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Doumazos S, Barlampa A, Kandarakis SA, Kanakis M, Kymionis G, Georgalas I, Petrou P. Prototype posterior chamber phakic IOL - 35 year follow up. Am J Ophthalmol Case Rep 2024; 35:102086. [PMID: 38933452 PMCID: PMC11200273 DOI: 10.1016/j.ajoc.2024.102086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/21/2024] [Accepted: 05/16/2024] [Indexed: 06/28/2024] Open
Abstract
Purpose To present a case involving a rarely seen prototype posterior chamber phakic IOL (PC-pIOL) in a highly myopic patient with bilateral cataract. Observations A 64-year-old male presented to our clinic with poor vision in both eyes. Clinical examination revealed bilateral mature cataract, phacodonesis as well as a PC-pIOL implanted 35 years ago to address his high myopia. The visual acuity (VA) was 20/200 in the right eye and no light perception in the left eye. PC-pIOL extraction as well as 23G pars plana vitrectomy (PPV) and fragmentation surgery was scheduled for the right eye. The left eye was treated conservatively. Successful extraction of the PC-pIOL was performed while it was easy to remove. It was a bow-tie shaped lens with a collar-stud-like button in the middle which extended anteriorly into the anterior chamber through the pupil. PPV with lens fragmentation was successful and the patient was left aphakic in order to avoid the placement of a zero diopter IOL. Final best corrected VA was 20/25 one month post-surgery. Conclusions and importance Removal of this rarely seen pIOL was performed without difficulty while excellent VA was achieved. Aphakia following complete vitrectomy represented a viable option in this case. Furthermore, we highlight the clinical manifestations associated with this IOL more than three decades after implantation.
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Affiliation(s)
- Spyridon Doumazos
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital of Athens, Greece
| | - Aikaterini Barlampa
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital of Athens, Greece
| | - Stylianos A. Kandarakis
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital of Athens, Greece
| | - Menelaos Kanakis
- Department of Ophthalmology, University of Patras, University Hospital of Patras, Greece
| | - George Kymionis
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital of Athens, Greece
| | - Ilias Georgalas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital of Athens, Greece
| | - Petros Petrou
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital of Athens, Greece
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Zeng Z, Zhu M, Zhang G. Accuracy of intraocular lens calculation formulas based on swept-source OCT biometer in cataract patients with phakic intraocular lens. BMC Ophthalmol 2024; 24:326. [PMID: 39103785 DOI: 10.1186/s12886-024-03605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024] Open
Abstract
PURPOSE To research the accuracy of intraocular lens (IOL) calculation formulas and investigate the effect of anterior chamber depth (ACD) and lens thickness (LT) measured by swept-source optical coherence tomography biometer (IOLMaster 700) in patients with posterior chamber phakic IOL (PC-pIOL). METHODS Retrospective case series. The IOLMaster 700 biometer was used to measure axial length (AL) and anterior segment parameters. The traditional formulas (SRK/T, Holladay 1 and Haigis) with or without Wang-Koch (WK) AL adjustment, and new-generation formulas (Barret Universal II [BUII], Emmetropia Verifying Optical [EVO] v2.0, Kane, Pearl-DGS) were utilized in IOL power calculation. RESULTS This study enrolled 24 eyes of 24 patients undergoing combined PC-pIOL removal and cataract surgery at Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China. The median absolute prediction error in ascending order was EVO 2.0 (0.33), Kane (0.35), SRK/T-WKmodified (0.42), Holladay 1-WKmodified (0.44), Haigis-WKC1 (0.46), Pearl-DGS (0.47), BUII (0.58), Haigis (0.75), SRK/T (0.79), and Holladay 1 (1.32). The root-mean-square absolute error in ascending order was Haigis-WKC1 (0.591), Holladay 1-WKmodified (0.622), SRK/T-WKmodified (0.623), EVO (0.673), Kane (0.678), Pearl-DGS (0.753), BUII (0.863), Haigis (1.061), SRK/T (1.188), and Holladay 1 (1.513). A detailed analysis of ACD and LT measurement error revealed negligible impact on refractive outcomes in BUII and EVO 2.0 when these parameters were incorporated or omitted in the formula calculation. CONCLUSION The Kane, EVO 2.0, and traditional formulas with WK AL adjustment displayed high prediction accuracy. Furthermore, the ACD and LT measurement error does not exert a significant influence on the accuracy of IOL power calculation formulas in highly myopic eyes implanted with PC-pIOL.
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Affiliation(s)
- Zongsheng Zeng
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Meiyi Zhu
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Guangbin Zhang
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China.
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China.
- Fujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China.
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China.
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Zhang J, Chen F, Han X, Qiu X, Liu Z, Chen X, Jin G, Qu B, Yao H, Ye Y, Yu K, Tan X, Luo L. Vault Height Is a Key Predictive Factor for Anterior Segment Measurement Error by IOLMaster 700 in Eyes With Phakic Intraocular Lens. Transl Vis Sci Technol 2023; 12:16. [PMID: 37738056 PMCID: PMC10519433 DOI: 10.1167/tvst.12.9.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose To identify risk factors of ocular anterior segment measurement error by the IOLMaster 700 in eyes implanted with an implantable Collamer lens (ICL). Methods In total, 152 patients with clear lens (152 eyes, group 1) and another 32 cataract patients (57 eyes, group 2) who underwent ICL implantation were included, and the presence of measurement error by the IOLMaster 700 was determined based on B-scan images. The risk factors for measurement error were evaluated by logistic regression, and the optimal threshold was determined using receiver operating characteristic analysis. Results The ICL was misidentified as the anterior surface of the crystalline lens in 51.97% of eyes (79/152) in group 1 and 80.70% of eyes (46/57) in group 2. For every 100-µm decrease in the vault height, a 3.57- and 5.78-fold increase in the risk of measurement error was observed in group 1 and group 2, respectively. We identified an optimal threshold of the vault height at 389.47 µm for predicting biometric measurement error in eyes implanted with ICL, which showed an area under the curve of 0.93 (95% confidence interval, 0.90-0.97), a sensitivity of 0.87, and a specificity of 0.86. Conclusions Patients with ICL implantation, particularly those with a vault height less than 389.47 µm, are at a greater risk of anterior segment biometric measurement error by the IOLMaster 700. Translational Relevance The threshold of vault height can help to identify high-risk patients and further optimize biometric measurement.
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Affiliation(s)
- Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaozhang Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Bo Qu
- Peking University Third Hospital, Peking, China
| | - Huan Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yiming Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Zhang T, Huang F, Gao N, Du M, Cheng H, Huang W, Ji Y, Zheng S, Wan W, Hu K. Three-Dimensional Quantitative Description of the Implantable Collamer Lens in the Ocular Anterior Segment of Patients With Myopia. Am J Ophthalmol 2023; 252:59-68. [PMID: 36933857 DOI: 10.1016/j.ajo.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE To describe the 3-dimensional (3D) location of the implantable collamer lens (ICL) quantitatively in the posterior ocular chamber of patients with myopia. DESIGN Cross-sectional study. METHODS To obtain visualization models before and after mydriasis, an automatic 3D imaging method based on swept-source optical coherence tomography was created. Parameters like the ICL lens volume (ILV), the tilt of the ICL and crystalline lens, the vault distribution index, and topographic maps were evaluated to describe the ICL location. Using a paired sample t test and the Wilcoxon signed rank test, the difference between nonmydriasis and postmydriasis conditions was compared. RESULTS The study investigated 32 eyes from 20 patients. The 3D central vault did not differ significantly before (P = .994) or after mydriasis (P = .549) compared with the 2D central vault. After mydriasis, the 5-mm ILV decreased by 0.85 mm2 (P = .016), and the vault distribution index increased significantly (P = .001). The ICL and the crystalline lens exhibited tilt (nonmydriasis: ICL total tilt 3.78 ± 1.85 degrees, lens total tilt 4.03 ± 1.53 degrees; postmydriasis: ICL total tilt 3.84 ± 1.56 degrees, lens total tilt 4.09 ± 1.64 degrees). The phenomenon of asynchronous tilt of the ICL and lens was found in 5 eyes, leading to the spatially asymmetric distribution of the ICL-lens distance. CONCLUSION The 3D imaging technique provided exhaustive and reliable data for the anterior segment. The visualization models offered multiple perspectives on the ICL in the posterior chamber. Before and after mydriasis, the intraocular ICL position was described by the 3D parameters.
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Affiliation(s)
- Tong Zhang
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Fanfan Huang
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Ning Gao
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Miaomiao Du
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Hong Cheng
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Wanyao Huang
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Yan Ji
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Shijie Zheng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Wenjuan Wan
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China.; The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China..
| | - Ke Hu
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China.; The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China..
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Brar S, Wadhokar ST, Sriganesh SS, Sriganesh. Comparison of Dynamic Vault Changes Following Implantation of Two Different Models of Phakic Intraocular Lenses. J Refract Surg 2023; 39:546-554. [PMID: 37578182 DOI: 10.3928/1081597x-20230626-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE To compare the dynamic vault range (the difference in the central vault height from scotopic to photopic light condition) after implantation of the ICL/TICL (STAAR Surgical) and Eyecryl phakic/Eyecryl phakic toric intraocular lens (IOL) (Biotech Healthcare). METHODS This retrospective study included patients with myopia or myopic astigmatism eligible for phakic IOL implantation with either the ICL/TICL or Eyecryl phakic/Eyecryl phakic toric IOL. Vault changes in varying light conditions (scotopic, mesopic, and photopic) were assessed using an anterior segment optical coherence tomography-based tomographer and dynamic vault range (DVR) was compared between the two groups. RESULTS A total of 60 eyes from 36 patients (30 eyes in each group) with a mean age of 28.63 ± 6.36 years were included. The mean postoperative follow-up at the time of assessment was 9.4 ± 5.3 and 8.9 ± 5.28 months (P = .75) in the ICL and Eyecryl groups, respectively. The mean values of scotopic, mesopic, and photopic vault were 490.56 ± 238.64, 453.56 ± 224.30, and 373.96 ± 200.24 μm in the ICL group and 515.46 ± 174.34, 490.26 ± 184.04, 450.43 ± 173.92 μm in the Eyecryl group (P = .32, .24, and .05, respectively). The DVR was 116.6 ± 59.29 μm in the ICL group versus 65.03 ± 31.78 μm in the Eyecryl group (P < .001). CONCLUSIONS The Eyecryl phakic IOL showed significantly fewer light-induced changes in the central vault height (DVR) compared to the ICL, which may be attributed to the difference in the material of the two phakic IOL models. This may be clinically significant in eyes with low postoperative vaults with respect to their follow-up and risk assessment of cataractogenesis in the long term. [J Refract Surg. 2023;39(8):546-554.].
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Sánchez-Trancón A, Manito SC, Sierra OT, Baptista AM, Serra PM. Prediction model of the horizontal trabecular iris angle after phakic posterior chamber implantable intraocular lens surgery. J Cataract Refract Surg 2023; 49:732-739. [PMID: 36807205 DOI: 10.1097/j.jcrs.0000000000001171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To determine the predictors of the postoperative horizontal trabecular iris angle (TIA 750 ) after phakic posterior chamber implantable intraocular lens (IOL) surgery. SETTING Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain. DESIGN Retrospective case series. METHODS 330 eyes implanted with spherical/toric implantable collamer lens (ICL) were included in this study. From 230 eyes implanted with 13.2 mm ICL, these were divided in modeling (n = 180) and evaluation group (n = 50). Two groups implanted with 12.6 mm and 13.7 mm (n = 50 each) were also used as evaluation. Anterior-segment optical coherence tomography was used preoperatively to perform anterior chamber biometry (angle-to-angle [ATA] distance, crystalline lens rise, anterior chamber depth [ACD], cornea sagittal depth, pupil diameter, nasal/temporal TIA 750 ); postoperatively for measuring the vault, pupil diameter and nasal/temporal TIA 750 . Corneal curvature and horizontal visible iris diameter were measured using optical tomography. Bivariate correlation analysis was used to determine associations between preoperative and postoperative horizontal TIA 750 with anterior chamber biometry, ICL-related parameters and age. Finally, a multivariate linear regression model was constructed for predicting the postoperative TIA 750 . RESULTS Horizontal TIA 750 reduced from 42.9 ± 8.0 degrees preoperatively to 24.4 ± 5.6 degrees postoperatively. Postoperative TIA 750 was positively correlated with the preoperative TIA 750 , cornea sagittal depth and ACD, and negatively associated with the vault. The main predictors of the postoperative TIA 750 were the preoperative parameters, TIA 750 , ICLsize - ATA and pupil diameter (adjusted- R2 = 0.39). The limits of agreement between predicted and real TIA 750 were close to ±10 degrees. CONCLUSIONS Implantation of a phakic posterior chamber implantable IOL leads to a reduction in TIA 750 and the main factors contributing for this are the preoperative TIA 750 aperture and the vault.
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Affiliation(s)
- Angel Sánchez-Trancón
- From the Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain (Sánchez-Trancón, Manito, Sierra, Serra); Centre of Physics, University of Minho, Braga, Portugal (Baptista)
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Kim T, Kim SJ, Lee BY, Cho HJ, Sa BG, Ryu IH, Kim JK, Lee IS, Han E, Kim H, Yoo TK. Development of an implantable collamer lens sizing model: a retrospective study using ANTERION swept-source optical coherence tomography and a literature review. BMC Ophthalmol 2023; 23:59. [PMID: 36765328 PMCID: PMC9921691 DOI: 10.1186/s12886-023-02814-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Optimal sizing for phakic intraocular lens (EVO-ICL with KS-AquaPort) implantation plays an important role in preventing postoperative complications. We aimed to formulate optimal lens sizing using ocular biometric parameters measured with a Heidelberg anterior segment optical coherence tomography (AS-OCT) device. METHODS We retrospectively analyzed 892 eyes of 471 healthy subjects treated with an intraocular collamer lens (ICL) and assigned them to either the development (80%) or validation (20%) set. We built vault prediction models using the development set via classic linear regression methods as well as partial least squares and least absolute shrinkage and selection operator (LASSO) regression techniques. We evaluated prediction abilities based on the Bayesian information criterion (BIC) to select the best prediction model. The performance was measured using Pearson's correlation coefficient and the mean squared error (MAE) between the achieved and predicted results. RESULTS Measurements of aqueous depth (AQD), anterior chamber volume, anterior chamber angle (ACA) distance, spur-to-spur distance, crystalline lens thickness (LT), and white-to-white distance from ANTERION were highly associated with the ICL vault. The LASSO model using the AQD, ACA distance, and LT showed the best BIC results for postoperative ICL vault prediction. In the validation dataset, the LASSO model showed the strongest correlation (r = 0.582, P < 0.001) and the lowest MAE (104.7 μm). CONCLUSION This is the first study to develop a postoperative ICL vault prediction and lens-sizing model based on the ANTERION. As the measurements from ANTERION and other AS-OCT devices are not interchangeable, ANTERION may be used for optimal ICL sizing using our formula. Because our model was developed based on the East Asian population, further studies are needed to explore the role of this prediction model in different populations.
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Affiliation(s)
| | | | | | | | | | - Ik Hee Ryu
- VISUWORKS, Seoul, South Korea ,Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea
| | - Jin Kuk Kim
- VISUWORKS, Seoul, South Korea ,Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea
| | - Eoksoo Han
- grid.36303.350000 0000 9148 4899Electronics and Telecommunications Research Institute (ETRI), Daejeon, South Korea
| | | | - Tae Keun Yoo
- VISUWORKS, Seoul, South Korea. .,Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea.
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Evaluation of the Effects of Multifocal Intraocular Lens Oculentis LENTIS Mplus LS-313 MF30 on Visual Performance in Patients Affected by Bilateral Cataract and Treated with Phacoemulsification. J Ophthalmol 2022; 2022:1315480. [PMID: 36081654 PMCID: PMC9448589 DOI: 10.1155/2022/1315480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
Background The purpose of this study was to evaluate the visual results and patients' satisfaction with surgical treatment of phacoemulsification and implantation of the innovative intraocular multifocal lens (MFIOL) Oculentis LENTIS Mplus MF30 in patients with bilateral cataracts. Materials and Methods A single-center prospective observational study was conducted on a total of 20 patients with bilateral cataracts. We evaluated the monocular UCVA and BCVA at 1 day, 7 days, 1 month, 3 months, and 6 months at different distances after phacoemulsification and MFIOL implantation and the binocular UCVA at the same distances. We also assessed the frequency of visual disturbances, overall visual satisfaction, spectacles dependence, and ease of performing different daily activities. Results The MFIOL Mplus MF30 was able to significantly improve the monocular UCVA and BCVA at all working distances. Overall visual satisfaction was above 9/10 in all postoperative observation intervals. The degree of independence from spectacles at all distances was 100%. The frequency of adverse visual phenomena was minimal. Conclusions In accordance with the literature, the Oculentis LENTIS Mplus MF30 has proved to be a valid therapeutic alternative for visual rehabilitation after phacoemulsification of the cataract in patients also wishing to treat presbyopia, at the cost of very few visual adverse effects. Trials Registration. This trial is registered with ISRCTN20862627.
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10
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Liu D, Tang J, Shen L, Liu S, Zhu S, Wen S, Lin Q. Foldable Bulk Anti-adhesive Polyacrylic Intraocular Lens Material Design and Fabrication for Posterior Capsule Opacification Prevention. Biomacromolecules 2022; 23:1581-1591. [PMID: 35271252 DOI: 10.1021/acs.biomac.1c01388] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Posterior capsular opacification (PCO) is a primary complication after phacoemulsification combined with intraocular lens (IOL) implantation, which is attributed to adhesion, proliferation, and migration of residual lens epithelial cells on IOL. Although surface hydrophilic coating is considered to be a powerful way to inhibit PCO incidence after surgery, it requires complex post-production processes, thus limiting their applicability. In comparison, bulk modification is a stable, effective, and facile IOL synthesis method for PCO prevention. Herein, a new anti-adhesive IOL material was designed and successfully synthesized by radical copolymerization of ethylene glycol phenyl ether methacrylate (EGPEMA) and 2-(2-ethoxyethoxy) ethyl acrylate (EA). The physicochemical properties of P(EGPEMA-co-EA) copolymer materials, including chemical structure, mechanical, thermal, surface, and optical properties, were analyzed by using 1H NMR spectroscopy, FT-IR spectroscopy, tensile test, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), water contact angle measurement, and UV-vis spectroscopy. The elongation at break and the modulus of elasticity of the copolymer were tunable through the change of the composition of monomers. Compared to other components, the tensile results showed that P(EGPEMA-co-EA) materials (70% EGPEMA in mass ratio, F7) are suitable for the preparation of foldable intraocular lens with lower elastic modulus and higher elongation at break. TGA and DSC showed that the material has high thermal stability, and the glass transition temperature of F7 material is 16.1 °C. The water contact angle measurement results showed that the introduction of EA improved the hydrophilicity of the material. The percentage of transmittance of all copolymers at 400-800 nm is above 85%. Then, the biocompatibility of the materials was evaluated by in vitro assay and subcutaneous implantation. Both in vitro results and subcutaneous implantation experiments showed that the designed IOL materials exhibited a good anti-adhesion effect and no cytotoxicity. Finally, phacoemulsification and IOL intraocular implantation were performed, and the in vivo results confirmed the good PCO prevention ability as well as the biocompatibility of the new IOL materials.
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Affiliation(s)
- Dong Liu
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
| | - Junmei Tang
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
| | - Liangliang Shen
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
| | - Sihao Liu
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
| | - Siqing Zhu
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
| | - Shimin Wen
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
| | - Quankui Lin
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, P. R. China
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11
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Teplovodskaya VV, Sobolev NP, Morina NA, Zhuravlev AS, Sudakova EP. [Correction of ametropia with posterior chamber phakic intraocular lens]. Vestn Oftalmol 2022; 138:64-70. [PMID: 35234423 DOI: 10.17116/oftalma202213801164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Posterior chamber phakic intraocular lens (PIOL) implantation is a widely accepted and performed refractive surgery for correction of moderate and high myopia used when corneal laser ablation procedures are not suitable. This paper analyzes literature data to reveal the advantages and limitations of the technology.
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Affiliation(s)
- V V Teplovodskaya
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N P Sobolev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N A Morina
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A S Zhuravlev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - E P Sudakova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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12
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Phakic intraocular lens explantation: a series of 175 surgeries. J Cataract Refract Surg 2022; 48:1004-1009. [PMID: 35239580 DOI: 10.1097/j.jcrs.0000000000000920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The ideal timing for phakic intraocular lens (pIOL) explantation remains unknown. Our study aims to evaluate the indications for pIOL explantation, pIOL survival time, visual outcomes, and access endothelial cell loss (ECL) after explantation. SETTING Ophthalmology Department, Centro Hospitalar Universitário do Porto, Portugal. Design: Retrospective longitudinal study. METHODS Chart review was performed for all consecutive patients that underwent pIOL explantation from January 2010 to December 2019 in a single center. RESULTS This study included 175 eyes of 112 patients, 77% of which were female. Phakic IOL survival was 12.9 ± 4.8 [3.7 - 28.6] years and the follow-up period after explantation was 4.1 ± 3.0 [0.3 - 9.9] years. The most frequent causes for explantation were cataract formation (44.0%, n=77) and ECL (50.3%, n=88). During the follow-up period after explantation, mean ECL rate was 2.27 ± 9.32 %/year in the cataract group and -2.14 ± 10.24 %/year in the ECL group, reflecting a positive change in cell density in the latter. Eight eyes (4.6%) required a corneal transplant during the follow-up. Mean corrected distance visual acuity was 0.17 ± 0.24 logMAR at the last visit. CONCLUSION Our study demonstrates that pIOL explantation, after an average survival time of 13 years, is a safe procedure. The main causes for explantation were cataract formation and ECL. Most patients show a sustained improvement in visual acuity and endothelial cell density after pIOL explantation, and yet its timing should be ideal to avoid irreversible complications.
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Nemcova I, Pasta J, Hladikova K, Komarc M, Pospisilova D, Nemec P, Tesar J, Kratky V, Sin M. Myopic Correction with Iris-Fixated Phakic Intraocular Lenses: Twelve-Year Results. J Ophthalmol 2021; 2021:7027793. [PMID: 34659825 PMCID: PMC8516571 DOI: 10.1155/2021/7027793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate a 12-year follow-up of myopic patients after iris-fixated phakic intraocular lenses (IF pIOLs) implantation. Setting. Ophthalmology Department, Military University Hospital in Prague (Czech Republic). DESIGN Single-center retrospective cohort study. METHODS We describe the results of a cohort study that included 85 eyes of 46 myopic patients who underwent implantation of Verisyse myopia, Veriflex, and Verisyse myopia toric (all Abbott Medical Optics, Inc.) intraocular lenses. Refractive functions and adverse events were assessed preoperatively, at 6 months, and 1, 2, 5, and 12 years after IF pIOL implantation. RESULTS Mean spherical equivalent was measured as -9.37 ± 2.87 D, 0.14 ± 0.61 D, and -0.42 ± 1.08 D, preoperatively, at 6 months and 12 years postoperatively, respectively. There was a significant reduction in the cylinder after surgery. At 12 years postoperatively, 90% of eyes had uncorrected distance visual acuity (UDVA) of 20/40 and 64% of 20/20. The safety index was 1.10 for the whole postoperative follow-up period. We found cataract formation in 3 eyes (3.5%). The endothelial cells loss (EC loss) directly caused by IF pIOL implantation was 6.0%, 8.10%, 12.8%, and 11.9%, at 1, 2, 5, and 12 years, respectively. In our cohort, 95% of eyes lost a higher percentage of EC than would be expected from a physiological loss at 12 years postoperatively. We found a significant negative interaction between preoperative pachymetry and EC loss, indicating that the lower pachymetry leads to a faster decline in endothelial cells density (ECD). IF pIOL re-enclavation was found in 28% of eyes. 7% of subluxations were caused by trauma. The mean time of nontraumatic re-enclavation was 6 years postoperatively. CONCLUSIONS The study confirmed the advantages of IF pIOL implantation due to rapid visual recovery and stable visual function over the 12-year follow-up and also showed the influence of lower corneal pachymetry regarding EC loss.
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Affiliation(s)
- Iveta Nemcova
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Jiri Pasta
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Katerina Hladikova
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Martin Komarc
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Darina Pospisilova
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
| | - Pavel Nemec
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Jan Tesar
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Vladimir Kratky
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
- Health Sciences Centre, Queen's University, Kingston, Canada
| | - Martin Sin
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
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Prediction of the trabecular iris angle after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg 2021; 48:604-610. [PMID: 34486579 DOI: 10.1097/j.jcrs.0000000000000804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To create an equation for predicting the trabecular iris angle (TIA) and to verify its accuracy after implantable collamer lens (ICL) implantation. SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Retrospective evaluation of a screening approach. METHODS The subjects included 174 eyes (174 patients) that underwent ICL implantation. Patients were randomly assigned to the prediction equation group (116 eyes) or verification group (58 eyes). Anterior segment optical coherence tomography (AS-OCT; CASIA2 TOMEY) was performed before and 3 months after ICL surgery. For the prediction group, a prediction equation was created with the preoperative AS-OCT parameters and ICL size as independent variables and the postoperative anterior chamber depth (ACD) as dependent variables. Then, by applying the predicted post-ACD and preoperative AS-OCT parameters as independent variables and TIA after ICL surgery as the dependent variable, a prediction equation was created to predict the postoperative TIA (post-TIA) after ICL surgery. Each prediction equation was created using stepwise multiple regression analysis, and its accuracy was verified by a Bland-Altman plot in the verification group. RESULTS The explanatory variables (standardized partial regression coefficient) selected in the post-TIA prediction equation were post-ACD (0.629), TIA750 (0.563), iris curvature (0.353), pupil diameter (-0.281), iris area (-0.249), and trabecular iris space area 250 (-0.171) (R2 = 0.646). There were no clinically significant systematic errors between measured and predictive post-TIA values in the verification group. The average absolute prediction error was 3.43° ± 2.22°. CONCLUSIONS Post-TIA can be accurately predicted from the predicted post-ACD and other preoperative AS-OCT parameters.
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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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Cakir I, Demir G, Yildiz BK, Öcal MC, Yildirim Y, Agca A. Efficacy and safety of iris-supported phakic lenses (Verisyse) for the treatment of high myopia: 5-year results. Int Ophthalmol 2021; 41:2837-2845. [PMID: 33864187 DOI: 10.1007/s10792-021-01841-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/01/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Evaluating efficacy and safety of iris-supported phakic lenses (Verisyse) for high myopia treatment. METHODS Patients treated with Verisyse (Abbott Medical Optics, Santa Ana, CA, USA) intraocular lens (IOL) implants were evaluated retrospectively. Patients with follow-up periods of more than 5 years were included in the study. Pre- and postoperative fifth-year spheric equivalent (SE) of manifest refraction values, uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), and endothelial cell density (ECD) values were recorded. Complications were evaluated. RESULTS Forty-seven eyes of 31 patients were included in the study. Pre- and postoperative fifth year mean SE was - 12.50 ± 3.51D and - 0.72 ± 0.40D, respectively. Pre- and postoperative fifth-year UDVA was 1.56 ± 0.22 and 0.33 ± 0.18 logMAR (p < 0.001), respectively. The safety index (pre- and postoperative CDVA) was 1.39 ± 0.63 at the 5-year follow-up (p > 0,05). The efficacy index (ratio of mean postoperative UDVA to mean preoperative CDVA) of the patients was 1.14 ± 0.60. The mean postoperative endothelial cell loss at 5 years was -7.42%. None of the patients had lost 25% of their preoperative endothelial cells at 5-year follow-up. The mean postoperative endothelial cell loss was -3.05% at 1 year, -1.23% between years one and three, -1.02% between the third and fifth years. CONCLUSION Verisyse IOL implantation is an effective and safe for high myopia surgical treatment. However, the 5-year follow-up period is not sufficient to evaluate the safety profiles in terms of endothelial cells.
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Affiliation(s)
- Ihsan Cakir
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey.
| | - Gökhan Demir
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Burcin Kepez Yildiz
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Mevlüt Celal Öcal
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Yusuf Yildirim
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Alper Agca
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
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Middle- and long-term results after iris-fixated phakic intraocular lens implantation in myopic and hyperopic patients: a meta-analysis. J Cataract Refract Surg 2021; 46:125-137. [PMID: 32050242 DOI: 10.1097/j.jcrs.0000000000000002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The iris-fixated phakic intraocular lens (pIOL) has been available for over 25 years. To provide a clear picture of outcomes and risks, for this systematic review and meta-analysis, the literature was searched for reports on middle- and long-term effects. The iris-fixated phakic intraocular lens (pIOL) has been available for over 25 years. To provide a clear picture of outcomes and risks, for this systematic review and meta-analysis, the literature was searched for reports on middle- and long-term effects of iris-fixated pIOLs on myopic and hyperopic eyes with a follow-up of at least 2 to 4 years. Visual and refractive results after implantation for correction of myopia are positive and the complication rate is low. Endothelial cell loss appears to be at an acceptable rate, although the range of endothelial cell change is too wide to draw firm conclusions. Care should be taken when considering an iris-fixated pIOL for hyperopic eyes because complication rates, particularly pigment dispersion, might be higher than those in myopic eyes. More well-designed, long-term studies are needed, especially in hyperopic eyes. The authors advocate for standardized reporting of refractive surgery data. Initiatives proposed by journal authors and editors to achieve uniformity should be supported.
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Oleszko AA, Marek JJ, Muzyka‐woźniak MM. Horizontal and anterior chamber diameter for phakic intraocular lens sizing. Clin Exp Optom 2021; 104:62-68. [DOI: 10.1111/cxo.13101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Baptista PM, Monteiro S, Abreu AC, Poças J, José D, Lume M, Pinto MDC. Visian ® ICLV4c™ and Artiflex ®: Comparative Analysis with the HD Analyser TM and Integration with Subjective Performance and Anatomical Parameters. Clin Ophthalmol 2020; 14:4541-4549. [PMID: 33408456 PMCID: PMC7779300 DOI: 10.2147/opth.s290611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/08/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze and compare the mid-term objective and subjective performance of two phakic intraocular lenses (PIOLs) – Visian® ICL™ V4c and Artiflex® and to correlate those results with anatomical parameters. Patients and Methods Observational retrospective study including thirty patients (15 for each PIOL) randomly selected from those who underwent bilateral implantation of one of the PIOLs (60 eyes were analysed). Uncorrected and corrected distance visual acuities (UDVA and CDVA), anterior chamber structural parameters, and corneal endothelial cells density and morphology were evaluated. Quality of vision was assessed both subjectively with a questionnaire, and objectively using a double-pass technology optical quality analysis system. Results At the end of follow-up the Artiflex® group showed better UDVA (0.95±0.11 vs 0.99±0.05, p=0.027) and higher proportion of eyes reaching at least 20/20 (28/30 vs 18/30, p=0.005). Excellent and similar objective scatter index (1.79±0.9 vs 2.14±1.6, p=0.306) and modular transfer function cutoff frequency (26.91±9.2 vs 26.51±11.9, p=0.784) results were achieved in the HD Analyzer® and the questionnaire showed comparable high Satisfaction (55.7±3.5 vs 54.3±5.4, p=0.386) and low Dysphotopsia Scores (3.1±1.8 vs 2.1±2.2, p=0.213). The ICL group showed inferior anterior chamber volume (p<0.001), and angle (p<0.001) and superior pupillary diameter (p=0.007). Minimum follow-up was 24 months. Conclusion Both the Visian® ICLV4c™ and the Artiflex® showed excellent optical performance through the HD AnalyzerTM technology, translated in high patient satisfaction. Overall, both PIOLs showed similar safety, predictability, stability and effectiveness of for the reduction of high sphero-cylindrical refractive errors, despite better UDVA results with the Artiflex®.
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Affiliation(s)
- Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
| | - Sílvia Monteiro
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Carolina Abreu
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Poças
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Diana José
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Lume
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Maria do Céu Pinto
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
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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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21
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Explantation of phakic intraocular lenses: causes and outcomes. Int Ophthalmol 2020; 41:265-271. [PMID: 32915392 DOI: 10.1007/s10792-020-01578-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To describe reasons for explantation of anterior and posterior chamber phakic intraocular lenses (pIOLs), as well as outcomes of the surgery. METHODS The medical files of patients who underwent pIOL explantation due to complications were reviewed. All patients were divided into three groups based on the type of explanted pIOL: anterior chamber angle-supported (AS pIOL), anterior chamber iris-fixated (IF pIOL), and posterior chamber (PC pIOL). RESULTS Sixty-two eyes of 41 patients were evaluated. There were 26 (41.9%), 16 (25.8%), and 20 (32.2%) eyes in the AS pIOL, IF pIOL, and PC pIOL groups, respectively. The mean interval between the implantation and removal of the pIOL (i.e., survival time) was 13.6 ± 8.1 years (range 0.01-21.22 years). The mean follow-up after the explantation was 22.5 ± 4.0 months (range 11.3-28.7 months). The main causes of explantation were cataract in the PC pIOL group (60%) and chronic endothelial cell loss in the AS pIOL group (53.8%) and IF pIOL group (56.2%). Overall, the procedure most often combined with pIOL explantation was phacoemulsification and implantation of a posterior chamber IOL (40.3%), followed by keratoplasty (9.6%). Intraoperative complications were significantly more common in the AS pIOL group than the other groups (p < 0.001). CONCLUSIONS Explantation of anterior chamber pIOLs due to severe endothelial cell loss and the proportion of keratoplasty was more common in patients with a relatively long survival time. Therefore, patients with pIOL implantation should be monitored regularly after surgery.
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Vargas V, Marinho A, El Sayyad F, Alio Del Barrio JL, Alio JL. Safety and visual outcomes following Iris-claw phakic intraocular lens bilensectomy. Eur J Ophthalmol 2020; 31:1795-1801. [PMID: 32715788 DOI: 10.1177/1120672120944033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the visual outcomes, safety, efficacy, and causes of bilensectomy for iris fixated phakic intraocular lenses (pIOLs). METHODS This was a two center consecutive retrospective study that included 43 eyes that underwent iris-claw pIOL bilensectomy. Patients with follow up less than 4 months were excluded from the study. Uncorrected, corrected visual acuity (UCVA, CDVA), refractive outcomes, efficacy, safety (number of eyes in which the postoperative CDVA was worse than the preoperative CDVA), endothelial cell density (ECD), causes of bilensectomy, the time between the implantation of the pIOL and bilensectomy, intra and postoperative complications were analyzed. RESULTS There was a statistically significant improvement in UCVA and CDVA after surgery (p = 0.001). The efficacy index was 0.7, four eyes had a postoperative CDVA worse than the preoperative CDVA. The mean spherical equivalent 1 year after bilensectomy was -0.78 ± 1.70 D. There was a statistically significant endothelial cell loss after iris claw lens bilensectomy (p = .003). Cataract development and endothelial cell loss were the only reasons for bilensectomy. The mean time between pIOL implantation and bilensectomy was 12.2 ± 5.5 years. One patient had corneal edema 8 months after surgery and one had a retinal detachment 11 months after surgery. CONCLUSION Bilensectomy was successful in improving UCVA and CDVA with an acceptable refractive outcome. Significant loss of ECD was found after surgery. The results recommend a larger ACD as selection criteria when choosing to implant an Artisan lens, and a close postoperative monitoring of the endothelial cell count.
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Affiliation(s)
- Veronica Vargas
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain
| | | | - Fouad El Sayyad
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain
| | - Jorge L Alio Del Barrio
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain.,Universidad Miguel Hernández, School of Medicine, Alicante, Spain
| | - Jorge L Alio
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain.,Universidad Miguel Hernández, School of Medicine, Alicante, Spain.,IBERIA eye bank, Oftalred, Universidad Miguel Hernández, Alicante, Spain
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Ang M, Gatinel D, Reinstein DZ, Mertens E, Alió Del Barrio JL, Alió JL. Refractive surgery beyond 2020. Eye (Lond) 2020; 35:362-382. [PMID: 32709958 DOI: 10.1038/s41433-020-1096-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023] Open
Abstract
Refractive surgery refers to any procedure that corrects or minimizes refractive errors. Today, refractive surgery has evolved beyond the traditional laser refractive surgery, embodied by the popular laser in situ keratomileusis or 'LASIK'. New keratorefractive techniques such as small incision lenticule extraction (SMILE) avoids corneal flap creation and uses a single laser device, while advances in surface ablation techniques have seen a resurgence in its popularity. Presbyopic treatment options have also expanded to include new ablation profiles, intracorneal implants, and phakic intraocular implants. With the improved safety and efficacy of refractive lens exchange, a wider variety of intraocular lens implants with advanced optics provide more options for refractive correction in carefully selected patients. In this review, we also discuss possible developments in refractive surgery beyond 2020, such as preoperative evaluation of refractive patients using machine learning and artificial intelligence, potential use of stromal lenticules harvested from SMILE for presbyopic treatments, and various advances in intraocular lens implants that may provide a closer to 'physiological correction' of refractive errors.
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Affiliation(s)
- Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore, Singapore.
| | | | - Dan Z Reinstein
- London Vision Clinic, London, UK.,Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Sorbonne Université, Paris, France.,Biomedical Science Research Institute, Ulster University, Belfast, UK
| | - Erik Mertens
- Medipolis-Antwerp Private Clinic, Antwerp, Belgium
| | - Jorge L Alió Del Barrio
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
| | - Jorge L Alió
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
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Duignan ES, Quigley C, Treacy MP, Aldouri A, O'Keefe M. Iris-fixated phakic intraocular lens explantation. Eur J Ophthalmol 2020; 31:988-993. [PMID: 32544989 DOI: 10.1177/1120672120934985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIMS To evaluate the visual outcomes and indication for surgery in a series of patients who underwent explantation of a phakic intraocular lens (PIOL). METHODS A retrospective case series of patients who underwent PIOL explantation in our institution was performed. The indication for explantation and visual and refractive outcomes were examined. The method of explantation is described. RESULTS Twenty-two eyes of 16 patients underwent PIOL explantation with a mean time to explantation of 7 ± 3 years (range 3-11.4). The mean age at explantation was 50.3 ± 9.3 years. Sixteen Artisan PIOLs and six Artiflex PIOLs were explanted. The indications for explanation were cataract development (17/22), endothelial cell loss (4/22) and synechiae formation (1/22). All patients with cataract underwent a combined procedure with explantation and phacoemulsification and the placement of a posterior chamber IOL. Mean corrected vision after explantation was 0.22 ± 0.10 logMAR (range 0.1-0.3 logMAR). One patient with endothelial cell loss required a Descemet's Stripping Endothelial Keratoplasty (DSEK). CONCLUSION Removal of PIOLs was necessitated most frequently by cataract followed by endothelial cell loss. Both explantation alone and explantation with concurrent phacoemulsification are safe procedures with good visual outcomes and will become more frequent in the future as more patients with PIOLs reach cataractous age.
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Han Y, Tang J, Liu S, Zhao X, Wang R, Xia J, Qin C, Chen H, Lin Q. Cellular Microenvironment-Sensitive Drug Eluting Coating on Intraocular Lens for Enhanced Posterior Capsular Opacification Prevention and in Vivo Biocompatibility. ACS APPLIED BIO MATERIALS 2020; 3:3582-3593. [PMID: 35025228 DOI: 10.1021/acsabm.0c00331] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Yuemei Han
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Junmei Tang
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Sihao Liu
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Xia Zhao
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Rui Wang
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Jiayi Xia
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Chen Qin
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Hao Chen
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Quankui Lin
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
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Abstract
We report a case of acute angle closure with significantly elevated intraocular pressure 9 hours after implantation of a phakic intraocular lens for high myopia.
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28
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Kook D, Mayer WJ, Steinwender G, Kohnen T. Phake Hinterkammerlinsen. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Irisfixierte phake Intraokularlinse. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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30
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Navarrete Argüello J, Bello López Portillo H, Cantero Vergara MA, Sierra Acevedo GA, Ruíz Salgado K, Nieto Aguilar MV, Aguilar Pérez MA, Ramos Hernández SY, Zaragoza Herrera A, de la Torre Tovar JD. Intraocular pressure fluctuations in patients implanted with an implantable collamer lens (ICL V4c). Three-month follow-up. ACTA ACUST UNITED AC 2019; 94:367-376. [PMID: 31266666 DOI: 10.1016/j.oftal.2019.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/02/2019] [Accepted: 05/10/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Fluctuating elevated intraocular pressure (IOP) is one of the complications of an implantable collamer lens (ICL), and its alteration is a predictive factor for the development of glaucoma. MATERIAL AND METHODS A prospective, cross-sectional analytic study was conducted on patients suitable for ICL implantation. Complete clinical and biometric work-ups were performed, as well as night-time IOP curve, in supine position, with 4 determinations, in order to assess fluctuation, considering abnormal with a value higher than 5 mmHg. Patients underwent surgery with conventional technique and three months after the work-ups were repeated, including a night-time IOP curve to assess any changes in IOP fluctuations. RESULTS A total of 31 eyes of 16 patients were studied. Mean IOP fluctuation in the preoperative assessment was 3.35 ± 2 mmHg, whereas the postoperative mean was 3.0 ± 2.2 mmHg, with the difference not being statistically significant. Visual acuity and capacity, as well as spheric equivalent did show a statistically significant improvement. There were 6 cases of complications, which were related to a higher vault and a greater ICL size. There was no relationship between these findings and the angle grade, pigment, and the level of training of the surgeon. CONCLUSIONS The effect of an ICL on IOP fluctuations, has been studied for the first time, which was found to be not statistically significant. As in previous publications, the procedure was safe and reproducible, adding the fact that the level of training of the surgeon is not a determining factor in these findings.
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Affiliation(s)
| | | | | | | | - K Ruíz Salgado
- Hospital Central Militar, México, Ciudad de México, México
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31
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Sidhu T, Desai A, Gagrani M, Dada T. Phacomorphic glaucoma in a high myope with phakic intraocular lens. BMJ Case Rep 2019; 12:12/2/e227096. [PMID: 30804159 DOI: 10.1136/bcr-2018-227096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a case of a young, one-eyed woman with high myopia who presented to our emergency department with sudden onset painful diminution of vision in the right eye after undergoing laser treatment. Her right eye had a phakic intraocular lens (pIOL) implantation 4 years back and her left eye had absent light perception. She was diagnosed as right eye lens induced secondary angle closure glaucoma with pIOL touching the corneal endothelium and left eye atrophic bulbi. She was admitted under eye emergency for medical intraocular pressure control followed by pIOL explantation with lens aspiration of the cataractous lens and posterior chamber intraocular lens implantation.
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Affiliation(s)
- Talvir Sidhu
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, New Delhi, India
| | - Arjun Desai
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, New Delhi, India
| | - Meghal Gagrani
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, New Delhi, India
| | - Tanuj Dada
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, New Delhi, India
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Verisyse versus Veriflex Phakic Intraocular Lenses: Refractive Outcomes and Endothelial Cell Density 5 Years after Surgery. J Ophthalmol 2018; 2018:4210460. [PMID: 30363928 PMCID: PMC6186327 DOI: 10.1155/2018/4210460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/11/2018] [Accepted: 08/26/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare refractive stability, central endothelial cell density (ECD), and complications between Verisyse (Abbott Medical Optics, Netherlands) and Veriflex (Abbott Medical Optics, Netherlands) phakic intraocular lenses (pIOL) over five years. Methods We retrospectively reviewed the medical records of patients who underwent Verisyse or Veriflex pIOL implantation for surgical correction of myopia. Patients with a 5-year follow-up period were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent of manifest refraction (SE), and ECD were compared between the groups preoperatively and 1, 3, and 5 years postoperatively. Results The study included 47 eyes in the Verisyse group and 50 eyes in the Veriflex group. There was no significant difference in mean SE, UDVA, CDVA, and ECD preoperatively or postoperatively. In both groups, there was a statistically significant myopic shift between 1-year and 5-year visits (−0.25 ± 0.30 D and −0.23 ± 0.48 D in the Verisyse and Veriflex groups, respectively). There was no significant difference between the groups in terms of efficacy and safety indexes at 5 years. ECD loss was highest during the first year (3.9% loss in the Verisyse group and 3.9% loss in the Veriflex group, p=0.670). At 5 years, the mean cumulative ECD losses in the Verisyse and Veriflex groups were 7.42% and 7.64%, respectively (p=0.709). Cataracts developed in 2.1% of the eyes in the Verisyse group and in 2.0% of those in the Veriflex group. No sight-threatening complications were observed. Conclusion Verisyse and Veriflex pIOLs are highly effective for treating high myopia up to 5 years after surgery. Longitudinal studies with longer follow-up periods are necessary to determine the endothelial safety profile.
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Abstract
In this new technique of cataract surgery in patients with iris-fixated phakic intraocular lens with cataract, phakic IOL is explanted at the end of surgery. Phakic IOL remains stable and securely enclaved to the iris during phacoemulsification which is performed through a small 2.2 mm incision. Endothelial protection is provided by viscodispersive OVD above the phakic IOL and space for surgery is created by high molecular weight viscocohesive OVD beneath the phakic IOL. This technique provides significant advantages from the previously described techniques in terms of chamber stability, endothelial protection, iris trauma and surgical ease.
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Affiliation(s)
- Sudarshan Khokhar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Manish Mahabir
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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34
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Gimbel HV, LeClair BM, Jabo B, Marzouk H. Incidence of implantable Collamer lens–induced cataract. Can J Ophthalmol 2018; 53:518-522. [DOI: 10.1016/j.jcjo.2017.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/17/2017] [Accepted: 11/21/2017] [Indexed: 10/17/2022]
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Motwani M. Treatment of high myopia/myopic astigmatism with a combination of WaveLight Contoura with LYRA protocol and wavefront-optimized treatment. Clin Ophthalmol 2018; 12:875-883. [PMID: 29785083 PMCID: PMC5953272 DOI: 10.2147/opth.s157486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this article was to demonstrate how WaveLight Contoura and wavefront optimization (WFO) can be used together to treat high myopia/myopic astigmatism corrections. Materials and methods A retrospective analysis was conducted on 24 consecutive myopic/myopic astigmatism eyes that exceeded the Contoura labeling of -8.00 with -3.00 D of astigmatism. Residual correction after Contoura with Layer Yolked Reduction of Astigmatism protocol was treated with WFO Contoura LASIK correction. All patients had 3 months of follow-up. Accuracy to the desired refractive goal was assessed by postoperative refraction, regression, postoperative vision, and anecdotal subjective night vision quality. Results No eyes lost best-corrected visual acuity (BCVA), and 54% of eyes gained BCVA. Out of 22 distance eyes, five achieved 20/15 or better, 18 achieved 20/20 vision, two achieved 20/25, and three achieved 20/30 vision. Preoperatively, only 14 eyes could achieve 20/20 vision. No night vision issues were observed in anecdotal reporting by patients except for those who needed enhancements that had not yet been performed. Conclusion Treatment of high myopia/astigmatism with this combination of Contoura with LYRA protocol and WFO results in excellent visual outcomes, large ablation zones on topography, and few subjective reported night vision issues.
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Excimer Laser Versus Phakic Intraocular Lenses for Myopia and Astigmatism: A Meta-Analysis of Randomized Controlled Trials. Eye Contact Lens 2018; 44:137-143. [DOI: 10.1097/icl.0000000000000327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steinwender G, Shajari M, Kohnen T. Refractive Outcomes After Femtosecond Laser-Assisted Cataract Surgery in Eyes With Anterior Chamber Phakic Intraocular Lenses. J Refract Surg 2018; 34:338-342. [PMID: 29738590 DOI: 10.3928/1081597x-20180228-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/02/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the efficacy, predictability, and safety of femtosecond laser-assisted cataract surgery (FLACS) in eyes with anterior chamber phakic intraocular lenses (IOLs). METHODS This retrospective case series included eyes with previous implantation of an angle-supported and an iris-fixated phakic IOL for the correction of myopia that underwent a combined procedure of phakic IOL ex-plantation and FLACS with in-the-bag implantation of a posterior chamber IOL. Postoperative corrected distance visual acuity (CDVA), predictability of refractive outcome, and occurrence of intraoperative and postoperative complications were analyzed. RESULTS Ten eyes of 7 patients with significant cataract were included: 5 eyes with an angle-supported foldable hydrophobic phakic IOL, 4 eyes with an angle-supported polymethylmethacrylate (PMMA) phakic IOL, and 1 eye with an iris-fixated PMMA phakic IOL. Mean follow-up after FLACS was 8.4 ± 5.8 months. Mean interval between phakic IOL implantation and FLACS was 11.9 ± 4.0 years. After the combined procedure of phakic IOL explantation and FLACS, mean manifest refractive spherical equivalent (MRSE) was -0.11 ± 0.49 diopters (D) and MRSE was within ± 0.75 D of target refraction in all eyes. Four eyes received a toric posterior chamber IOL after phacoemulsification. Mean preoperative CDVA of 0.40 ± 0.23 logMAR improved significantly to 0.22 ± 0.11 logMAR postoperatively (P = .027). No intraoperative or postoperative complications occurred. CONCLUSIONS The results in this series showed that FLACS in eyes with previous implantation of both rigid and foldable anterior chamber phakic IOLs offers good refractive outcomes with a high level of predictability and safety. [J Refract Surg. 2018;34(5):338-342.].
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Femtosecond laser–assisted cataract surgery in eyes with foldable anterior or posterior chamber phakic intraocular lenses. J Cataract Refract Surg 2018; 44:124-128. [DOI: 10.1016/j.jcrs.2017.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 11/17/2022]
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Lee JH, Ryu GW, Park BG. Changes in Ocular Biometrics Measured after Implantation of a Phakic Intraocular Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.3.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jung Hoo Lee
- Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | | | - Byung Gun Park
- Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Hashemian SJ, Mohebbi M, Yaseri M, Jafari ME, Nabili S, Hashemian SM, Hashemian MS. Adjustment formulae to improve the correlation of white-to-white measurement with direct measurement of the ciliary sulcus diameter by ultrasound biomicroscopy. J Curr Ophthalmol 2017; 30:217-222. [PMID: 30197950 PMCID: PMC6127356 DOI: 10.1016/j.joco.2017.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/25/2017] [Accepted: 11/29/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose This study evaluates the correlation between horizontal white-to-white (WTW) distance using Caliper and Orbscan IIz with the ciliary sulcus diameter measured by high frequency ultrasound biomicroscopy (UBM) and presents an adjustment formula to improve the correlation. Methods We measured horizontal sulcus-to-sulcus (STS) dimension of 273 right eyes of 273 high myopic patients with 35 MHz UBM and horizontal WTW using Orbscan IIz and Caliper. Mean WTW diameter, differences, and the correlation of measurement methods were evaluated. Results The mean spherical equivalent was −8.79 ± 4.87 diopters. Mean horizontal STS dimension with UBM was 12.13 ± 0.45 mm (range, 10.81–13.42 mm). Mean WTW diameter in the Caliper method was 11.70 ± 0.40 mm (range, 10.6–12.8 mm) and 11.70 ± 0.40 mm (range, 10.5–13.1 mm) in the Orbscan method. Mean difference of UBM STS and WTW with Caliper was 0.48 ± 0.28 mm (range, −0.19 to 1.37 mm). Mean difference of UBM STS diameter and Orbscan WTW was 0.38 ± 0.31 mm (range, −0.64 to 1.29 mm). The Pearson correlations of WTW diameter measured by Caliper and Orbscan with UBM's STS diameter were 0.778 and 0.773, respectively. This difference diminished after adjustment. The 95% limit of agreement was almost the same in Caliper and Orbscan (−0.07 to 1.03 compared with −0.23 to 0.99). Conclusion There is a significant difference in measurements between STS diameter using UBM and WTW diameter utilizing Caliper and Orbscan. This difference diminished after our recommended adjustment.
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Affiliation(s)
- Seyed Javad Hashemian
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Corresponding author. No 86 Boostan, 10 Pasdaran, Tehran, Iran.
| | - Majid Mohebbi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Biostatistics Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Jafari
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shadrokh Nabili
- University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal, United Kingdom
| | | | - Mahsa Sadat Hashemian
- School of Pharmacy, International Campus, Tehran University of Medical Sciences, Tehran, Iran
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Doroodgar F, Niazi F, Sanginabadi A, Niazi S, Baradaran-Rafii A, Alinia C, Azargashb E, Ghoreishi M. Comparative analysis of the visual performance after implantation of the toric implantable collamer lens in stable keratoconus: a 4-year follow-up after sequential procedure (CXL+TICL implantation). BMJ Open Ophthalmol 2017; 2:e000090. [PMID: 29354720 PMCID: PMC5721648 DOI: 10.1136/bmjophth-2017-000090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/28/2017] [Accepted: 08/24/2017] [Indexed: 11/23/2022] Open
Abstract
Aims To report on 4-year postoperative visual performance with the toric implantable collamer lens (TICL) for stable keratoconus after sequential procedure (corneal collagen crosslinking plus TICL implantation). Methods Forty eyes of 24 patients with stable keratoconus with myopia between 0.00 and −18.00 dioptres (D) and astigmatism between 1.25 and 8.00 D were evaluated in this prospective interventional study (https://clinicaltrials.gov/ct2/show/NCT02833649). We evaluated refraction, visual outcomes, astigmatic changes analysed by Alpins vector, contrast sensitivity, aberrometry, modulation transfer functions (MTFs), defocus curve, and operative and postoperative complications. Results At 4-year follow-up, 45% had 20/20 vision or better and 100% had 20/40 or better uncorrected visual acuity (UCVA). Vector analysis of refractive astigmatism shows that the surgically induced astigmatism (SIA) (3.20±1.46 D) was not significantly different from the target induced astigmatism (TIA) (3.14±1.42 D) (p=0.620). At 4 years postoperatively, none of the eyes showed a decrease in UCVA, in contrast to 24 eyes in which UCVA was increased by ≥1 lines, with contrast sensitivity and improvement in total aberrations and MTF value at 5 per degree (*p=0.004) after TICL implantation. The cumulative 4-year corneal endothelial cell loss was ≤5%. No patients reported dissatisfaction. At the end of follow-up, the vault was 658±54.33m (range, 500–711) and the intraocular pressure was 11.7±2.08 mm Hg. Occurrences of glare and night-driving troubles diminished after TICL surgery. Conclusion The results from this standardised clinical investigation support TICL implantation from clinical and optical viewpoints in patients with stable keratoconus. Trial registration number NCT02833649, Pre-results
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Affiliation(s)
- Farideh Doroodgar
- Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Feazollah Niazi
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Thran, Tehran, Iran
| | - Azad Sanginabadi
- Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Sana Niazi
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Alireza Baradaran-Rafii
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Cyrus Alinia
- Department of Public Health, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran
| | - Eznollah Azargashb
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Mohammad Ghoreishi
- Ophthalmology Department, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran
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Eissa SA, Khafagy MM, Sidky MK. Implantable Collamer Lens in the Management of Pseudophakic Ametropia. J Refract Surg 2017; 33:532-537. [DOI: 10.3928/1081597x-20170606-02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/16/2017] [Indexed: 11/20/2022]
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43
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Steinwender G, Varna-Tigka K, Shajari M, Kohnen T. Anterior subcapsular cataract caused by forceful irrigation during implantation of a posterior chamber phakic intraocular lens with a central hole. J Cataract Refract Surg 2017; 43:969-974. [DOI: 10.1016/j.jcrs.2017.03.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 03/22/2017] [Accepted: 03/28/2017] [Indexed: 10/19/2022]
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Meier PG, Majo F, Othenin-Girard P, Bergin C, Guber I. Refractive outcomes and complications after combined copolymer phakic intraocular lens explantation and phacoemulsification with intraocular lens implantation. J Cataract Refract Surg 2017; 43:748-753. [DOI: 10.1016/j.jcrs.2017.03.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/14/2017] [Accepted: 03/07/2017] [Indexed: 11/26/2022]
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45
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Reinstein DZ, Carp GI, Archer TJ, Lewis TA, Gobbe M, Moore J, Moore T. Long-term Visual and Refractive Outcomes After LASIK for High Myopia and Astigmatism From -8.00 to -14.25 D. J Refract Surg 2017; 32:290-7. [PMID: 27163613 DOI: 10.3928/1081597x-20160310-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 01/27/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate outcomes of high myopic LASIK using the MEL 80 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS Retrospective analysis of 479 consecutive high myopic LASIK procedures (318 patients) using the MEL 80 excimer laser and VisuMax femtosecond laser (Carl Zeiss Meditec) in 77% of cases or zero compression Hansatome microkeratome (Bausch & Lomb, Rochester, NY) in 23% of cases. Inclusion criteria were preoperative spherical equivalent refraction (SEQ) of between -8.00 and -14.25 diopters (D) and corrected distance visual acuity (CDVA) of 20/20 or better. Patients were observed for a minimum of 1 year. Flap thickness was between 80 and 160 µm and optical zone was between 5.75 and 6.50 mm. Standard outcomes analysis was performed. RESULTS Mean attempted SEQ was -9.39 ± 1.22 D (range: -8.00 to -14.18 D) and mean cylinder was -1.03 ± 0.84 D (range: 0.00 to -4.50 D). Mean age was 37 ± 9 years (range: 21 to 60 years) with 54% female patients. Postoperative SEQ was ±0.50 D in 55% and ±1.00 D in 83% of eyes after primary treatment. After re-treatment, 69% of eyes were within ±0.50 D and 95% were within ±1.00 D. UDVA was 20/20 or better in 89% of eyes after final treatment. One line of CDVA was lost in 3% of eyes and no eyes lost two or more lines. Statistically significant increases (P < .001) were measured in contrast sensitivity (CSV-1000) at 12 and 18 cycles per degree. CONCLUSIONS The MEL 80 excimer laser was found to achieve high efficacy and safety for treatment of high myopia between -8.00 and -14.25 D and up to -4.50 D of cylinder. [J Refract Surg. 2016;32(5):290-297.].
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Chan AT, Zauberman NA, Chan CC, Rootman DS. Outcomes after implantable collamer lens surgery in a Canadian cohort. Can J Ophthalmol 2017; 52:150-154. [DOI: 10.1016/j.jcjo.2016.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 08/31/2016] [Indexed: 11/26/2022]
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Eissa SA. Management of pseudophakic myopic anisometropic amblyopia with piggyback Visian ® implantable collamer lens. Acta Ophthalmol 2017; 95:188-193. [PMID: 27681455 DOI: 10.1111/aos.13203] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 06/21/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the outcomes of sulcus implantation of the Visian® implantable collamer lens (ICL) to correct pseudophakic myopic anisometropic amblyopia with myopic shift and/or primary refractive overcorrection. METHODS Prospective case series enrolled 14 pseudophakic eyes of 14 patients, 5-9 years old, with history of cataract surgery and primary in the bag-intraocular lenses (IOL) implantation, followed by myopic shift and/or refractive overcorrection and anisometropic amblyopia of variable degrees. All cases had implantation of a piggyback ICL/toric ICL, to correct the myopia/myopic astigmatism. Preoperatively, we evaluated the uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), intraocular pressure (IOP) and endothelial cell density (ECD). We assessed the position and vaulting of the ICLs on slit lamp examination and confirmed by Scheimpflug tomography. Postoperative follow-up was at 1st week and 1, 3, 6, 9, 12, 18 and 24 months. RESULTS Uncorrected distance visual acuity improved in all cases, and CDVA improved in 11 amblyopic eyes (2-4 lines). There was no evidence of interlenticular opacification (ILO) throughout the 2-year follow-up. Two cases were complicated with early postoperative acute elevation of IOP and were controlled with topical beta-blockers. Postoperative acute anterior uveitis occurred in six eyes and controlled by topical steroids. Implantable collamer lens (ICL) vault was measured using Pentacam, with mean value of 470 ± 238 μm. CONCLUSION Sulcus implantation of the secondary piggyback ICL to correct unilateral pseudophakic myopic refractive error in children was safe, efficient, predictable and well tolerated in management of anisometropic amblyopia in all eyes.
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Affiliation(s)
- Sherif A. Eissa
- Faculty of medicine; Kasr Al Ainy; Ophthalmology department; Cairo University; Cairo Egypt
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48
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Nuzzi R, Tridico F. Comparison of visual outcomes, spectacles dependence and patient satisfaction of multifocal and accommodative intraocular lenses: innovative perspectives for maximal refractive-oriented cataract surgery. BMC Ophthalmol 2017; 17:12. [PMID: 28196497 PMCID: PMC5309975 DOI: 10.1186/s12886-017-0411-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to evaluate visual outcomes for different working distances (far, 60 cm and 33 cm) and impact on vision quality of multifocal IOLs AcrySof ResTOR SN6AD1 and SN6AD3 (Alcon, Inc., Fort Worth, Texas, USA) as well as REVIEW FIL611PV multifocal and OPTOFLEX FIL618 accommodative IOLs (Soleko, Ltd., Rome, Italy) in patients undergoing bilateral phacoemulsification. Methods In this observational prospective study 63 patients undergoing binocular cataract surgery were divided into four groups for implantation of one of the IOLs under evaluation. Visual outcomes were evaluated at 1 day, 7 days, 1 month, 3 months and 6 months after surgery. Patients’ satisfaction and spectacle independence were evaluated with questionnaires administered at the 6-months follow-up. Results Improvements in visual acuity for the three working distances were statistically significant in all cases compared to the preoperative status, especially after binocular implantation. The AcrySof ReSTOR SN6AD1 multifocal IOL provided the best visual acuity results and tolerability for all working distances. While performing worse than SN6AD1, FIL611PV and FIL618 provided better uncorrected visual acuity and spectacles independence for intermediate/close-up and far distances respectively, in comparison with the SN6AD3 group. Conclusions SN6AD1 was confirmed the best choice for all working distances. However, FIL611PV IOL may represent a valid and more cost-effective alternative, especially if surgeons intend to prioritize spectacle independence and patient autonomy at intermediate and close-up distances, in accordance to specific needs and requests. Trial registration Trial retrospectively registered in ISRCTN Registry on 02/02/2017. TRN: ISRCTN14145737.
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Affiliation(s)
- Raffaele Nuzzi
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Via Juvarra 19, 10100, Turin, Italy. .,Unit of Ophthalmology, San Luigi Gonzaga University Hospital, University of Turin, Regione Gonzole 10, Orbassano, 10043, Turin, Italy.
| | - Federico Tridico
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Via Juvarra 19, 10100, Turin, Italy
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Kawamorita T, Shimizu K, Shoji N. Theoretical study on the need for laser iridotomy in an implantable collamer lens with a hole using computational fluid dynamics. Eye (Lond) 2017; 31:795-801. [PMID: 28106892 DOI: 10.1038/eye.2016.279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 09/29/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeAlthough one of the advantages of the Hole-ICL implantation is that laser iridotomy (LI) is unnecessary, the evidence have not been reported from the viewpoint of aqueous humor circulation. We investigated the effect of laser iridotomy (LI) on the fluid dynamics of aqueous humor in an implantable collamer lens (ICL) with a central hole, that is, a Hole-ICL using computational fluid dynamics.MethodsA fluid dynamics simulation was performed using the thermal-hydraulic analysis software FloEFD (Mentor Graphics Corp.). For the simulation, three-dimensional eye models with a conventional ICL (Model ICM, STAAR SURGICAL) and a Hole-ICL were used. The LI diameters were 250 and 500 μm. The flow distribution between the anterior surface of the crystalline lens and the posterior surface of the ICL was also calculated.ResultsThe flow velocity 0.25 mm in front of the center of the crystalline lens in the Hole-ICL without LI, with LI of 250 μm, and with LI of 500 μm was 1.48 × 10-1, 1.20 × 10-1, and 4.52 × 10-2 mm/s, respectively. The flow velocity in the conventional ICL without LI, with LI of 250 μm, and with LI of 500 μm was 1.21 × 10-5, 3.60 × 10-4, and 6.33 × 10-4 mm/s, respectively.ConclusionsThese results suggest that there is less need for LI in a posterior chamber phakic intraocular lens with a central hole from the viewpoint of aqueous humor circulation, although the results can be considered only in an ideal condition and further studies are needed to clarify the effect of LI in clinical practice.
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Affiliation(s)
- T Kawamorita
- Department of Orthoptics and Visual Science, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - K Shimizu
- Sanno Hospital Ophthalmology, Tokyo, Japan
| | - N Shoji
- Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
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Chen H, Niu G, Fan Y, Ma J. Comparison of intraocular pressure andvault after implantation of implantable collamer lens with and without a central hole. BMC Ophthalmol 2016; 16:203. [PMID: 27852246 PMCID: PMC5112696 DOI: 10.1186/s12886-016-0375-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUD The Implantable Collamer Lens (ICL) has been used widely for refractive errors, We performed this prospective randomized comparative study to compare postoperative intraocular pressure (IOP) and vaults of the eyes implanted with conventional ICL and central hole ICL. METHODS This study evaluated 44 eyes of 22 patients who underwent central hole ICL implantation in one eye and conventional ICL implantation in the other eye by randomization assignment. noncontact intraocular pressure were performed on 6 h, 1 day, 3 days, 1 week, 2 weeks, 1 month, 3 months and 6 months, while ICL vaults were measured on 1 day, 1 week, 1 month and 6 months. RESULTS The IOP of both eyeswithcentral hole and conventional ICLrosetemporarily during the first month after surgeries, especially on 1 day and 2 weeks points postoperatively. The IOP ofeyes with central hole ICL was higher than that of conventionl ICL. The vaults ofeyes with central hole and conventional ICL decreased slightly with time but did not significantly affect the postoperative IOP. CONCLUSIONS Despite the sensitivity of viscoelastic agents or inflammation, this newly developed central hole ICL implantation appears to be equivalent in safty and effcacy to conventional ICL implantation for the correction of ametropia. TRIAL REGISTRATION Current Controlled Trials ChiCTR-INR-16008896 . Retrospectively registered 24 July 2016.
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Affiliation(s)
- Haiting Chen
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China.,Department of Ophthalmology, Second Hospital of Hebei Medical University, Hebei, China
| | - Guangzeng Niu
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China
| | - Yuxiang Fan
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China
| | - Jingxue Ma
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Hebei, China.
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