18.37 ± 1.92 mmHg, P < 0.05) than in the standard technique group. IOP decreased gradually after 24 h to preoperative levels. The postoperative IOP remained stable over a 12-month period. The ECD at 6 and 12 months was not significantly different between the groups (P > 0.05). SIA in the total, anterior, and posterior corneal surfaces were assumed to have no clinically meaningful differences between groups at one month after operation (P > 0.05). Conclusions The modified technique is efficient and safe, producing comparable visual and structural outcomes without adversely affecting ECD, and reduces fluctuations in IOP at the early postoperative stages. The auxiliary incision in the standard technique does not increase corneal SIA, which is also a factor to consider for inexperienced surgeons.
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Affiliation(s)
- Ying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruibo Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Yue Huang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Chen Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Hui Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Zhe Jia
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Shaozhen Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
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24
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Baamonde B, Madrid-Costa D, Alfonso JF. Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty. EYE AND VISION 2022; 9:34. [PMID: 36068603 PMCID: PMC9450313 DOI: 10.1186/s40662-022-00306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up.
Methods
This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed.
Results
The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery (P < 0.0001) and remained unchanged throughout the whole follow-up (P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up (P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%.
Conclusions
The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.
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25
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Alonso-Juárez E, Velázquez-Villoria D. Low Diopter Phakic Implantable Collamer Lens: Refractive and Visual Outcomes in Low Myopia and Myopic Astigmatism. Clin Ophthalmol 2022; 16:2969-2977. [PMID: 36081600 PMCID: PMC9447455 DOI: 10.2147/opth.s373378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ernesto Alonso-Juárez
- INSADOF Clinic, Salamanca, Spain
- Correspondence: Ernesto Alonso-Juárez, INSADOF, Calle Doctrinos, 4, 1, Salamanca, 37002, Spain, Email
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26
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Zhu QJ, Zhu WJ, Chen WJ, Ma L, Yuan Y. A prediction model for sulcus-to-sulcus diameter in myopic eyes: a 1466-sample retrospective study. BMC Ophthalmol 2022; 22:307. [PMID: 35842598 PMCID: PMC9287952 DOI: 10.1186/s12886-022-02535-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background To establish and verify the accuracy and reliability of a sulcus-to-sulcus diameter (STS) prediction model. Methods In this retrospective study, the prediction formula was established with the data from 1466 eyes from 733 subjects from July 2020 to April 2021 and verified with the data from 278 eyes from 139 subjects between May 2021 and June 2021. Each subject was measured with a Pentacam, IOLMaster 700, OPD-Scan III, and ultrasound biomicroscope. The prediction formulas were established with multiple linear regression, and intergroup correlation coefficients (ICCs) and Bland–Altman tests were used to assess the agreement between the predicted and actual STS (actual STS was measured by UBM). Results The explanatory variables relevant to the horizontal STS (STSH) were the Pentacam white-to-white diameter (WTWP; standardized partial regression coefficient [β] = 0.330; p < 0.001), the flat K value (β = -0.211; p < 0.001), and the anterior corneal diameter (ACD) (β = 0.178; p < 0.001). The corresponding multiple regression equation was : STSH (mm) = 8.061 + 0.510 × WTWP − 0.090 × Flat K value + 0.430 × ACD. The explanatory variables relevant to the vertical STS (STSV) were the WTWP (β = 0.435; p < 0.001), the steep K value (β = -0.271; p < 0.001), and the ACD (β = 0.187; p < 0.001). The corresponding multiple regression equation was : STSV (mm) = 8.540 + 0.492 × WTWP − 0.075 × Steep K value + 0.329 × ACD. The bias of the predicted to the actual STSH was − 0.021, with 95% limits of agreement (95% LoA) from − 0.499 to 0.457. The bias of the predicted to the actual STSV was 0.057, with 95% LoA from − 0.462 to 0.575. The ICC was 0.883 between the predicted and actual STSH and 0.859 between the predicted and actual STSV. Conclusions The Pentacam-measured WTW, the K value and the ACD are important for predicting the STS diameter. The prediction model has good accuracy and reliability. Trial registration Not applicable.
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Affiliation(s)
- Qiu-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Wei-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Wen-Jing Chen
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Lie Ma
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - You Yuan
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China.
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27
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Mahmoud MSED, AttaAllah HR. Clinical Outcomes of Toric Implantable Collamer Lens (T-ICL) and Toric Implantable Phakic Contact Lens (IPCL) for High Myopia with Astigmatism: A Comparative Study. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2204050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Our study aimed to compare the clinical, visual outcomes, and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) in patients with high myopia and astigmatism over a follow-up period of 6 months.
Methods:
A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B, including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, central corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1 and 6 months post-surgery. Any complications either during or after surgery were assessed.
Results:
In both study groups, the mean central corneal endothelial cell count was significantly decreased after 1 month and improved to reach near pre-operative values after 6 months postoperatively, indicating good lens biocompatibility. A statistically significant increase in IOP was found in both groups during the early follow-up, and a significant decrease after 6 months postoperatively (p=0.036) was reported in group A. A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with pre-operative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.3 D & - 0.3 D) at the end of 6 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.3 D & - 0.3 D) by the end of follow up period. A statistically significant improvement of UCDVA at 6 months postoperatively was found in both groups, as median preoperative LogMAR UCDVA was 1.1 and 1.3 in groups A and B respectively, which was improved to 0.3 in both groups at the end of follow-up period. There were no reported intra- or postoperative complications such as cataract, keratitis, or lens decentration.
Conclusion:
Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier to implant than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.
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28
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Kamiya K, Shimizu K, Igarashi A, Kitazawa Y, Kojima T, Nakamura T, Ichikawa K, Fukuoka S, Fujimoto K. A Nationwide Multicenter Study on 1-Year Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Low Myopia. Front Med (Lausanne) 2022; 9:762153. [PMID: 35602510 PMCID: PMC9115804 DOI: 10.3389/fmed.2022.762153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the nationwide multicenter outcomes of posterior chamber phakic intraocular lens implantation with a central hole (EVO-ICL, STAAR Surgical) for patients with low myopia. Methods This multicenter study comprised 172 eyes of 111 consecutive patients undergoing hole ICL implantation to correct low myopia and myopic astigmatism [manifest spherical equivalent (MSE);-3 diopters (D) or less] at seven nationwide major surgical facilities. We retrospectively determined safety, efficacy, predictability, stability, and adverse events at 1 week, 1, 3, 6, and 12 months postoperatively, and at the final visit. Results The mean follow-up period was 1.4 ± 1.0 years. Uncorrected and corrected visual acuities at 1 year postoperatively were -0.17 ± 0.12 and -0.24 ± 0.07 logarithm of the minimal angle of resolution (logMAR), respectively. At 1 year postoperatively, 91% and 100% of eyes were within 0.5 and 1.0 D of the target correction, respectively. No significant manifest refraction changes of -0.07 ± 0.26 D occurred from 1 week to 1 year. No vision-threatening complications occurred at any time in this series. Conclusions According to our experience, the EVO-ICL performed well without significant complications throughout the 1-year observation period, even for the correction of low myopia. It is suggested that current ICL implantation is one of the viable surgical options for correcting low myopia.
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, Tokyo, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | | | - Takashi Kojima
- Department of Ophthalmology, Keio University, Tokyo, Japan
| | | | - Kazuo Ichikawa
- Department of Ophthalmology, Chukyo Eye Clinic, Aichi, Japan
| | - Sachiko Fukuoka
- Department of Ophthalmology, Tane Memorial Eye Hospital, Osaka, Japan
| | - Kahoko Fujimoto
- Department of Ophthalmology, Fujimoto Eye Clinic, Osaka, Japan
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29
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Multicenter clinical outcomes of hole implantable collamer lens implantation in middle-aged patients. Sci Rep 2022; 12:4236. [PMID: 35273340 PMCID: PMC8913835 DOI: 10.1038/s41598-022-08298-7] [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: 12/27/2021] [Accepted: 03/01/2022] [Indexed: 11/19/2022] Open
Abstract
To assess the multicenter clinical outcomes of the implantation of hole implantable collamer lens (Hole ICL, ICL KS-AquaPORTTM; STAAR Surgical, Nidau, Switzerland) in patients of 45 years or more. We retrospectively assessed the surgery’s safety, efficacy, predictability, stability, and adverse events before surgery and after the surgery at 1 week; 1, 3, and 6 months; and 1 year, followed by once every year for approximately 2.2 years. A total of 118 eyes of 65 patients aged 45–65 years with myopic refractive errors ranging from − 2.13 to − 18.75 diopters (D) underwent hole ICL implantation and routine postoperative examinations. The average observation period was 2.2 ± 1.0 years. The safety and efficacy indices were 1.08 ± 0.21 and 0.87 ± 0.25, respectively. Manifest refraction changes of − 0.20 ± 0.43 D occurred from 1 month to the final visit after ICL implantation. Eight eyes (6.8%) developed asymptomatic anterior subcapsular cataract (ASC) immediately after surgery, and three eyes (2.5%) developed clinically significant symptomatic nuclear cataracts during the follow-up period. According to our experience, hole ICL implantation offered favorable outcomes in all measures of safety, efficacy, predictability, and stability, even in middle-aged patients, during the 2.2-year observation period.
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30
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Nonpassopon M, Jongkhajornpong P, Phimpho P, Cheewaruangroj N, Lekhanont K, Chuckpaiwong V. Agreement of implantable collamer lens sizes using parameters from different devices. BMJ Open Ophthalmol 2022; 7:e000941. [PMID: 35372697 PMCID: PMC8905975 DOI: 10.1136/bmjophth-2021-000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/25/2022] [Indexed: 11/11/2022] Open
Abstract
Objective To assess agreement and repeatability of white-to-white (WTW) and anterior chamber depth (ACD), and agreement of implantable collamer lens (ICL) size using these measurements from different devices. Methods and analysis A retrospective review of 83 eyes with ICL implantation (42 patients) was conducted. The agreement of WTW (measured with WaveLight Topolyzer and Orbscan IIz) and ACD (measured with WaveLight Oculyzer and Orbscan IIz) was analysed. Correlation of ICL sizes and difference of eyes with unacceptable vaults between two data sets (WaveLight platform; Topolyzer and Oculyzer and Orbscan IIz) were assessed. Results Average WTW measured by Orbscan IIz and Topolyzer demonstrated good agreement (Ρ 0.884) with low systematic bias (−0.03±0.1 mm) and narrow 95% limits of agreement (LoA) of −0.28 to 0.22. Average ACD measured by Orbscan IIz and Oculyzer also showed good agreement (Ρ 0.903) with low systematic bias (−0.04±0.1 mm) and relatively narrow 95% LoA (0.2 to 0.12). ICL size selected according to two data sets showed moderate to strong level of agreement (Kappa=0.81). There was a statistically significant difference (p<0.001) in the proportion of eyes with unacceptable postoperative vaults when using the Wavelight platform data set (five eyes, 6.02%) and the Orbscan IIz data set (12 eyes, 14.46%). Conclusion Although the agreement of WTW and ACD between devices was good, there was a significant difference in proportion of eyes with unacceptable postoperative vaults when using two data sets. Therefore, Topolyzer and Oculyzer might not be suitable for operating interchangeably with Orbscan IIz for ICL size selection.
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Affiliation(s)
- Manachai Nonpassopon
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Passara Jongkhajornpong
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prae Phimpho
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nontawat Cheewaruangroj
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kaevalin Lekhanont
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Varintorn Chuckpaiwong
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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31
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Evaluation of the anterior chamber angle by anterior segment optical coherence tomography after implantable phakic contact lens implantation in myopic eyes. Int Ophthalmol 2022; 42:2449-2457. [PMID: 35243558 PMCID: PMC9314284 DOI: 10.1007/s10792-022-02244-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 02/08/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the changes in the angle of the AC and lens vault after IPCL implantation by AS-OCT in myopic patients. METHODS This was a prospective observational study involving 30 myopic eyes implanted with IPCL. AS-OCT was used to evaluate lens vault and AC angle parameters including anterior chamber angle, angle opening distance and trabecular-iris space area (TISA) at 1, 3 and 6 months postoperatively. RESULTS All 3 AC angle parameters were significantly reduced at the 1st postoperative month compared to preoperative values, but remained stable thereafter with no significant change at the 3rd or 6th postoperative months. The lens vault showed no significant change over the entire follow-up period. CONCLUSION IPCL implantation is a safe method for correction of myopia with stable AC angle narrowing over the course of 6 months postoperatively as monitored using AS-OCT.
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32
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Chen Z, Niu L, Zhao J, Yao P, Wang X, Zhou X. One-year Observation of Safety of Implantable Collamer Lens V4c Implantation Without Using an Ophthalmic Viscosurgical Device. Front Med (Lausanne) 2022; 9:790137. [PMID: 35237622 PMCID: PMC8882649 DOI: 10.3389/fmed.2022.790137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/24/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the feasibility and safety of the implantable collamer lens V4c (ICL V4c) implantation without using an ophthalmic viscosurgical device (OVD-free technique). Methods This prospective consecutive case study enrolled 118 eyes of 60 patients (15 eyes were of male patients, 103 eyes were of female patients, age 26.19 ± 5.03 years, spherical equivalent −10.05 ± 2.73 D). Eyes were considered for OVD-free or OVD-using ICL V4c implantation based on the maintenance of the anterior segment during the surgery. The follow-up lasted for 12 months. The main measurements were visual acuity and changes in endothelial cell density (ECD) at 12 months. Results A total of 75 eyes were included in the OVD-free group and 43 in the OVD group. No infection or other complications were observed in any eye. In the OVD-free group, the safety and efficacy indices were 1.19 ± 0.15 and 1.05 ± 0.20, respectively. 74.5% of the eyes gained one or two lines of corrected distance visual acuity (CDVA), and 25.5% were stable. In the OVD group, the safety and efficacy indices were 1.17 ± 0.17 and 1.03 ± 0.15, respectively; 65.7% of the eyes gained one or two lines of CDVA, and 34.3% were stable. The mean change of ECD was 65.34 cell/ mm2 compared to the baseline in the OVD-free group and 25.94 cell/ mm2 compared to baseline in the OVD group (P = 0.038). Conclusions The ICL V4c implantation with an OVD-free technique is a safe and feasible method in eyes with good maintenance of the anterior segment.
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Affiliation(s)
- Zhuoyi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- 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 & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- *Correspondence: Xingtao Zhou
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Kamiya K, Shimizu K, Takahashi M, Ando W, Hayakawa H, Shoji N. Eight-Year Outcomes of Implantation of Posterior Chamber Phakic Intraocular Lens With a Central Port for Moderate to High Ametropia. Front Med (Lausanne) 2022; 8:799078. [PMID: 34977099 PMCID: PMC8716586 DOI: 10.3389/fmed.2021.799078] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To assess the 8-year clinical outcomes of implantation of an implantable collamer lens (ICL) with a central port (KS-Aquaport; EVO-ICL) for moderate to high myopia and myopic astigmatism. Methods: This retrospective study comprised a total of 177 eyes of 106 patients with spherical equivalents of -7.99 ± 3.33 D [mean ± standard deviation], who underwent EVO-ICL implantation. We evaluated the safety, efficacy, predictability, stability, and adverse events of the surgery, at 1 month, and 1, 2, 4, 6, and 8 years postoperatively. Results: The logarithm of the minimal angle of resolution (LogMAR) uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were -0.07 ± 0.17 and -0.20 ± 0.09, respectively, at 8 years postoperatively. The safety and efficacy indices were 1.18 ± 0.24 and 0.89 ± 0.28, respectively. At 8 years, 83 and 93% eyes were within ± 0.5 D and ± 1.0 D of the targeted correction, respectively. Change in manifest refraction from 1 month to 8 years postoperatively was -0.13 ± 0.30 D. Three eyes (1.7%) that developed cataracts had a slight pre-existing peripheral anterior subcapsular cataract formation required simultaneous ICL extraction and cataract surgery at 2 or 3 years or ICL size change (1 size up) at 7 years postoperatively. We found that neither significant intraocular pressure (IOP) rise (including pupillary block) nor significant endothelial cell loss occurred in any case throughout the 8-year observation period. Conclusions: Current ICL implantation with central port technology offered good continuous outcomes for all measures of safety, efficacy, predictability, and stability for correcting moderate to high myopic errors over a long period, thereby suggesting its long-term viability as a surgical approach for the treatment of such eyes.
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, Tokyo, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | - Wakako Ando
- Department of Ophthalmology, School of Medicine, Kitasato University, Tokyo, Japan
| | - Hideki Hayakawa
- Department of Ophthalmology, School of Medicine, Kitasato University, Tokyo, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, Tokyo, Japan
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Zhang Z, Niu L, Zhao J, Miao H, Chen Z, Shen Y, Chen X, Ye Y, Wang X, Zhou X. Safety of EVO ICL Implantation With an Ophthalmic Viscosurgical Device-Free Technique in the Early 24 h After Surgery. Front Med (Lausanne) 2021; 8:764653. [PMID: 34869472 PMCID: PMC8635781 DOI: 10.3389/fmed.2021.764653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/21/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: To compare the safety of the non-ophthalmic viscosurgical device (OVD) technique with that of the minimum OVD technique in EVO Implantable Collamer Lens (EVO-ICL) implantation. Methods: A total of 180 eyes of 90 consecutive patients were enrolled in the study, of which 100 eyes of 50 patients were treated with non-OVD technique, with a 55% success rate. The remaining 80 eyes of 40 patients were treated with min-OVD technique, so they were classified into the min-OVD group. Preoperative and postoperative intraocular pressure (IOP) measurements were collected and analyzed at 1, 2, 3, and 24 h. Visual acuity, corneal endothelial cell density (ECD), and corneal densitometry 24 h postoperatively were evaluated. Results: No significant difference was found in visual outcomes (P = 0.54) or ECD (P = 0.78) between the two groups. The operation time was significantly shorter in the non-OVD group (P < 0.0001). The IOP was significantly higher at 1 h (P < 0.0001), 2 h (P < 0.0001) and 3 h (P = 0.0045) postoperatively in the min-OVD group. The non-OVD group had significantly lower IOP than the min-OVD group at 1 h (P = 0.01) and 2 h (P = 0.013) postoperatively. The temporal corneal densitometry in the non-OVD group were significantly lower than those in the minimum group (P = 0.0063) 1 day after surgery. Conclusion: The non-OVD technique is safe and efficient for ICL implantation. It can be a safer method of ICL implantation in that it completely eliminates ophthalmic viscoelastic devices related complications without causing additional complications in short term.
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Affiliation(s)
- Zhe Zhang
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Huamao Miao
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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Reinstein DZ, Vida RS, Archer TJ. Visual Outcomes, Footplate Position and Vault Achieved with the Visian Implantable Collamer Lens for Myopic Astigmatism. Clin Ophthalmol 2021; 15:4485-4497. [PMID: 34848942 PMCID: PMC8612663 DOI: 10.2147/opth.s330879] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Report the outcomes of the implantable collamer lens (ICL) in myopic astigmatism using very high-frequency (VHF) digital ultrasound sizing. Methods Analysis of 42 consecutive ICL procedures using EVO and EVO+ (Visian V4c) lenses (STAAR Surgical) was done. ICL size was chosen using the ultrasound-based Kojima Formula with Insight 100 VHF digital ultrasound (VHFDU). Standard visual outcomes analysis was performed using 3-month data, also including contrast sensitivity, refractive and corneal vector analysis, and ECC. Postoperative lens position was evaluated using VHF digital ultrasound. Results Attempted SEQ was −10.83±3.39D (−4.40 to −16.98D). Cylinder was −1.46±1.15D (0.00 to −4.25D). One-year follow-up was available in 86% of the eyes and 3 months in 96%. Postoperative UDVA was 20/20 or better in 89% of the eyes, relative to 71% preoperatively. Postoperative SEQ refraction was ±0.50 D in 74% and ±1.00 D in 98% of the eyes. There was a gain of one line of CDVA in 43% of the eyes, 2 or more lines in 10% of the eyes, while there was a one line loss in 7% and no eyes lost 2 or more lines. The vector mean for the corneal SIA was 0.24 D Ax 100. Contrast sensitivity showed a statistically significant increase with a mean of 0.14 log units at 6, 12, and 18 cycles per degree (P<0.01). The mean change in ECC was −153±353 cells/mm2. Lens vault was 506±233 µm (114–924 µm). Footplate insertion was in zonular position in 48.3%, ciliary body in 49.2%, and sulcus in 2.5% of locations. Conclusion ICL implantation resulted in high safety and efficacy but with an implantation vault range that ideally would be improved upon. VHF digital ultrasound of the lens footplate and posterior anatomical relations may provide essential information for evaluating postoperative vault outliers.
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Affiliation(s)
- Dan Z Reinstein
- London Vision Clinic, London, UK.,Columbia University Medical Center, New York, NY, USA.,Sorbonne Université, Paris, France.,Biomedical Science Research Institute, Ulster University, Coleraine, UK
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Alhamzah A, Alharbi SS, Alfardan F, Aldebasi T, Almudhaiyan T. Indications for exchange or explantation of phakic implantable collamer lens with central port in patients with and without keratoconus. Int J Ophthalmol 2021; 14:1714-1720. [PMID: 34804861 DOI: 10.18240/ijo.2021.11.10] [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: 02/25/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the causes of phakic implantable collamer lens (ICL) exchange/explantation in patients with and without keratoconus (KC) at two tertiary hospitals in Riyadh, Saudi Arabia. METHODS A retrospective chart review of all patients who underwent ICL (model V4c with central port) exchange/explantation was performed using the electronic medical record systems. All available preoperative and postoperative data were documented for each patient. RESULTS Over 7y, 2283 ICL implantation procedures were performed; 46 implants (2%) required exchange (21 implants)/explantation (25 implants), of which 14 cases (30.4%) were patients with KC. Indications for ICL exchange/explantation in non-KC group were vault measurement, cataract formation, increased intraocular pressure, inaccurate refraction, and patient dissatisfaction in 22 (68.75%), 4 (12.5%), 3 (9.37%), 2 (6.25%), and 1 (3.12%) case, respectively. The most common indication for ICL exchange/explantation in the KC group was inaccurate vault sizing in 11 patients (78.57%), inaccurate refraction in 2 patients (14.28%), and patient dissatisfaction postoperatively in 1 (7.14%) case. CONCLUSION ICL implantation results in predictable refractive outcomes over the long term with exchange/explantation rates comparable to previous literature. Improper vault size is the most common cause of ICL exchange/explantation among patients with or without KC.
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Affiliation(s)
- Albanderi Alhamzah
- King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh 22490, Saudi Arabia
| | - Saad S Alharbi
- Anerior Segment Department, King Khaled Eye Specialist Hospital, Riyadh 7191, Saudi Arabia
| | - Fahad Alfardan
- Department of Surgery, Division of Ophthalmology, National Guard Hospital, Riyadh 22490, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh 22490, Saudi Arabia
| | - Tariq Aldebasi
- Department of Surgery, Division of Ophthalmology, National Guard Hospital, Riyadh 22490, Saudi Arabia
| | - Tariq Almudhaiyan
- Department of Surgery, Division of Ophthalmology, National Guard Hospital, Riyadh 22490, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh 22490, Saudi Arabia
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Chung B, Kim JH, Kang DSY, Kang DJ, Kim EK, Seo KY, Jun I, Kim TI. 3-month surgical outcomes of Implantable Collamer Lens implantation for myopic regression after laser vision correction surgeries: a retrospective case series. BMC Ophthalmol 2021; 21:397. [PMID: 34784925 PMCID: PMC8597254 DOI: 10.1186/s12886-021-02163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 10/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background To investigate the surgical outcomes of implantable collamer lens (ICL) implantation in eyes with residual myopia after primary laser vision correction (LVC) surgeries. Methods This study included patients who underwent ICL implantation and had a history of LVC surgery, including photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK). Visual acuity and refractive error were assessed pre and 3-months postoperatively and the efficacy and safety indices calculated accordingly. Results A total of 30 eyes of 17 patients were included in this study. At 3 months, the mean logMAR uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalent were − 0.03 ± 0.11 (include logMAR), − 0.04 ± 0.09 (include logMAR), and − 0.06 ± 0.33 diopters (D), respectively. The 3-month Snellen UDVA was better than 20/20 for 83% of eyes, and 97% of eyes showed an unchanged or improved CDVA after surgery. The mean efficacy and safety indices were 1.11 ± 0.22 and 1.13 ± 0.20, respectively. Further, 93 and 100% of eyes were within ±0.5 and ± 1.0 D of the attempted spherical equivalent refraction, respectively. Conclusions ICL implantation in eyes with myopic regression after previous LVC surgery showed safe, effective, and predictable outcomes. Trial registration retrospectively registered.
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Affiliation(s)
| | | | | | | | - Eung Kweon Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ikhyun Jun
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Gonzalez-Lopez F, Bouza-Miguens C, Tejerina V, Druchkiv V, Mompean B, Ortega-Usobiaga J, Bilbao-Calabuig R. Dynamic assessment of variations in pupil diameter using swept-source anterior segment optical coherence tomography after phakic collamer lens implantation. EYE AND VISION 2021; 8:39. [PMID: 34688308 PMCID: PMC8542318 DOI: 10.1186/s40662-021-00262-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Purpose To dynamically assess variations in pupil diameter induced by changes in brightness in myopic eyes implanted with an implantable collamer lens (ICL, STAAR Surgical) with a central port.
Methods This prospective, observational single-center case series study comprised 65 eyes from 65 consecutive patients undergoing ICL implant. A modified commercially available swept-source Fourier-domain anterior segment optical coherence tomography (AS-OCT) device was used for imaging and performing dynamic pupillometry under changing light conditions before and after a mean follow-up interval of four months after surgery. Results Preoperative mean pupil size under photopic conditions was 3.38 ± 0.64 mm; after surgery, this increased to 3.48 ± 0.61 mm. Mean pupil size under scotopic light conditions was 5.72 ± 0.79 mm before surgery and 5.84 ± 0.77 mm postoperatively. The differences between preoperative and postoperative pupil diameter in miosis and mydriasis were 0.10 ± 0.44 mm (P = 0.078) and 0.12 ± 0.58 mm (P = 0.098), respectively. The scotopic pupil exceeded the optic zone of the implanted lens in 39 eyes (60%). The mean central vault value was 412 ± 177 μm under maximum miosis and 506 ± 190 μm under maximum mydriasis. We found a positive correlation between vault and differences in pupil diameter under all light conditions (P < 0.05). Conclusion Dynamic AS-OCT enables a very precise determination of the pupillary diameter in the iris plane. The changes in the pupil diameter under different light conditions after the implantation of an ICL are related to the postoperative vault. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00262-2.
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Affiliation(s)
- Felix Gonzalez-Lopez
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain.
| | - Carmen Bouza-Miguens
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Victor Tejerina
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Vasyl Druchkiv
- Department of Research and Development, Clinica Baviera, Valencia, Spain
| | - Blas Mompean
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Julio Ortega-Usobiaga
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Rafael Bilbao-Calabuig
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
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Long term efficacy and safety profiles following posterior chamber phakic intraocular lens implantation in eyes with ≥ 10-year follow-up. J Cataract Refract Surg 2021; 48:813-818. [PMID: 34670948 DOI: 10.1097/j.jcrs.0000000000000848] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Evaluate long-term efficacy, safety, predictability and stability of a posterior chamber phakic intraocular lens (Visian ICL) in eyes with ≥10-year follow-up. SETTING Instituto de Microcirugía Ocular, Barcelona, Spain. DESIGN Retrospective study. METHODS Eyes undergoing ICL implantation from 2008-2011 with ≥10-year follow-up were included. Variables analyzed were: preoperative, 1-month, 1-year, 5-years and last follow-up uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent (SE), endothelial cell count (ECC) and intraocular pressure (IOP). Descriptive statistics were performed and results reported following the Standard for Reporting Refractive Surgery Outcomes. RESULTS 45 eyes (26 patients) were analyzed, mean follow-up 11.35 ± 1.30 years. Mean preoperative SE was -10.06 ± 3.40D and mean preoperative cylinder -1.55 ± 1.45D. At last follow-up, efficacy and safety indices were 0.79 and 1.12, respectively. In total, 32 (71%) eyes achieved an UDVA of ≥20/40. 22 (49%) eyes gained ≥1 line of CDVA, and 2 (4%) eyes lost ≥2 lines of CDVA. At final follow-up, 19 (42%) and 29 (64%) eyes were within ±0.50D and ±1.00D of attempted SE correction, respectively. 31 (69%) eyes had ≤1.00D of postoperative astigmatism and 29 (74%) eyes were within ±15° from the intended correction axis. At the last visit, a statistically significant myopic progression of -0.75 ± 1.20D was observed (p=0.01). ECC loss at last follow-up was 9.85 ± 11.35%. IOP remained stable. There were no intraoperative complications. 3 eyes (7%) developed cataract after 10 years. CONCLUSIONS Long-term results demonstrate that ICL is effective, predictable, stable and safe.
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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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Short-Term Efficacy and Safety of Cataract Surgery Combined with Iris-Fixated Phakic Intraocular Lens Explantation: A Multicentre Study. J Clin Med 2021; 10:jcm10163672. [PMID: 34441969 PMCID: PMC8397074 DOI: 10.3390/jcm10163672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/08/2021] [Accepted: 08/17/2021] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to evaluate the short-term efficacy and safety of cataract surgery for patients with iris-fixated phakic intraocular lenses (pIOLs). This study included 96 eyes of 91 patients. The changes in the logMAR uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), subjective spherical equivalent (SE), astigmatism, and endothelial cell density (ECD) were collected retrospectively. The intraoperative and postoperative complications also were investigated to assess the surgical safety. The preoperative UCVA and BCVA improved significantly at month 1 postoperatively, respectively (p < 0.001 for both comparisons). The efficacy and safety index at month 1 postoperatively were 1.02 ± 0.56 and 1.31 ± 0.64, respectively. The SE at month 1 postoperatively was significantly (p < 0.001) higher compared to preoperatively, whereas the subjective astigmatism did not differ significantly (p = 0.078). The ECD significantly decreased at month 1 (p < 0.001). The most common postoperative complication was intraocular pressure elevation exceeding 25 mmHg in 10.4% of eyes, which was controlled with medications in all cases until month 1 postoperatively. No intraoperative complications developed. Cataract surgeries for patients with iris-fixated pIOLs were performed safely with good visual outcomes.
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Kim BK, Chung YT. Long-term Clinical Outcomes of Implantable Collamer Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.8.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the long-term clinical outcomes of implantable collamer lens (ICL) implantation in myopic patients.Methods: This retrospective study included 129 eyes of 68 patients who underwent ICL implantation for correction of myopia with a 10-year follow-up.Results: Ten years after ICL implantation, the mean uncorrected and corrected distance visual acuities (LogMAR) were 0.03 ± 0.13 and -0.07 ± 0.06, respectively. Ten years postoperatively, 52.7% and 84.5% of the eyes were within ± 0.5 and ± 1.0 diopters, respectively. The mean efficacy and safety indices were 0.91 ± 0.22 and 1.07 ± 0.19, respectively. There was no significant difference between mean preoperative (13.52 ± 2.88 mmHg) and postoperative (13.59 ± 3.55 mmHg) intraocular pressures. The endothelial cell density decreased from before surgery to 10 years after surgery (3,074 ± 365 cells/mm2, 2,812 ± 406 cells/mm2, respectively; mean decrease: 8.5 ± 10.8%; p = 0.011). Eight eyes (6.2%) developed cataract during follow-up, which was symptomatic in three eyes (2.3%) and treated with ICL explantation and phacoemulsification. Rhegmatogenous retinal detachment occurred in one eye (0.8%) and was treated with vitrectomy.Conclusions: ICL implantation for the correction of myopia had good efficacy and safety outcomes during long-term follow-up of 10 years. However, patients should be closely monitored for complications such as cataract formation, endothelial cell loss, and retinal detachment.
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Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Lisa C, Madrid-Costa D, Alfonso JF. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. EYE AND VISION 2021; 8:23. [PMID: 34112241 PMCID: PMC8194243 DOI: 10.1186/s40662-021-00247-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. METHODS Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. RESULTS The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was - 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.
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Affiliation(s)
| | | | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, University Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
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Martínez-Plaza E, López-Miguel A, López-de la Rosa A, McAlinden C, Fernández I, Maldonado MJ. Effect of the EVO+ Visian Phakic Implantable Collamer Lens on Visual Performance and Quality of Vision and Life. Am J Ophthalmol 2021; 226:117-125. [PMID: 33577790 DOI: 10.1016/j.ajo.2021.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the effect of EVO+ (V5) Visian implantable collamer lens implantation on mesopic visual performance, quality of vision (QoV), and quality of life (QoL). DESIGN Prospective interventional case series. METHODS Thirty-six eyes of 36 participants who underwent EVO+ implantation for myopia were evaluated preoperatively and at postoperative visits at 1 week and 1, 3, and 6 months. Visual acuity (VA) and mesopic contrast sensitivity (CS) with and without halogen- and xenon-type glare sources were evaluated at each visit. Subjective QoV was assessed with the QoV questionnaire and QoL assessed with the Quality of Life Impact of Refractive Correction (QIRC) questionnaire at each visit. Ring-shaped dysphotopsia was also assessed at each postoperative visit. Linear, cumulative link and logit mixed models were fitted to analyze the effect of the EVO+. RESULTS Following EVO+ implantation, VA significantly (P ≤ .012) improved at the 4 postoperative visits. Mesopic CS progressively improved at 1, 3, and 6 months postoperatively (P ≤ .012). Halogen glare CS decreased at 1 week and halogen and xenon glare CS improved at 6 months (P ≤ .016). Photostress recovery time after halogen glare improved at 3 and 6 months (P ≤ .004). QoV scores improved at 1 week and 3 and 6 months (P ≤ .001). QIRC scores improved postoperatively (P < .001). Ring-shaped dysphotopsia decreased at 3 and 6 months (P ≤ .007). CONCLUSIONS EVO+ implantation provides good mesopic visual performance, QoV, and QoL during up to 6 months follow-up. Some activities performed under mesopic conditions with glare sources may be affected during the first postoperative week. Ring-shaped dysphotopsia is negligibly bothersome 6 months after surgery.
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Affiliation(s)
- Elena Martínez-Plaza
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto López-Miguel
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | | | - Colm McAlinden
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, United Kingdom
| | - Itziar Fernández
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
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Zhu QJ, Chen WJ, Zhu WJ, Xiao HX, Zhu MH, Ma L, Yuan Y, Song E. Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation. BMC Ophthalmol 2021; 21:199. [PMID: 33957891 PMCID: PMC8101126 DOI: 10.1186/s12886-021-01963-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/26/2021] [Indexed: 12/16/2022] Open
Abstract
Background To describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault. Methods Eighty-three eyes from eighty-three subjects with complete data who met follow-up requirements were recruited in this retrospective study between May 2019 and March 2020. We quantitatively assessed the postoperative vault at 2 h, 1 day, 1 week, and 1 month following implantation. Associations between the postoperative vault and age, ICL size, spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), flat keratometry (K), steep K, mean K, anterior chamber depth (ACD), crystalline lens thickness (LT), white-to-white (WTW) diameter obtained by three devices, horizontal and vertical sulcus-to-sulcus (STS) diameter, bright and dark pupil sizes (BPS and DPS) and DPS-BPS were investigated using Spearman’s correlation analysis and stepwise multiple regression analysis. Results The mean vault values at 2 h, 1 day, 1 week, and 1 month after ICL implantation were 672.05 ± 30.72, 389.15 ± 28.33, 517.23 ± 30.76 and 530.12 ± 30.22 μm, respectively. Significant differences were found in the vault values at 2 h, 1 day and 1 week after the operation. The ICL size (β = 0.942; p < 0.001), followed by horizontal STS (β = -0.517; p < 0.001), crystalline LT (β = -0.376; p < 0.001) and vertical STS (β = -0.257; p = 0.017), significantly influenced the vault at 1 month after the operation. The multiple regression equation was expressed as follows: central vault (µm) = -1369.05 + 657.121 × ICL size- 287.408 × horizontal STS − 432.497 × crystalline LT − 137.33 × vertical STS (adjusted R2 = 0.643). Conclusions After ICL implantation, the vault decreased and then increased, but it did not return to the vault value 2 h after surgery. The ICL size, horizontal and vertical STS and crystalline LT are key factors for predicting postoperative vaulting. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01963-x.
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Affiliation(s)
- Qiu-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Wen-Jing Chen
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Wei-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Hai-Xiang Xiao
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Man-Hui Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Lie Ma
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - You Yuan
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China.
| | - E Song
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
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Kalra N, Asif MI, Bafna RK, Sharma N, Sinha R. Posterior Chamber Phakic Intraocular Lens Implantation for Refractive Correction in Corneal Ectatic Disorders: A Review. J Refract Surg 2021; 37:351-359. [PMID: 34044697 DOI: 10.3928/1081597x-20210115-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To summarize the indications and outcomes of posterior chamber phakic intraocular lens (PIOL) implantation in corneal ectasias including keratoconus, pellucid marginal degeneration (PMD), post-refractive surgery, and post-keratoplasty ectasias. METHODS A review of the literature was conducted using the relevant keywords from various databases up to August 15, 2020. All pertinent studies were reviewed, and the relevant articles were studied in detail for efficacy, stability, predictability, and safety outcomes. In addition, visual quality, corneal biomechanical outcomes, complications, the role of posterior chamber PIOL in combination treatment, and comparison of posterior chamber PIOL with other PIOLs for ectasias were also evaluated. RESULTS A total of 30 relevant studies (13 prospective, 13 retrospective, 4 case reports) on the subject were studied and summarized. All studies showed a favorable refractive outcome. Quality of vision remained unaffected and no significant complications were reported in any of the studies. CONCLUSIONS Posterior chamber PIOLs represent a viable option in the treatment of mild to moderate and stable corneal ectasia in patients with contact lens intolerance who have low irregular astigmatism, a clear central cornea, and good preoperative corrected distance visual acuity. [J Refract Surg. 2021;37(5):351-359.].
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Cano-Ortiz A, Sánchez-Ventosa Á, Membrillo A, Castillo R, Gomera A, López-Pérez MD, Villarrubia A. Astigmatism correction with toric implantable collamer lens in low and high astigmatism groups. Eur J Ophthalmol 2021; 32:183-192. [PMID: 33663238 DOI: 10.1177/1120672121999991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To analyze the target induced astigmatism (TIA), surgically induced astigmatism (SIA), difference vector (DV), and correction index (CI) in the correction of astigmatism with phakic lenses, and its influence on visual acuity, and to analyze the safety and efficacy indexes of the correction of high and low power astigmatism with toric phakic lenses. DESIGN Retrospective comparative study. METHODS The medical records of patients that were operated on at the research center during the period were analyzed. Results were divided into Low Astigmatism Group - LAG (33 eyes) and High Astigmatism Group - HAG (93 eyes) according to the implanted toric ICL lens power. Preoperative refraction and resultant postoperative refraction were analyzed by vector analysis. Visual acuity pre and postop, with and without optical correction, were compared. RESULTS A total of 126 eyes were studied. The average preop refraction was -5.02 D sphere with -2.61 D cylinder. The average ICL lens power implanted was -8.31 D sphere +2.77 D cylinder. Refractive remaining was -0.01 ± 0.11 D sphere -0.15 ± 0.28 D cylinder. The arithmetic average angle of error in the astigmatism correction was 1.08°. The resultant cylinder was -0.03 ± 0.12 D and -0.19 ± 0.30 D in the low and high astigmatism groups, respectively, with a mean UDVA -0.01 ± 0.10 and 0.01 ± 0.16 and CDVA -0.03 ± 0.08 and -0.01 ± 0.17 for each group. The safety and efficacy indexes for the low astigmatism group were 1.09 ± 0.16 and 1.05 ± 0.17, respectively, with 1.11 ± 0.17 and 1.06 ± 0.16 for the high astigmatism group. CONCLUSIONS The correction of astigmatism by the implantation of toric phakic lenses of the posterior chamber is safe and effective, independently of the amount of cylinder corrected.
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Jabbour S, Bower KS. Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement ("Bioptics") in the Treatment of High Myopic Astigmatism. Clin Ophthalmol 2021; 15:635-643. [PMID: 33623364 PMCID: PMC7896759 DOI: 10.2147/opth.s283888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Describe three-year outcomes of spherical implantable Collamer lens (ICL) followed by excimer laser enhancement (bioptics) in eyes with high myopic astigmatism. Patients and Methods Retrospective case series of thirty-four cases that underwent bioptics enhancement at the Johns Hopkins Wilmer Eye Institute. All eyes had a preoperative sphere of −6.00 D or more with a cylinder of at least 2.00 D. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest spherical equivalent refraction (MSE), ICL vault measurements and central corneal thickness (CCT) were collected. Endothelial cell counts (ECC), root mean square (RMS) of higher order aberrations (HOAs), adverse events and subsequent surgeries were also assessed. Results All patients had a minimum follow-up of 3 years. Preoperative UDVA was 2.29 ± 0.46 logMAR and improved to 0.03 ± 0.23 logMAR at 3 years (p<0.05). MSE was −12.30 ± 4.05 preoperatively and changed to −0.21 ± 0.46 at 3 years (p<0.05). The efficacy and safety indices were 1.28 ± 0.32 and 1.47 ± 0.27 at 3 years post-enhancement. HOA did not significantly change throughout the follow-up (p<0.05). Endothelial cell loss at 12 months was calculated at 5.7%. Two eyes required ICL exchange due to vault-related issues. Conclusion Bioptics offered excellent long-term safe, predictable, and efficient outcomes for high myopic astigmatism and can be considered an option if toric ICL is not available. Results confirm that wavefront-guided photoablation remains an excellent option to manage residual refractive error after phakic IOL.
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Affiliation(s)
- Samir Jabbour
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kraig S Bower
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Siedlecki J, Schmelter V, Mayer WJ, Schworm B, Priglinger SG, Dirisamer M, Luft N. SMILE Versus Implantable Collamer Lens Implantation for High Myopia: A Matched Comparative Study. J Refract Surg 2021; 36:150-159. [PMID: 32159819 DOI: 10.3928/1081597x-20200210-02] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/10/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the safety, efficacy, and patient-reported quality of vision of small incision lenticule extraction (SMILE) and implantable Collamer lens (ICL) implantation for the treatment of high myopia. METHODS A database of 1,634 SMILE (Carl Zeiss Meditec AG, Jena, Germany) and 225 ICL implantation (STAAR Surgical, Monrovia, CA) procedures was screened for patients with a binocular preoperative manifest refraction spherical equivalent between -6.00 and -10.00 diopters (D) and plano target refraction. One-to-one matching was performed by preoperative manifest refraction spherical equivalent, age, and pupil size. All identified patients were then prospectively examined at their next regular postoperative follow-up visit and presented with the standardized and clinically validated Quality of Vision questionnaire to gauge patient-reported postoperative visual quality. RESULTS A total of 80 eyes (40 patients) were eligible for 1:1 matching. Mean postoperative follow-up was 27.8 ± 14.3 months in the SMILE group and 26.6 ± 17.7 months in the ICL group (P = .44). Regarding the percentage of eyes within ±0.50 D of plano target, refractive predictability was better in eyes treated with ICL implantation (90%) than SMILE (72.5%) (P = .045). Mean UDVA was comparable (ICL: -0.09 ± 0.10 logMAR; SMILE: -0.06 ± 0.09 logMAR; P < .09), but the efficacy (1.28 vs 1.05; P < .001) and safety (1.31 ± 0.22 vs 1.10 ± 0.25; P < .001) indices were higher after ICL implantation. ICL implantation induced significantly fewer higher order aberrations (total higher order aberrations: SMILE 0.724 ± 0.174 µm vs ICL 0.436 ± 0.114 µm; P < .01). Regarding subjective quality of vision, patients who had ICL implantation were significantly less bothered by visual disturbances, which were mainly halos after ICL and starbursts and fluctuations of vision after SMILE (P < .05). CONCLUSIONS In this refraction-matched comparative study, ICL implantation for high myopia yielded better refractive accuracy, better uncorrected distance visual acuity, fewer higher order aberrations, and better subjective quality of vision than SMILE. [J Refract Surg. 2020;36(3):150-159.].
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Jonker SMR, Berendschot TTJM, Saelens IEY, Bauer NJC, Nuijts RMMA. Phakic intraocular lenses: An overview. Indian J Ophthalmol 2020; 68:2779-2796. [PMID: 33229653 PMCID: PMC7856940 DOI: 10.4103/ijo.ijo_2995_20] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Phakic intraocular lenses (pIOLs) are a common solution for the surgical correction of high myopia and myopia in thin corneas. Global trends result in increasing rates of patients with high myopia which will result in increased rates of pIOL implantation. Three types of lenses can be distinguished: anterior chamber angle-supported, anterior chamber iris-fixated, and posterior chamber phakic IOLs. The efficacy of phakic intraocular lenses is generally very good, but pIOLs have undergone many changes over the years to improve the safety profile and decrease pIOL-related complications such as endothelial cell loss, corneal decompensation and cataract formation. This article describes the efficacy and safety profiles of the most recent pIOLs, as well as suggests gaps of knowledge that are deserve additional research to optimize the results of pIOLs.
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Affiliation(s)
- Soraya M R Jonker
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Noël J C Bauer
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht; Department of Ophthalmology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht; Department of Ophthalmology, Zuyderland Medical Center, Heerlen, The Netherlands
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