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Yoon HY, Byun YS, Kim HS, Chung SH. Causes and outcomes of implantable collamer lens explantation in patients with corneal endothelial cell loss. J Cataract Refract Surg 2024; 50:453-459. [PMID: 38270485 DOI: 10.1097/j.jcrs.0000000000001406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate the correlated factors of corneal endothelial cell density (ECD) loss and ECD change in implantable collamer lens (ICL) explantation patients. SETTING Seoul St. Mary's Hospital, Seoul, South Korea. DESIGN Retrospective analysis. METHODS The study cohort consisted of 93 eyes from 50 patients who underwent ICL explantation. Correlation analysis was performed to assess the ocular parameters associated with ECD loss, while percentage of ECD change (ΔECD%) was monitored up to 6 months postoperatively. Receiver operating characteristic (ROC) curve was used to set cutoff values of ocular parameters to prevent ECD loss after explantation. RESULTS In multiple regression analysis, high vaulting, high vaulting/anterior chamber depth (ACD), low anterior chamber angle (ACA), and high iris pigmentations are the significant factors of ECD loss. At postoperative 6 months, 14 eyes (15.1%) had decrease (10.5% loss), 47 eyes (51.0%) were stationary, and 32 eyes (34.4%) had increase (12.7% gain) of ECD. The ROC curve analysis showed that vaulting had the highest area under the curve (AUC = 0.822), followed by vaulting/ACD (AUC = 0.821), ECD (AUC = 0.753), and ACA (AUC = 0.723) (all P < .01). Preoperative ECD showed a sensitivity of 77.6% and specificity of 86.7% in preventing ECD loss after explantation, with a cutoff value of 1722 cells/mm 2 , as determined by ROC curve analysis. CONCLUSIONS Our study demonstrated that high vaulting is a significant factor in ECD loss among ICL-inserted patients. To prevent continuous ECD loss in ICL patients, close monitoring of ECD and making appropriate decisions regarding explantation may be necessary.
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Affiliation(s)
- Hye Yeon Yoon
- From the Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
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Zhou Z, Zhao X, Jiao X, Xue W, Yang J, Wang W, Bai Y. The Distribution of Crystalline Lens Rise in High Myopia Population and Its Influence on Vault After Implanting Intraocular Collamer Lens. Ophthalmol Ther 2024; 13:969-977. [PMID: 38319552 PMCID: PMC10912385 DOI: 10.1007/s40123-024-00891-5] [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: 11/14/2023] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION As a result of the insufficient ocular anatomical parameters used to customize implantable collamer lens (ICL), many patients still cannot achieve a suitable vault after ICL implantation surgery. This study analyzed the characteristics of a new anatomical parameter crystalline lens rise (CLR) in a population with high myopia and explored the influence of CLR on the vault after ICL implantation. METHODS Patients (298 eyes) with high myopia who underwent ICL implantation were enrolled to study CLR characteristics. Postoperatively, patients (159 eyes) were divided into five groups according to the value of CLR (A, CLR ≤ - 150; B, - 150 < CLR ≤ 0; C, 0 < CLR < 150; D, 150 ≤ CLR < 300; E, CLR ≥ 300 μm), and to investigate the correlation between CLR and vault. RESULTS In the 298 eyes, the CLR had a normal distribution (P = 0.35) and the mean CLR was 67.93 ± 150.66 μm. Ninety-nine eyes (33.22%) had a CLR ≤ 0 μm, of which 20 eyes (6.71%) had a CLR ≤ - 150 μm; 199 eyes (66.78%) had a CLR > 0 μm, of which 20 eyes (6.71%) had a CLR ≥ 300 μm. In 159 eyes, the CLR was negatively correlated with the vault at 1 day (R = - 0.497, P < 0.001), 3 months (R = - 0.505, P < 0.001), and 6 months (R = - 0.505, P < 0.001) postoperatively. At 6 months, the vault of group A was statistically significantly different compared to groups B-E (all P < 0.05), and that of group E was statistically significantly different compared to groups A-D (all P < 0.001). The remaining groups did not show statistically significant differences (all P > 0.05). CONCLUSION The CLR had a normal distribution in the high myopia population, and 13.42% of the CLR values were extreme (CLR ≤ - 150 μm or CLR ≥ 300 μm). A larger ICL diameter than that recommended by the manufacturer should be considered when the CLR is ≥ 300 μm and a smaller ICL diameter should be considered when the CLR is ≤ - 150 μm.
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Affiliation(s)
- Ziyu Zhou
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaoyu Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaohang Jiao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Wenxin Xue
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Jing Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Weiqun Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Yanhui Bai
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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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. [PMID: 38242162 DOI: 10.1055/a-2209-5251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [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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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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Wang Q, Fan L, Zhou Q. The best choice for low and moderate myopia patients incapable for corneal refractive surgery: implantation of a posterior chamber phakic intraocular lens. Int Ophthalmol 2023; 43:575-581. [PMID: 35984557 PMCID: PMC9971141 DOI: 10.1007/s10792-022-02459-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aims to evaluate the early clinical outcomes of central hole phakic posterior chamber intraocular lens(ICLV4c) implantation for low and moderate myopia correction. METHODS This retrospective clinical study included 27 patients(47 eyes)who underwent ICLV4c implantation to correct myopia with spherical equivalent (SE) between - 1.75D and -6.0D. The uncorrected visual acuity (UCVA), intraocular pressure(IOP), central anterior chamber depth (ACD), vault, and endothelial cell density (ECD) were evaluated after surgery. RESULTS At one year follow-up, the postoperative UCVA of patients was higher than the preoperative CDVA and showed a stable trend. There was no significant difference in ECD (p > 0.05) one month after the surgery, the vault was 0.77 ± 0.32 mm, which decreased to 0.63 ± 0.26 mm after one year of surgery. Similarly, ACD was 3.24 ± 0.25 mm in the preoperative, which decreased significantly to 2.05 ± 0.39 mm at one month, while rose to 2.2 ± 0.39 mm at one year after surgery. There was no significant correlation between IOP and ACD and vault at one month and one year after surgery. The correlation coefficient between ACD and vault was found to be - 0.72 at one month after surgery, while the same -0.71 after one year. One patient developed visual fatigue, one with glare, and while no other complications were observed with the rest of the patients. CONCLUSION The ICL implantation is a safe, effective and stable method to correct low and moderate myopia, and may be a good alternative for patients with low and moderate myopia who cannot undergo corneal refractive surgery.
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Affiliation(s)
- Qin Wang
- Chongqing Aier Eye Hospital, Chongqing, 400020 China
| | - Lina Fan
- Chongqing Aier Eye Hospital, Chongqing, 400020 China
| | - Qizhi Zhou
- Aier Chongqing Optometry Eye hospital, No. 77, Daping Changjiang Second Road, Yuzhong, Chongqing, 400040, China.
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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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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Guan N, Zhang XN, Zhang WJ. Correlation between intraoperative and postoperative vaulting of the EVO implantable Collamer lens: a retrospective study of real-time observations of vaulting using the RESCAN 700 system. BMC Ophthalmol 2022; 22:2. [PMID: 34980022 PMCID: PMC8721482 DOI: 10.1186/s12886-021-02237-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background Implantable Collamer lens (ICL) vaulting is one of the most important parameters for the safety, aqueous humor circulation, and lens transparency after ICL implantation. This study aimed to investigate the factors associated with the actual vaulting after refractive EVO-ICL surgery. Methods This retrospective study included patients who underwent EVO-ICL surgery at a tertiary eye hospital between October and December 2019. A RESCAN 700 was used for the intraoperative and CIRRUS HD-OCT was used for postoperative observation of vaulting. Subjective and objective refractions, anterior ocular segment, corneal morphology, intraocular pressure (IOP), anterior chamber volume (ACV), crystalline lens rise (CLR), white-to-white distance (WTW), anterior chamber depth (ACD), axial length, corneal endothelial cell density (ECD), and fundoscopy were examined. A multivariable analysis was performed to determine the factors independently associated with 1-month postoperative vaulting. Results Fifty-one patients (102 eyes) were included. Compared with the eyes with normal vaulting, those with high vaulting had higher preoperative diopter values (P = 0.039), lower preoperative corrected visual acuity (P = 0.006), lower preoperative IOP (P = 0.029), higher preoperative ACD (P = 0.004), lower preoperative CLR (P = 0.046), higher ICL spherical equivalent (P = 0.030), higher intraoperative vaulting (P < 0.001), and lower IOP at 1 month (P = 0.045). The multivariable analysis showed that the only factor independently associated with high vaulting at 1 month after surgery was the intraoperative vaulting value (odds ratio = 1.005, 95% confidence interval: 1.002–1.007, P < 0.001). The intraoperative and 1-month postoperative vaulting values were positively correlated (R2 = 0.562). Conclusions The RESCAN700 system can be used to perform intraoperative optical coherence tomography to predict the vaulting value of ICL at 1 month.
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Affiliation(s)
- Nian Guan
- Department of Refractive, Wuhan Bright Eye Hospital, Wuhan, 430000, Hubei, China
| | - Xiao-Nong Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China
| | - Wan-Jun Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China.
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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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Zaldívar R, Adamek P, Zaldívar R, Domínguez MS, Cerviño A. Intraoperative Versus Postoperative Vault Measurement After Implantable Collamer Lens Implantation in a Large Cohort of Patients. J Refract Surg 2021; 37:477-483. [PMID: 34236904 DOI: 10.3928/1081597x-20210405-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare intraoperative and postoperative central vault measurement after implantable Collamer lens (ICL; STAAR Surgical) implantation using optical coherence tomography (OCT). METHODS A total of 574 eyes of 338 consecutive patients undergoing myopic ICL implantation were evaluated (mean age of 30.8 ± 5.7 years, 117 men and 221 women). Central ICL vault was measured both intraoperatively using the microscope-integrated iOCT (Optomedical Technologies GmbH) mounted on a standard surgical microscope (HS Hi-R NEO 900A; Haag-Streit Surgical GmbH), and postoperatively using the CASIA2 swept-source OCT (Tomey GmbH) at 4 and 24 hours. RESULTS Mean differences between intraoperative and postoperative vault values were 11.5 ± 29.0% of the mean value 4 hours postoperatively (P < .001) and 2.7 ± 33.5% of the mean value 24 hours postoperatively (P < .001). Correlation analysis shows significant agreement between vault values obtained intraoperatively and at the two postoperative times, 4 hours (Spearman Rho = 0.850, P < .001) and 24 hours (Spearman Rho = 0.745, P < .001). In 73% of cases, postoperative vault values 4 hours after the surgery could be predicted from intraoperative vault values, and so were 56% of vault values 1 day after surgery. Significant differences in vault were found at the different times, grouping cases by ICL size (Kruskal-Wallis, P = .028 for intraoperative vault, and P < .001 for both postoperative vault times), with smaller vault values for the smaller ICL size. CONCLUSIONS Intraoperative determination of ICL vault using iOCT is an effective method for predicting postoperative ICL vault and minimizing postoperative vault surprises that could require surgical retouching. [J Refract Surg. 2021;37(7):477-483.].
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van Rijn GA, Gaurisankar ZS, Saxena R, Gibbes D, Jongman HP, Haasnoot GW, Cheng YYY, Beenakker JWM, Luyten GPM. Implantation of an iris-fixated phakic intraocular lens for the correction of hyperopia: 15-year follow-up. J Cataract Refract Surg 2021; 47:748-758. [PMID: 33298790 DOI: 10.1097/j.jcrs.0000000000000532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the predictability, efficacy, stability, and safety of implantation of an Artisan iris-fixated phakic intraocular lens (IF-pIOL) for the correction of hyperopia with a follow-up of up to 15 years. SETTING Leiden University Medical Center, the Netherlands. METHODS Patients operated by a single surgeon up to 2007 were identified, and data on refraction, corrected distance visual acuity (CDVA), uncorrected distance visual acuity, endothelial cell (EC) density, and complications were collected. RESULTS A total of 61 eyes (32 patients) were analysed. The mean spherical equivalent decreased from +6.43 ± 1.78 diopters (D) preimplantation to -0.22 ± 0.57 D at 1 year postimplantation and remained stable throughout follow-up. A stable CDVA with safety indices ranging from 0.91 to 1.10 and efficacy indices between 0.43 and 0.86 were observed. Follow-up time had a significant effect on EC density with an estimated annual decline of 58 cells/mm2 after IF-pIOL implantation. IF-pIOL explantation was performed in a 10 eyes (16.4%) after 8.13 ± 5.11 years. The main reason for IF-pIOL explantation was EC loss (4 eyes [6.6%]). Pigment dispersion was the most encountered complication, observed in 9 eyes (14.8%). CONCLUSIONS Visual and refractive results after implantation of an IF-pIOL to correct hyperopia show favorable and stable results with long-term follow-up. Lifelong monitoring of EC counts is mandatory. Pigment dispersion might be a problem in hyperopic eyes implanted with an IF-pIOL; a shallower anterior chamber depth and a convex iris configuration might be predisposing factors.
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Affiliation(s)
- Gwyneth A van Rijn
- From the Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands (van Rijn, Gaurisankar, Gibbes, Jongman, Cheng, Beenakker, Luyten); Department of Ophthalmology, The Hague Medical Center, The Hague, the Netherlands (Saxena); Department of Immunohematology and blood transfusion, Leiden University Medical Center, Leiden, The Netherlands (Haasnoot); Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (Beenakker)
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Phakic intraocular lens implantation for the correction of hyperopia. J Cataract Refract Surg 2020; 45:1503-1511. [PMID: 31564323 DOI: 10.1016/j.jcrs.2019.05.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 11/27/2022]
Abstract
The prevalence of myopia is much higher than hyperopia. Hence, there are relatively few studies investigating phakic intraocular lens (pIOL) implantation for the correction of hyperopia. This review aimed to summarize the available relevant literature on the efficacy and safety of pIOL implantation for the correction of hyperopia and hyperopic astigmatism. At present, two types of pIOLs are used to correct hyperopia and hyperopic astigmatism: anterior chamber iris-fixated pIOLs and posterior chamber implantable collamer lenses. Both have been found to be safe and effective. No serious events (eg, retinal or choroidal detachment, endophthalmitis) were reported in the reviewed articles. Implantation of pIOLs might be the optimal refractive surgery for the correction of high hyperopia.
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Vargas V, Alió JL, Barraquer RI, D' Antin JC, García C, Duch F, Balgos J, Alió Del Barrio JL. Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy. EYE AND VISION 2020; 7:34. [PMID: 32626790 PMCID: PMC7329535 DOI: 10.1186/s40662-020-00200-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/28/2020] [Indexed: 12/13/2022]
Abstract
Background To evaluate the safety, efficacy, refractive outcomes and causes for bilensectomy (phakic intraocular lens – pIOL – explantation with cataract surgery and pseudophakic intraocular lens implantation) in patients previously implanted with posterior chamber pIOLs. Methods This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for posterior chamber pIOL with a follow up time of 12 months. The uncorrected and best corrected distance visual acuities (UDVA, CDVA), endothelial cell density before and after bilensectomy were assessed, as well as the cause of bilensectomy and intra or postoperative complications. Results There was a statistically significant improvement in uncorrected and best corrected visual acuities after bilensectomy (p = 0.00). The main reason for bilensectomy was cataract development (93.1% of the cases), followed by miscalculation of lens size, and corneal edema. The endothelial cell count remained stable without a statistically significant change after surgery (p = 0.67). The refractive efficacy index was 0.8, none of the patients lost lines of CDVA after surgery, 73% of the patients were within ±1 D (spherical equivalent) of the target refraction. Intraoperative complications were one posterior capsule rupture with the intraocular lens (IOL) implanted in the sulcus, and 3 eyes required the use of pupil expanders for adequate pupil dilation. Postoperatively, one eye developed retinal detachment. The three pIOLs models explanted were the Implantable Collamer Lens (ICL), Implantable Phakic Contact Lens (IPCL) and the Phakic Refractive Lens (PRL). Conclusions Good safety and visual outcomes were observed 1 year after bilensectomy for posterior chamber phakic intraocular lenses (PC pIOLs). There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.
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Affiliation(s)
| | - Jorge L Alió
- Vissum Instituto Oftalmológico de Alicante, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| | - Rafael I Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Oftalmología Barraquer, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
| | - Justin Christopher D' Antin
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Oftalmología Barraquer, Barcelona, Spain
| | | | - Francisco Duch
- Instituto Catalán de Retina (ICR) unidad de Cirugía Refractiva, Barcelona, Spain
| | - Joan Balgos
- Vissum Instituto Oftalmológico de Alicante, Alicante, Spain
| | - Jorge L Alió Del Barrio
- Vissum Instituto Oftalmológico de Alicante, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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Comparison of intraoperative vs postoperative optical coherence tomography measurement of implantable collamer lens vaulting. J Cataract Refract Surg 2020; 46:737-741. [DOI: 10.1097/j.jcrs.0000000000000119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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He T, Zhu Y, Zhou J. Optical quality after posterior chamber Phakic implantation of an intraocular Lens with a central hole (V4c implantable Collamer Lens) under different lighting conditions. BMC Ophthalmol 2020; 20:82. [PMID: 32131800 PMCID: PMC7055093 DOI: 10.1186/s12886-020-01340-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background The current study compared optical quality before and after implantation of a posterior chamber phakic intraocular lens with a central hole [V4c implantable collamer lens (ICL)] under bright and dark lighting conditions by means of the Optical Quality Analysis System™ (OQAS; Visiometrics, Terrassa, Spain). Methods This prospective study involved 91 eyes of 46 consecutive high myopia patients (15 males and 31 females, average spherical equivalent − 10.50 ± 0.33D) undergoing implantation of a V4c ICL. The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs; 100, 20, and 9%), under different lighting conditions, were measured before and 1 week, 1 month, and 3 months after surgery. Results All optical parameters showed significant improvements, at all time points, under dark condition after surgery. We observed no significant changes in PVA 9% at 1 week (mean value 0.539, P = 0.12) or 1 month after surgery (mean value 0.573, P = 0.08) under bright condition; but all other postoperative parameters improved significantly. Comparing the two lighting conditions, the OSI decreased more under dark conditions at 1 week (P = 0.02), 1 month (P = 0.004), and 3 months (P = 0.002), but there was no significant difference in any other parameter. In addition, patients were divided into super high myopia (group S, spherical equivalent greater than − 10 D) and high myopia (group H, spherical equivalent from − 6 D to − 10 D), the group S improved significantly more than group H in all parameters, under both bright and dark conditions. Conclusions V4c ICL implantation improved optical quality under both bright and dark lighting conditions, and had a better ability to reduce the extent of scattering in the dark. Furthermore, group S achieved greater improvement in visual quality, which should be considered by physicians before surgery.
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Affiliation(s)
- Tianrui He
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong, University School of Medicine, No.639, Road Zhizaoju, Shanghai, Huangpu District of Shanghai, China
| | - Yi Zhu
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong, University School of Medicine, No.639, Road Zhizaoju, Shanghai, Huangpu District of Shanghai, China
| | - Jibo Zhou
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong, University School of Medicine, No.639, Road Zhizaoju, Shanghai, Huangpu District of Shanghai, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Vastardis I, Sagri D, Fili S, Wölfelschneider P, Kohlhaas M. Current Trends in Modern Visual Intraocular Lens Enhancement Surgery in Stable Keratoconus: A Synopsis of Do's, Don'ts and Pitfalls. Ophthalmol Ther 2019; 8:33-47. [PMID: 31605318 PMCID: PMC6789053 DOI: 10.1007/s40123-019-00212-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Indexed: 10/29/2022] Open
Abstract
Keratoconus is a relatively common ectatic, non-inflammatory corneal disorder that involves gradual visual deterioration through progressive alteration of the shape of the cornea. The corneal thinning, irregular astigmatism and higher order aberrations that occur as the disease progresses pose major challenges in the visual rehabilitation of such patients. This paper summarizes the current literature regarding the results of visual enhancement procedures in patients with stable keratoconus treated with standalone anterior or posterior chamber phakic intraocular lens implantation and monofocal, toric or multifocal toric intraocular lens implantation following phacoemulsification for age-related cataract extraction or refractive lens exchange.
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Affiliation(s)
| | | | - Sofia Fili
- St Johannes Hospital, Eye Clinic, Dortmund, Germany
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17
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Nakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y. Posterior Chamber Phakic Intraocular Lens Implantation for the Correction of Myopia and Myopic Astigmatism: A Retrospective 10-Year Follow-up Study. Am J Ophthalmol 2019; 206:1-10. [PMID: 31078536 DOI: 10.1016/j.ajo.2019.04.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/10/2019] [Accepted: 04/23/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the 10-year clinical outcomes of implantable collamer lens (ICL) implantation for myopia and astigmatism. DESIGN Retrospective observational case series. METHODS This study included 114 eyes of 61 patients who underwent ICL implantation for correction of myopia and myopic astigmatism. We assessed the safety, efficacy, predictability, stability, and adverse events preoperatively, at 6 months (106 eyes) and 1 (94 eyes), 3 (58 eyes), 5 (65 eyes), 8 (89 eyes), and 10 (70 eyes) years postoperatively. Only the eyes with clinical data available at each follow-up time were analyzed. RESULTS The mean logMAR uncorrected and corrected distance visual acuities were -0.01 ± 0.24 and -0.18 ± 0.07 at 10 years postsurgery. The mean indices for safety and efficacy were 0.88 ± 0.15 and 0.66 ± 0.26, respectively. At 10 years postsurgery, 71.4% and 87.1% of the eyes were within 0.5 and 1.0 diopters (D), respectively, of the attempted spherical equivalent correction. The mean intraocular pressure was 13.1 ± 2.4 mmHg preoperatively and 13.1 ± 2.9 mmHg at 10 years postoperatively. The mean endothelial cell loss was 5.3% at 10 years postsurgery. Twelve of 114 eyes (10.5%) developed anterior subcapsular cataract during 5-10 years' follow-up; among these, 4 eyes (3.5%) were symptomatic and ICL explantation and phacoemulsification surgery were performed. No vision-threatening complications occurred during the observation period. CONCLUSION ICL implantation offered good overall outcomes in all measures of safety, efficacy, predictability, and stability for the correction of myopia and myopic astigmatism throughout a long-term follow-up period of 10 years.
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Affiliation(s)
| | | | - Takashi Kojima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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18
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Jadidi K, Mosavi SA, Nejat F, Mohammadi N, Aghamolaei H, Daryabari SH, Torabi H, Alishiri A. Use of low-vault posterior chamber collagen copolymer phakic intraocular lenses for the correction of myopia: a 3-year follow-up. Graefes Arch Clin Exp Ophthalmol 2019; 257:1555-1560. [DOI: 10.1007/s00417-019-04336-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 11/28/2022] Open
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Vasavada V, Srivastava S, Vasavada SA, Sudhalkar A, Vasavada AR, Vasavada VA. Safety and Efficacy of a New Phakic Posterior Chamber IOL for Correction of Myopia: 3 Years of Follow-up. J Refract Surg 2019; 34:817-823. [PMID: 30540364 DOI: 10.3928/1081597x-20181105-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/02/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the outcomes of a new posterior chamber phakic intraocular lens (IPCL; Care Group, Baroda, India) to correct myopia. METHODS This prospective, observational case series included 30 eyes undergoing implantation of the IPCL for high myopia (> -8.00 diopters [D]). Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, vault, endothelial cell loss, and adverse events were evaluated 3 years after implantation of the IPCL for high myopia. RESULTS The mean spherical equivalent decreased from -16.50 ± 5.62 D preoperatively to -0.89 ± 1.27 D at 3 years. The mean UDVA and CDVA were 0.38 ± 0.21 and 0.24 ± 0.09 logMAR. No eye lost any lines and 49% of eyes gained one line or more of CDVA. One eye (3.3%) developed anterior subcapsular cataract, but did not require cataract surgery at 3 years of follow-up. Two eyes (6.6%) developed a mild transient increase in intraocular pressure, which required topical medication only for 3 months. The percentage of endothelial cell loss at 3 years was 9.73% ± 6.72%. The IPCL vault tended to reduce with time, from a mean of 626.66 ± 188.98 μm at 1 month to 540.22 ± 210.76 μm at 3 years. No vision-threatening complications occurred. CONCLUSIONS Implantation of the new posterior chamber phakic IOL is an effective alternative to correct high myopia, showing good outcomes at 3 years. [J Refract Surg. 2018;34(12):817-823.].
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Effect of laser peripheral iridotomy using argon and neodymium-YAG lasers on corneal endothelial cell density: 7-year longitudinal evaluation. Jpn J Ophthalmol 2018; 62:216-220. [DOI: 10.1007/s10384-018-0569-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
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22
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Coskunseven E, Kavadarli I, Sahin O, Kayhan B, Pallikaris I. Refractive Outcomes of 20 Eyes Undergoing ICL Implantation for Correction of Hyperopic Astigmatism. J Refract Surg 2017; 33:604-609. [DOI: 10.3928/1081597x-20170504-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/18/2017] [Indexed: 11/20/2022]
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Park MJ, Jeon HM, Lee KH, Han SY. Comparison of postoperative optical quality according to the degree of decentering of V4c implantable collamer lens. Int J Ophthalmol 2017; 10:619-623. [PMID: 28503437 DOI: 10.18240/ijo.2017.04.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/08/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the clinical outcomes of V4c implantable collamer lens (Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering. METHODS This included 49 eyes that received conventional ICL and 94 eyes that received Hole ICL. The eyes that received Hole ICL were divided into three groups according to the degree of decentering: group 1, central hole within 1 hole diameter (HD) from the pupil center; group 2, central hole within 1 HD to 2 HD; and group 3, central hole within 2 HD to 3 HD. Visual acuity (VA), intraocular pressure (IOP), and spherical equivalent (SE) values were assessed at 1wk, 1 and 3mo after surgery. The ocular modulation transfer function, Strehl ratio, objective scattering index, and higher order aberrations (HOAs) were measured for 4-mm pupils at 3mo after surgery. RESULTS There were no significant differences in VA, IOP, and SE among the conventional and Hole ICL groups. With regard to HOAs, values for coma and spherical aberrations showed no differences. The total HOA and trefoil values were significantly higher in group 2 than in group 1 (P=0.02, 0.03, respectively). There were no significant differences among groups with regard to other optical quality parameter at 3mo after surgery. CONCLUSION Our results suggest that Hole ICL implantation provides satisfactory visual quality that is equivalent to that provided by conventional ICL, regardless of the presence of central hole and degree of decentering.
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Affiliation(s)
- Min Ji Park
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
| | - Hye Min Jeon
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
| | - Kyoung Heon Lee
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
| | - Sang Youp Han
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
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Goukon H, Kamiya K, Shimizu K, Igarashi A. Comparison of corneal endothelial cell density and morphology after posterior chamber phakic intraocular lens implantation with and without a central hole. Br J Ophthalmol 2017; 101:1461-1465. [PMID: 28292776 DOI: 10.1136/bjophthalmol-2016-309363] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 01/09/2017] [Accepted: 02/15/2017] [Indexed: 11/04/2022]
Abstract
AIM To compare the corneal endothelial cells after posterior chamber phakic intraocular lens with and without a central hole (hole implantable collamer lens (ICL) and conventional ICL) implantation for the correction of moderate to high myopia. METHODS This retrospective study evaluated 34 eyes of 34 patients who underwent hole ICL implantation and 25 eyes of 25 patients who underwent conventional ICL implantation. Preoperatively and 3 months, and 1 and 2 years postoperatively, we compared the central corneal endothelial cell density (ECD), coefficient of variation in cell size (CV) and the percentage of hexagonal cells (HEX) between the two groups using a non-contact specular microscope (EM-3000, Tomey). Preoperatively and 2 years postoperatively, we also compared them in the peripheral regions. RESULTS The mean central ECD loss was 0.3% and 1.1%, 2 years after hole ICL and conventional ICL implantation, respectively (Mann-Whitney U test, p=0.72). There were no significant changes in central ECD, CV or HEX at any time points either after hole ICL or conventional ICL implantation, and a significant decrease only in terms of ECD in the superior regions after conventional ICL implantation. CONCLUSIONS Both ICLs do not induce a significant change in the density, polymegethism or polymorphism of corneal endothelial cells even 2 years postoperatively, except for the density in the superior regions after conventional ICL implantation. However, hole ICL implantation may have advantages over conventional ICL implantation only in terms of the density in the superior regions, possibly because preoperative laser iridotomies are unnecessary.
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Affiliation(s)
- Hiroyasu Goukon
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Kocová H, Vlková E, Michalcová L, Motyka O. Implantation of posterior chamber phakic intraocular lens for myopia and hyperopia - long-term clinical outcomes. J Fr Ophtalmol 2017; 40:215-223. [PMID: 28291554 DOI: 10.1016/j.jfo.2016.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/21/2016] [Accepted: 10/18/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate long-term refractive outcomes of implantable collamer lens (ICL) implantation and late postoperative complications. METHODS We assessed outcomes of patients who underwent ICL implantation (type ICM V4 for myopia, ICH V3 for hyperopia, TICM V4 for astigmatism) in our department between 1998 and 2013. It comprised 62 eyes (40 myopic and 22 hyperopic). The average follow-up period was 10.5 years. We evaluated: uncorrected and best-corrected visual acuity (UCVA and BCVA), spherical equivalent (SE), ICL vault, endothelial cell density and late postoperative complications. RESULTS In myopes, the average UCVA was 1.0±0.37 and BCVA 1.18±0.38, in hyperopes 0.78±0.19 and 1.14±0.18, respectively. The average SE in myopes, whose target refraction was emmetropia, was -0.6±0.83 Dsf, in hyperopes +0.73±0.93. Central ICL vault was 206.16μm±105.94, (range 10-427) in myopes, 195.5μm±109.09, (range 20-404) in hyperopes. The most common late postoperative complication was cataract formation. Three myopic eyes (7.5%) developed symptomatic anterior subcapsular opacities with loss of at least two lines of BCVA. Cataract significantly affecting visual acuity occurred in 5 myopic eyes (12.5%) and 2 hyperopic eyes (9.09%). In these eyes, ICL removal and cataract surgery was performed. CONCLUSIONS In our experience, ICL implantation in moderate and high ametropia was effective and relatively safe. The most common late complication was cataract formation. This complication can be managed effectively surgically with good refractive outcomes without loss of BCVA.
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Affiliation(s)
- H Kocová
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic.
| | - E Vlková
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - L Michalcová
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - O Motyka
- Nanotechnology Centre, VŠB - Technical University of Ostrava, 17, Listopadu 15, 70833 Ostrava, Czech Republic
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Esteve-Taboada JJ, Domínguez-Vicent A, Ferrer-Blasco T, Alfonso JF, Montés-Micó R. Posterior chamber phakic intraocular lenses to improve visual outcomes in keratoconus patients. J Cataract Refract Surg 2017; 43:115-130. [DOI: 10.1016/j.jcrs.2016.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/06/2016] [Accepted: 05/25/2016] [Indexed: 12/01/2022]
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Chen X, Wang XY, Zhang X, Chen Z, Zhou XT. Implantable collamer lens for residual refractive error after corneal refractive surgery. Int J Ophthalmol 2016; 9:1421-1426. [PMID: 27803858 DOI: 10.18240/ijo.2016.10.09] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/29/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the safety, efficacy, predictability and stability of implantable collamer lens (ICL) for residual refractive error after corneal refractive surgery. METHODS This study evaluated 19 eyes of 12 patients who underwent ICL implantation after corneal refractive surgeries. They were followed up for 1y to 5y of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive error, flat and steep K value, axial length, intraocular pressure, corneal endothelial cell density, adverse events after ICL surgery. RESULTS The mean follow-up period was 39.05±19.22 mo (range, 1-5y). Spherical equivalent refractive error changed from -7.45±3.02 D preoperatively to -0.85±1.10 D 1wk to 1mo after ICL implantation, with the safety and efficacy indices being 1.12 and 1.15, respectively. A total of 52.63% of eyes were within ±0.5 D of the predicted spherical equivalents, 73.68% were within ±1.0 D. A trend of mild regression towards myopia with axial elongation after 5y was observed. One eye with mild anterior capsule opacity and retinal detachment 1y after surgery were observed. CONCLUSION ICL implantation is safe and effective for the correction of residual refractive error after corneal refractive surgeries, especially in moderate to high residual myopia.
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Affiliation(s)
- Xun Chen
- Myopia Key Laboratory of the Health Ministry, Shanghai 200031, China; Department of Ophthalmology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China
| | - Xiao-Ying Wang
- Myopia Key Laboratory of the Health Ministry, Shanghai 200031, China; Department of Ophthalmology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China
| | - Xi Zhang
- Myopia Key Laboratory of the Health Ministry, Shanghai 200031, China; Department of Ophthalmology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China
| | - Zhi Chen
- Myopia Key Laboratory of the Health Ministry, Shanghai 200031, China; Department of Ophthalmology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China
| | - Xing-Tao Zhou
- Myopia Key Laboratory of the Health Ministry, Shanghai 200031, China; Department of Ophthalmology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China
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Wu Y, Han F, Quan Y, Jiang W, Zhang H, Luo T. Comparison of peripheral iridectomy methods for posterior chamber phakic intraocular lens implantation in patients with brown irides. BMC Ophthalmol 2016; 16:51. [PMID: 27150380 PMCID: PMC4857290 DOI: 10.1186/s12886-016-0229-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 04/28/2016] [Indexed: 11/25/2022] Open
Abstract
Background We explore and compare the advantages and disadvantages of different operating methods for a peripheral iridectomy (PI) for phakic posterior chamber implantable contact lens (ICL) implantation in patients with dark-brown irides. Methods Forty-six patients completed this prospective comparative study. Neodymium: yttrium-aluminum-garnet (Nd:YAG) PI was performed in 15 patients (30 eyes) 2 weeks prior to surgery (YAG PI group). Surgical PI was performed in 17 patients (34 eyes) 2 weeks prior to the ICL implantation (preoperative PI group), and intraoperative PI was performed during ICL implantation in 14 patients (28 eyes) (intraoperative PI group). The postoperative recovery of visual acuity, intraoperative complications, operation duration, and patients’ visual disturbances were compared. Results Compared with the preoperative BCVA, the uncorrected visual acuity (UCVA) at 1 week was markedly restored in the preoperative PI group (P = 0.004). UCVA in the three groups of patients had all recovered well at 1 and 3 months after ICL implantation and were significantly better than the preoperative BCVA (all P < 0.01). In the YAG PI group, iris bleeding occurred in nine eyes (30.0 %) and 14 eyes (46.7 %) had pigment dispersion; these values were significantly higher than those in the preoperative PI group (5.9 and 14.7 %, respectively, both P = 0.01). In the intraoperative PI group, elevated high intraocular pressure occurred in four eyes (14.3 %), and eight eyes (28.6 %) had varying degrees of pigment dispersion after ICL implantation. Conclusions For patients with dark-brown irides, surgical PI performed 2 weeks prior to the implantation facilitated better postoperative recovery of visual acuity. Trial registration Current Controlled Trials ISRCTN35178162. Retrospectively registered March 4th, 2013.
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Affiliation(s)
- Yan Wu
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Fei Han
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Yan Quan
- Department of Health, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Wei Jiang
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China.
| | - Hengdi Zhang
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Tao Luo
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
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Sixteen-year follow-up of hyperopic laser in situ keratomileusis. J Cataract Refract Surg 2016; 42:717-24. [DOI: 10.1016/j.jcrs.2016.03.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/13/2016] [Accepted: 03/22/2016] [Indexed: 11/20/2022]
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Domínguez-Vicent A, Ferrer-Blasco T, Pérez-Vives C, Esteve-Taboada JJ, Montés-Micó R. Optical quality comparison between 2 collagen copolymer posterior chamber phakic intraocular lens designs. J Cataract Refract Surg 2016; 41:1268-78. [PMID: 26189382 DOI: 10.1016/j.jcrs.2014.09.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 08/30/2014] [Accepted: 09/29/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the optical quality in vitro of 2 designs of the Visian Implantable Collamer Lens phakic intraocular lens (pIOL) for different powers and optical apertures. SETTING University of Valencia, Valencia, Spain. DESIGN Experimental study. METHODS The Nimo TR1504 deflectometry device was used to measure the V4c pIOL, which has a smaller optic diameter, and the V5 pIOL, which has a larger optic diameter. The pIOLs were measured for -3.00 diopters (D), -6.00 D, -9.50 D, and -10.50 D at different optical apertures from 3.00 to 6.00 mm depending on the IOL power and model. The root mean square of higher-order aberrations (RMS HOAs) was analyzed. The Strehl ratio, point-spread functions (PSFs), and simulated images were calculated from wavefront aberrations. RESULTS There were no statistically significant differences in any Zernike RMS or RMS HOAs between the 2 pIOL models with the same power and optical aperture (P > .05). Both pIOLs had negative spherical aberration that increased with the pIOL power. Strehl ratio values showed no statistically significant differences between the pIOLs with the same power and pupil aperture. Minimal differences were seen in the PSFs and simulated images between the pIOLs. CONCLUSIONS Both pIOLs showed good and comparable in vitro optical quality similar that of a perfect lens in that they should not affect visual performance after implantation. Patients with larger pupil diameters could benefit from the pIOL with the larger optic diameter because it showed better in vitro optical quality than the previous design with a smaller optic diameter. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Alberto Domínguez-Vicent
- From the Optometry Research Group (GIO), Department of Optics, University of Valencia, Valencia, Spain
| | - Teresa Ferrer-Blasco
- From the Optometry Research Group (GIO), Department of Optics, University of Valencia, Valencia, Spain
| | - Cari Pérez-Vives
- From the Optometry Research Group (GIO), Department of Optics, University of Valencia, Valencia, Spain
| | - Jose J Esteve-Taboada
- From the Optometry Research Group (GIO), Department of Optics, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- From the Optometry Research Group (GIO), Department of Optics, University of Valencia, Valencia, Spain.
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Lisa C, Naveiras M, Alfonso-Bartolozzi B, Belda-Salmerón L, Montés-Micó R, Alfonso JF. Posterior chamber collagen copolymer phakic intraocular lens with a central hole to correct myopia: One-year follow-up. J Cataract Refract Surg 2016; 41:1153-9. [PMID: 26189376 DOI: 10.1016/j.jcrs.2014.10.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/16/2014] [Accepted: 10/19/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess the predictability, stability, efficacy, and safety of a newly developed posterior chamber phakic intraocular lens (pIOL) (model V4c Visian Implantable Collamer Lens) to correct moderate to high myopia. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Prospective case series. METHODS This study evaluated eyes that had implantation of the new pIOL model with a central hole for myopia correction. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density, pIOL vault, and adverse events were evaluated over 12 months. RESULTS The study comprised 147 eyes of 80 patients. Preoperatively, the mean spherical equivalent (SE) was -8.80 diopters (D) ± 2.60 (SD). At 12 months, the mean SE was -0.14 ± 0.26 D, with 93.9% of eyes within ±0.50 D of the target and 100% of eyes within ±1.00 D. The mean UDVA and CDVA were 0.028 ± 0.055 logMAR and 0.003 ± 0.013 logMAR, respectively. The efficacy and safety indices were 1.00 and 1.04, respectively. All eyes had unchanged CDVA or gained 1 or more lines during the follow-up. The IOP remained stable over time; no eye developed anterior subcapsular cataract. Twelve months postoperatively, the mean vault was 405.5 ± 184.7 μm (range 100 to 980 μm), and the mean endothelial cell loss was 1.7%. CONCLUSION The good refractive and visual acuity outcomes and the highly stable IOP values obtained over 12 months support the use of the new pIOL model with a central hole for the correction of moderate to high myopia. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Carlos Lisa
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Miguel Naveiras
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Belén Alfonso-Bartolozzi
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Lurdes Belda-Salmerón
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - José F Alfonso
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain.
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Eighteen-year follow-up of hyperopic photorefractive keratectomy. J Cataract Refract Surg 2016; 42:258-66. [DOI: 10.1016/j.jcrs.2015.09.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 08/17/2015] [Accepted: 09/09/2015] [Indexed: 11/19/2022]
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Simulated prototype of posterior chamber phakic intraocular lens for presbyopia correction. J Cataract Refract Surg 2015; 41:2266-73. [PMID: 26703304 DOI: 10.1016/j.jcrs.2015.10.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/18/2015] [Accepted: 02/23/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the visual impact of adding different spherical aberration values to an Implantable Collamer Lens phakic intraocular lens (pIOL) to increase the depth of focus using an adaptive optics visual simulator. SETTING University of Valencia, Valencia, Spain. DESIGN Experimental study. METHODS Wavefront aberrations in -3.00 D and -6.00 diopter (D) pIOLs were measured in vitro. Afterward, different simulated pIOL experimental prototypes were created along with variances in the spherical aberration. An adaptive optics visual simulator was used to simulate vision after the implantation of the different pIOL prototypes from their wavefront aberrations. The corrected distance visual acuity (CDVA) and depth of focus were measured in 3.0 and 4.5 mm pupils. RESULTS In a 3.0 mm pupil, the CDVA achieved with -3.00 and -6.00 D pIOLs and all pIOL prototypes evaluated was above 20/20 except for a -6.00 D pIOL + spherical aberration 4 at 50% CDVA contrast, which decreased to 20/25. However, in a 4.5 mm pupil, the CDVA obtained with the pIOL prototypes decreased significantly and was more pronounced when the spherical aberration induced was negative. The depth of focus increment was larger with the highest spherical aberration added and with a small pupil. Nevertheless, it was independent of the sign of the added spherical aberration. CONCLUSIONS The outcomes show that residual negative spherical aberration after pIOL implantation will disrupt the CDVA. However, some residual positive spherical aberration after pIOL implantation increased the depth of focus with excellent CDVA, providing a possible pIOL design for young presbyopic patients. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Alfonso JF, Lisa C, Fernández-Vega L, Almanzar D, Pérez-Vives C, Montés-Micó R. Prevalence of cataract after collagen copolymer phakic intraocular lens implantation for myopia, hyperopia, and astigmatism. J Cataract Refract Surg 2015; 41:800-5. [PMID: 25840304 DOI: 10.1016/j.jcrs.2014.07.039] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the prevalence of cataract after Implantable Collamer Lens phakic intraocular lens (pIOL) implantation with different models at different ages and for different refractive powers. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective nonrandomized clinical study. METHODS The pIOL (models V4, V4b, or V4c) was implanted in all cases. RESULTS The study included 3420 eyes (1898 patients). The mean patient age at surgery was 31.2 years ± 6.4 (SD) (range 18 to 50 years) and the mean spherical refractive error, -7.27 ± 5.24 diopters (D) (range -26.5 to 12.5 D). Twenty-one eyes (0.61%) of 15 patients had pIOL explantation (all model V4) because cataract developed. The mean age of the patients who had explantation was 39.43 ± 4.57 years; 7 were younger than 40 years, and 8 were 40 years or older. The mean spherical equivalent was -10.1 ± 5.41 D; 3 eyes had a pIOL power less than -10.50 D, 4 eyes between -10.50 D and -13.50 D, and 14 higher than -13.50 D. The mean time between pIOL implantation and cataract surgery was 4.2 ± 1.8 years. No eye with implantation of the latest models (V4b and V4c) developed cataract. The mean vault distance in eyes that developed cataracts was 103 ± 69 μm. CONCLUSIONS The incidence of cataract was low after pIOL implantation at the 6-year follow-up. The rate of cataract was higher in older patients and in those with high refractive errors. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- José F Alfonso
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain.
| | - Carlos Lisa
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Luis Fernández-Vega
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Dagoberto Almanzar
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Cari Pérez-Vives
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
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Zeng QY, Xie XL, Chen Q. Prevention and management of collagen copolymer phakic intraocular lens exchange: causes and surgical techniques. J Cataract Refract Surg 2015; 41:576-84. [PMID: 25804582 DOI: 10.1016/j.jcrs.2014.06.036] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/14/2014] [Accepted: 06/20/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze causes leading to explantation and exchange of Implantable Collamer Lens phakic intraocular lenses (pIOLs) and examine the surgical techniques of pIOL exchange. SETTING Wuhan Aier Eye Hospital, Wuhan, China. DESIGN Retrospective analysis of prospectively collected data. METHODS Different techniques were used to explant the pIOLs based on the amount of vaulting. Preoperative and postoperative data were collected to evaluate possible causes leading to pIOL exchange and the safety of pIOL exchange. RESULTS Of 616 myopic eyes with previous pIOL implantation, 16 eyes of 15 patients having pIOL exchange were reviewed. Eight surgeries (50%) were performed because of low vaulting (≤100 μm) and another 8 (50%) because of too high vaulting (≥1000 μm). The causes leading to low vaulting included increased crystalline lens thickness (≥4.0 mm), low anterior chamber depth (ACD) (<3.1 mm), and a too-small pIOL (<12.0 mm). The high vaulting was primarily the result of oversized white-to-white (WTW) measurements with Scheimpflug pachymetry (Pentacam) or the use of a digital caliper by an unskilled examiner and of ciliary body cysts. Six months after pIOL exchange, the vaulting ranged from 162 to 715 μm. No anterior subcapsular cataracts or other complications occurred during the observation period. CONCLUSIONS The main causes of abnormal vaulting and subsequent pIOL exchange included a thick crystalline lens, low ACD, too-small pIOL, WTW measurement error, and ciliary body cysts. Phakic IOL explantations were individually designed based on the vaulting to achieve proper safety and efficacy. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Qing-Yan Zeng
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China.
| | - Xiu-Li Xie
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China
| | - Qian Chen
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China
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Kann die implantierbare Collamer-Linse mit Aquaport eine Winkelblockproblematik sicher verhindern? Ophthalmologe 2015; 112:418-23. [DOI: 10.1007/s00347-015-3237-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Shi M, Jiang H, Ye Y, Chen B. Treatment of adults with accommodative esotropia using implantable collamer lenses. J Pediatr Ophthalmol Strabismus 2015; 52:31-6. [PMID: 25643368 DOI: 10.3928/01913913-20141230-05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 10/30/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of the implantation of an implantable collamer lens (ICL) for accommodative esotropia in adults. METHODS From May 2011 to May 2012, 3 adults with complete accommodative esotropia underwent ICL implantation with 12 months of follow-up. Inclusion criteria included having an appropriate anterior chamber depth and endothelial cell count, and hyperopia that was not typically responding well to corneal refractive surgery. Preoperative and postoperative visual acuity, refraction, eye position, corneal endothelial cell count, intraocular pressure, anterior chamber depth, and complications (intraoperative and postoperative) were observed. RESULTS Cycloplegic refraction changed from 6.04 ± 0.53 preoperatively to 0.41 ± 0.21 postoperatively (t = 38.9, P < .001). Before surgery, the average esotropia at near (without glasses) was 25 prism diopters (range: 20 to 30 prism diopters). After surgery, all patients achieved orthophoria or microesophoria. Postoperative uncorrected visual acuity at distance and near significantly increased (P < .05), best-corrected visual acuity at near did not change significantly (P = .36), and best-corrected visual acuity at distance improved significantly (P = .03). The average decline in corneal endothelium cell density was 10.3% and remained stable during the follow-up period. One patient complained of glare when driving at night after surgery and this phenomenon gradually disappeared after 3 months. No other intraoperative and postoperative complications, such as ICL-related iris depigmentation, atrophy, glaucoma, or cataracts (partial or complete), were observed. CONCLUSIONS The preliminary results of this small case study demonstrated that the use of ICL implantation to treat accommodative esotropia in adults was effective and safe; however, a larger scale study is necessary.
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Kang DW, Eom YS, Rhim JW, Kang SY, Kim HM, Song JS. Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.5.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dong Wan Kang
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Sub Eom
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jay Won Rhim
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Su Yeon Kang
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Benda F, Filipová L, Filipec M. Correction of moderate to high hyperopia with an implantable collamer lens: medium-term results. J Refract Surg 2014; 30:526-33. [PMID: 25325893 DOI: 10.3928/1081597x-20140711-05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/12/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the medium-term results of phakic posterior chamber implantable collamer lens implantation to correct moderate and high hyperopia. METHODS In this retrospective study, patients were treated for hyperopia with the Visian Implantable Collamer Lens (ICH model V3; STAAR Surgical AG, Nidau, Switzerland). Examined parameters were manifest refraction spherical equivalent, uncorrected distance visual acuity, corrected distance visual acuity, vault, anterior chamber depth, anterior chamber angle width, endothelial cell density, intraocular pressure, patient satisfaction, and complications. RESULTS The mean age of 15 patients (28 eyes) was 28 years (range: 18 to 36 years), with a mean follow-up period of 3.6 years (range: 3 to 6 years). The mean manifest refraction spherical equivalent decreased from +6.30 ± 1.42 diopters (D) (range: +4.25 to +8.50 D) preoperatively to -0.37 ± 0.56 D (range: -1.25 to +1.00 D) at 3 years postoperatively. The mean uncorrected distance visual acuity improved from 0.77 ± 0.38 logMAR (range: 0.16 to 1.30 logMAR) to 0.20 ± 0.17 logMAR (range: 0.00 to 0.48 logMAR) at the 3-year follow-up. Postoperatively, 62% of eyes gained one line of corrected distance visual acuity or remained unchanged. The mean vault reduced from 367.1 ± 253.6 μm (range: 70.0 to 1,190.0 μm) at 1 month postoperatively to 283.6 ± 210.0 μm (range: 75.0 to 915.0 μm) at the last follow-up visit (P = .005). The mean preoperative anterior chamber depth and anterior chamber angle width also decreased at the last follow-up visit (P = .037 and < .0001, respectively). The mean endothelial cell loss was 4.91% (P = .089). No serious complications occurred. Thirteen (87%) patients were satisfied with the outcomes and no patient was dissatisfied. CONCLUSIONS Implantation of a posterior chamber implantable collamer lens is a safe, effective, predictable, and stable method for the correction of moderate and high hyperopia in highly selected patients. No case of cataract or anterior subcapsular opacities formation was recorded in relation to the decrease of vault over the studied period and low vault in some eyes.
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Wang Q, Ding X, Savini G, Chen H, Feng Y, Pan C, Hua Y, Huang J. Anterior chamber depth measurements using Scheimpflug imaging and optical coherence tomography: repeatability, reproducibility, and agreement. J Cataract Refract Surg 2014; 41:178-85. [PMID: 25465212 DOI: 10.1016/j.jcrs.2014.04.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE To determine the repeatability, reproducibility, and agreement of anterior chamber depth (ACD) measurements obtained with 3 Scheimpflug cameras and an anterior segment optical coherence tomography (AS-OCT) device. SETTING Eye Hospital of Wenzhou Medical University, Zhejiang, China. DESIGN Observational cross-sectional study. METHODS Two observers took 3 consecutive measurements in healthy right eyes using each device to assess intraoperator repeatability. The mean values obtained at different sessions by the first operator were used to determine the intersession reproducibility. Three consecutive measurements obtained by the first operator at the first session were averaged and used to assess agreement. RESULTS The ACD measurements obtained by 2 observers in 71 eyes were highly repeatable using the 4 devices, with a test-retest repeatability of 0.04 to 0.07 mm for intraoperator repeatability. The interoperator and intersession reproducibility of ACD measurements were high, and the test-retest repeatability ranges of interoperator and intersession reproducibility were 0.06 to 0.07 mm and 0.05 to 0.08 mm, respectively. The ACD measurements of the 4 systems were sorted from the thickest to the thinnest (Galilei G2 > Visante > Sirius > Pentacam). The differences in the measurements were statistically significant except between the ACD measurements obtained by the Sirius device and the Visante device. However, good agreement with narrow 95% limits of agreement was found between these devices. CONCLUSIONS The 4 devices provided high intraoperator repeatability and interoperator and intersession reproducibility for ACD measurements. Good agreement in ACD measurements was found between the devices in healthy eyes. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Qinmei Wang
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Xixia Ding
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Giacomo Savini
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Hao Chen
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Yifan Feng
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Chao Pan
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Yanjun Hua
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Jinhai Huang
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy.
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Gu Y, Xie C, Tong J, Hong N, Shen Y. Pre-operative visual evaluation for implantable collamer lenses in highly myopic eyes. Clin Exp Optom 2014; 97:516-22. [PMID: 25143147 DOI: 10.1111/cxo.12199] [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: 02/10/2014] [Revised: 04/18/2014] [Accepted: 05/19/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate a clinical procedure based on trial rigid gas-permeable (RGP) contact lenses fitting to assess the real pre-operative visual acuity (VA) of highly myopic eyes undergoing surgery with an implantable collamer lens. METHODS Highly myopic eyes with a spectacle visual acuity (SVA) of 0.2 logMAR (6/9.6 Snellen) or worse were enrolled. A trial RGP contact lens with high dioptric power was fitted before collamer lens implantation. The trial contact lens residual refractive error was corrected by spectacle over-refraction to estimate contact lens VA (CLVA). The three-month post-operative uncorrected vision and visual acuities were also measured. The safety and efficacy indices of collamer lens implantation were calculated based on pre-operative SVA and CLVA, respectively. RESULTS The study enrolled 42 patients with 68 highly myopic eyes with a mean pre-operative spherical equivalent of -16.40 ± 4.43 D. The mean pre-operative SVA was 0.38 ± 0.19 logMAR. Pre-operative trial RGP contact lens fitting resulted in a significant improvement of VA (2.02 ± 1.05 lines), which was statistically insignificantly different from the VA with the implantable collamer lens (2.07 ± 0.8 lines). The safety index of collamer lens implantation was 1.70 ± 0.38 in reference to the pre-operative SVA but significantly decreased to 1.02 ± 0.17 in reference to CLVA. Similarly, the efficacy index of 1.17 ± 0.48 on SVA decreased to 0.71 ± 0.28 on CLVA. CONCLUSIONS Trial RGP contact lens fitting was found to indicate the potential implantable collamer lens VA more accurately than spectacle refraction. Consideration should be given to the use a trial RGP contact lens as part of the pre-operative work-up prior to collamer lens implantation in order to provide an assessment of the patient's potential post-operative VA.
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Affiliation(s)
- Yangshun Gu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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Mushawiahti M, Shaw A, Chiu D. Retinal detachment associated with posterior chamber phakic intraocular lens implantation. Clin Exp Optom 2014; 97:471-2. [PMID: 24898822 DOI: 10.1111/cxo.12153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 03/07/2014] [Indexed: 11/30/2022] Open
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Huseynova T, Ozaki S, Ishizuka T, Mita M, Tomita M. Comparative study of 2 types of implantable collamer lenses, 1 with and 1 without a central artificial hole. Am J Ophthalmol 2014; 157:1136-43. [PMID: 24503407 DOI: 10.1016/j.ajo.2014.01.032] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 01/27/2014] [Accepted: 01/28/2014] [Indexed: 01/30/2023]
Abstract
PURPOSE To compare the outcomes between implantable collamer lenses (ICLs), 1 with and 1 without a central artificial hole. DESIGN Comparative study. METHODS We included 65 eyes of 65 patients with refractive error in our study. The mean manifest refraction spherical equivalent (MRSE) was -9.32 ± 4.02 diopters (range, 6.75 to -16.50 diopters). We divided patients into 2 groups based on the type of ICL used, 1 for those without a central artificial hole (Group I, 21 eyes) and 1 for those with a hole (Group II, 44 eyes). The postoperative changes in visual acuity, endothelial cell density, MRSE, higher order aberrations readings, and objective scatter index between the 2 kinds of ICLs were compared. The follow-up period was 3 months. RESULTS There were no statistically significant differences in the postoperative changes in uncorrected distance visual acuity (P = 0.81), corrected distance visual acuity (P = 0.24), MRSE (P = 0.18), and endothelial cell density (P = 0.76) between the groups. Also, no difference in objective scatter index was found at 3 months (P = 0.32). None of the higher order aberrations readings showed any significant difference between the groups. CONCLUSION There were no significant differences between the outcomes of these ICLs, either with or without a central artificial hole.
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Abstract
PURPOSE OF REVIEW Treatment of hyperopia presents greater challenges than treatment of myopia for multiple reasons, including the fact that hyperopia tends to progress with age and becomes more symptomatic with the loss of accommodation. RECENT FINDINGS Despite these issues, surgeons have multiple options to treat hyperopia successfully. Modern laser vision correction has high success rates for most patients and performs acceptably in the presence of high hyperopia or high cylinder. Early studies combining excimer laser treatment with collagen cross-linking (CXL) suggest that this may improve refractive stability. Recent studies have also described femtosecond lenticule extraction and use of a solid-state laser in place of the excimer. In addition to cornea-based treatment, long-term studies of a hyperopic phakic intraocular lens have shown excellent visual outcomes and good safety. Cross-linking is increasingly being applied to the hyperopia that follows radial keratotomy. SUMMARY The established treatments for hyperopia continue to accumulate evidence supporting their safety and efficacy. The next step forward in treatment may arise from combining these treatments with CXL to stabilize the cornea long-term.
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Lin HJ, Wan L, Tsai FJ, Tsai YY, Chen LA, Tsai AL, Huang YC. Overnight orthokeratology is comparable with atropine in controlling myopia. BMC Ophthalmol 2014; 14:40. [PMID: 24685184 PMCID: PMC3994267 DOI: 10.1186/1471-2415-14-40] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 03/24/2014] [Indexed: 11/10/2022] Open
Abstract
Background Many efforts have been invested in slowing progression of myopia. Among the methods, atropine administration and orthokeratology (OK) are most widely used. This study analyzed the efficacy of atropine and OK lens in controlling myopia progression and elongation of axial length. Methods This retrospective study included 105 patients (210 eyes) who wore OK lenses and 105 patients (210 eyes) who applied 0.125% atropine every night during the 3 following period. Student t-test, linear regression analysis, repeated measure ANOVA, and Pearson’s correlation coefficient were used for statistical analysis. Results The change in axial length per year was 0.28 ± 0.08 mm, 0.30 ± 0.09 mm, and 0.27 ± 0.10 mm in the OK lens group, and 0.38 ± 0.09 mm, 0.37 ± 0.12 mm, and 0.36 ± 0.08 mm in the atropine group for years 1, 2, and 3, respectively. Linear regression analysis revealed an increase in myopia of 0.28 D and 0.34 D per year, and an increase in axial length of 0.28 mm and 0.37 mm per year in the OK lens and atropine groups, respectively. Repeated measure ANOVA showed significant differences in myopia (p = 0.001) and axial length (p < 0.001) between the atropine and OK lens groups; in astigmatism, there was no significant difference in these parameters (p = 0.320). Comparison of increases in axial length in relation to baseline myopia showed significant correlations both in the OK lens group (Pearson’s correlation coefficient, r = 0.259; p < 0.001) and atropine group (r = 0.169; p = 0.014). High myopia patients benefited more from both OK lenses and atropine than did low myopia patients. The correlation of baseline myopia and myopia progression was stronger in the OK lens group then in the atropine group. Conclusions OK lens is a useful method for controlling myopia progression even in high myopia patients.
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Affiliation(s)
| | | | | | | | | | | | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital, No, 2 Yuh Der Road, Taichung 404, Taiwan.
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Igarashi A, Shimizu K, Kamiya K. Eight-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia. Am J Ophthalmol 2014; 157:532-9.e1. [PMID: 24239774 DOI: 10.1016/j.ajo.2013.11.006] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/04/2013] [Accepted: 11/06/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the long-term clinical outcomes of Implantable Collamer Lens (Visian ICL; STAAR Surgical) implantation for moderate to high myopia. DESIGN Retrospective observational case series. METHODS This study evaluated 41 eyes of 41 patients with myopic refractive errors of -4.00 to -15.25 diopters (D) who underwent ICL implantation and routine postoperative examinations. Before surgery, and 1 and 6 months and 1, 4 and 8 years after surgery, we assessed the safety, efficacy, predictability, stability, and adverse events of the surgery. RESULTS The safety and efficacy indices were 1.13 ± 0.27 and 0.83 ± 0.36. At 8 years, 68.3% and 85.4% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of -0.32 ± 0.73 D occurred between 1 month and 8 years. The mean endothelial cell loss from preoperative levels was 6.2% at 8 years. Two eyes (4.9%) developed clinically significant symptomatic cataract during the follow-up period. Simultaneous lens extraction and phacoemulsification with IOL implantation was successfully performed in these 2 eyes. CONCLUSIONS According to our experience, ICL implantation was overall good in measures of safety, efficacy, predictability, and stability for the correction of moderate to high myopia during the 8-year observation period, suggesting its long-term viability as a surgical option for the treatment of such eyes.
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Affiliation(s)
- Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Pérez-Vives C, Ferrer-Blasco T, Madrid-Costa D, García-Lázaro S, Montés-Micó R. Visual quality comparison of conventional and Hole-Visian implantable collamer lens at different degrees of decentering. Br J Ophthalmol 2013; 98:59-64. [PMID: 24246374 DOI: 10.1136/bjophthalmol-2013-303787] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare the visual quality of implantable collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering. METHODS An adaptive optics visual simulator (crx1, Imagine Eyes, Orsay, France) was used to simulate the -3, -6 and -12 dioptres (D) conventional and Hole ICLs in three conditions: centred and decentred 0.3 and 0.6 mm. Visual acuity (VA) at high-contrast, medium-contrast and low-contrast and contrast sensitivity (CS) were measured in 15 observers for 3 and 4.5 mm pupils. RESULTS No statistically significant differences in VA and CS were found between conventional and Hole ICLs for any ICL powers and pupil sizes evaluated (p>0.05). Regarding the effect of the ICL decentration on visual performance, we did not find statistically significant differences in VA and CS between centred, 0.3 and 0.6 mm decentred (p>0.05). Moreover, the ICL decentration affected the same manner on the conventional and Hole ICLs. CONCLUSIONS The outcomes showed that conventional and Hole ICLs provided good and comparable visual performance for all powers and pupil sizes evaluated. Besides, ICL decentering affects the same manner both ICL models evaluated. The ICL decentering did not have any effect on the visual performance.
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Affiliation(s)
- Cari Pérez-Vives
- GIO, Optics Department, Faculty of Physics, University of Valencia, , Valencia, Spain
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Patryn EK, Vrijman V, Nieuwendaal CP, van der Meulen IJE, Mourits MP, Lapid-Gortzak R. Indications for and outcomes of tertiary referrals in refractive surgery. J Refract Surg 2013; 30:54-61. [PMID: 24168790 DOI: 10.3928/1081597x-20131023-05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 08/05/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To review the spectrum of disease, symptomatology, and management offered to patients referred for a second opinion after refractive surgery. METHODS A prospective cohort study was done on all patients referred from October 1, 2006, to September 30, 2011, to a tertiary eye clinic after refractive surgery of any kind (ie, corneal laser surgery, conductive keratoplasty, radial keratotomy, phakic implants, refractive lens exchanges, or any combination thereof). Data analysis was performed on all demographic and clinical aspects of this cohort, including the initial complaint, type of referral, number of complaints, procedure previously performed, diagnosis at our center, type of advice given, and rate and type of surgical intervention. RESULTS One hundred thirty-one eyes (69 patients) were included. Corneal refractive surgery was performed in 82% (108 eyes), and 11% (14 eyes) were seen after phakic intraocular lens (PIOL) implantation and 7% (9 eyes) after refractive lens exchange. The most common diagnoses were tear film dysfunction (30 eyes, 23%), residual refractive error (25 eyes, 19%), and cataract (20 eyes, 15%). Most patients (42 patients, 61%) were treated conservatively. In 27 patients (39%), 36 eyes (28%) were managed surgically. Severe visual loss was seen in 1 eye. CONCLUSIONS No major problems were found in most second opinions after refractive surgery referral. Dry eyes, small residual refractive error, or higher-order aberrations were the most common complaints. Surgical intervention was needed in 36 eyes (28%), almost half of which were cataract extractions. Severe visual loss was seen in 1 eye with a PIOL. There was no incidence of severe visual loss in keratorefractive and refractive lens exchange procedures.
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Pérez-Vives C, Domínguez-Vicent A, Ferrer-Blasco T, Madrid-Costa D, Montés-Micó R. Optical quality of hyperopic and myopic phakic intraocular lenses. Indian J Ophthalmol 2013; 62:437-41. [PMID: 24145572 PMCID: PMC4064218 DOI: 10.4103/0301-4738.119423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS To assess and compare the optical quality of the myopic and hyperopic implantable collamer lens (ICL) from its wavefront aberrations for different powers and pupil diameters. SETTINGS AND DESIGN Prospective study. MATERIAL AND METHODS The wavefront aberrations of two myopic (-3 and -6 diopters (D)) and two hyperopic V4b ICLs (+3 and +6D) were measured in vitro. To assess and compare the optical quality of different powers of ICLs, we analyzed the root mean square (RMS) of total higher order aberrations (HOAs), trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration at 3- and 4.5-mm pupil. In addition, the point spread functions (PSFs) of each ICL evaluated were calculated from the wavefront aberrations at 3- and 4.5-mm pupil. STATISTICAL ANALYSIS A Student's t-test for unpaired data was used for comparison between myopic and hyperopic ICLs. RESULTS Myopic ICLs showed negative spherical aberration, in contrast hyperopic ICLs showed positive spherical aberration, which increases when the ICL power increases, due to the innate optical properties of the lens. All ICLs evaluated had negligible amounts of other aberrations. We did not find statistical significant differences in any Zernike coefficient RMS values analyzed between myopic and hyperopic ICLs at 3- and 4.5-mm pupil (P > 0.05). CONCLUSIONS Myopic and hyperopic ICLs provide good and comparable optical quality for low to moderate refractive error. The ICLs evaluated showed values of wavefront aberrations clinically negligible to affect the visual quality after implantation.
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Affiliation(s)
- Cari Pérez-Vives
- Department of Optics, Faculty of Physics, University of Valencia, Valencia, Spain
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Collagen copolymer posterior chamber phakic intraocular lens for hyperopia correction: Three-year follow-up. J Cataract Refract Surg 2013; 39:1519-27. [DOI: 10.1016/j.jcrs.2013.04.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 04/05/2013] [Accepted: 04/10/2013] [Indexed: 11/17/2022]
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