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Chen X, Wan L, Ye Y, Yao H, Cui Z, Huang Y, Wang X, Hou X, Luo Q, Qiu J, Li Y, Zhuang J, Yu K. Ocular features in myopic eyes with longer horizontal ciliary sulcus diameters for intended implantable collamer lens surgery. Eur J Ophthalmol 2023:11206721231223543. [PMID: 38151004 DOI: 10.1177/11206721231223543] [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: 12/29/2023]
Abstract
PURPOSE To assess the ocular anterior segment characteristics in myopic eyes intended for ICL surgery with horizontal ciliary sulcus-to-sulcus (STS) diameters being greater than vertical STS diameters. METHODS This retrospective, comparative case study included 1230 eyes of patients who underwent ICL implantation for the treatment of myopia or myopic astigmatism at the Zhongshan Ophthalmic Center from September 2020 to November 2021. The myopic eyes were divided into two groups according to the relatively long diameter of the ciliary sulcus. General parameters and anterior chamber parameters were compared between the two groups. RESULTS 1230 eyes of 694 patients were included. The proportion of myopic eyes with longer horizontal STS diameters was 4.63%. Horizontal STS distances exceeding vertical meridians in these eyes were mainly attributed to the shortening of vertical STS distances (horizontal STS: P = 0.112; vertical STS: P < 0.001). Eyes with longer horizontal meridians of the ciliary sulcus displayed larger steep keratometry value (P = 0.001), larger corneal volume (P = 0.002), larger corneal astigmatism (P < 0.001), larger ocular residual astigmatism (P = 0.017), worse visual acuity (logMAR UDVA: P = 0.021; logMAR CDVA: P = 0.001), and more iridociliary cysts (P = 0.017) compared to eyes with vertically oval shapes. CONCLUSION Myopic eyes with longer horizontal STS diameters are commonly accompanied by a change in corneal morphology and more iridociliary cysts. The anatomical features of the ciliary sulcus should be given sufficient consideration to ICL size and placement selection, contributing to more personalized and precise surgery.
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Affiliation(s)
- Xi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Linxi Wan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Yiming Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Huan Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Zedu Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Yuke Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Xiao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Xiangtao Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Qian Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Jin Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Tianhe District, Guangzhou City, China
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Short-term clinic observation of misalignment and rotational stability after implantable collamer lens implantation. Graefes Arch Clin Exp Ophthalmol 2022; 261:1473-1481. [PMID: 36484805 DOI: 10.1007/s00417-022-05929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/04/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE We aimed to investigate misalignment (tilt and decentration) and rotational stability of the implantable collamer lens V4c 6 months after implantation and to explore the potential risk factors associated with postoperative misalignment and rotation. METHODS A total of 36 eyes of 36 patients with high myopia and myopic astigmatism who underwent implantable collamer lens V4c implantation were included in this study. Tilt, decentration, and rotation of the implantable collamer lens were assessed postoperatively at l week, 1 month, 3 months, and 6 months. Correlation analysis was used to identify the potential risk factors for implantable collamer lens tilt, decentration, and rotation at 6 months postoperatively. Higher-order aberration was measured to evaluate the effect of implantable collamer lens misalignment on visual quality at pupil diameters of 4.0 mm and 6.0 mm. RESULTS The tilt and decentration at the last follow-up were 2.43 ± 1.35° and 0.278 ± 0.160 mm, respectively. There was a significant positive correlation between tilt and decentration (r = 0.31, P = 0.046). No significant correlation was detected between implantable collamer lens decentration and internal higher-order aberrations (P > 0.05). The degree of implantable collamer lens rotation (3.11 ± 2.00°) was significantly associated with the vault (r = - 0.422, P = 0.01), while it was positively associated with the preoperative anterior chamber depth (r = 0.36, P = 0.034). No significant correlation was found between postoperative astigmatism and rotation (r = - 0.07, P = 0.351). CONCLUSIONS The implantable collamer lens V4c provides relatively stable misalignment and rotation after implantation. The ICL lens vault is a potential risk factor for postoperative implantable collamer lens rotation. The absolute value of decentration and tilt was relatively small, which showed no correlation with internal higher-order aberration in short-term observation.
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Huang W, Ji Y, Zheng S, Huang F, Zhang T, Cheng H, Li Z, Gao N, Du M, Zuo H, Wan W, Hu K. The Effectiveness and Rotational Stability of Vertical Implantation of the Implantable Collamer Lens for the Treatment of Myopia. J Refract Surg 2022; 38:641-647. [DOI: 10.3928/1081597x-20220831-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Factors leading to realignment or exchange after implantable collamer lens implantation in 10 258 eyes. J Cataract Refract Surg 2022; 48:1190-1196. [PMID: 35351844 PMCID: PMC9514736 DOI: 10.1097/j.jcrs.0000000000000950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/24/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the incidence, causes, and outcomes of implantable collamer lens (ICL) realignment or exchange after implantation of the EVO-ICL. SETTING Eye and ENT Hospital of Fudan University, China. DESIGN Retrospective study. METHODS The study included 10 258 consecutive eyes after ICL implantation. Preoperative refractive and biometric measurements were compared between eyes with and without realignment or exchange. For eyes with ICL realignment or exchange, visual and biometric outcomes were also compared before and after ICL realignment or exchange. RESULTS The overall incidence of ICL realignment or exchange was 0.21% 22 eyes. 12 eyes (0.12%) underwent ICL realignment by axis rotation (10 eyes) or ICL exchange (2 eyes) due to toric ICL (TICL) misalignment. After realignment, uncorrected distance visual acuity improved, and residual cylinder decreased from -1.75 ± 0.48 diopters (D) to -0.87 ± 0.59 D ( P = .01). 10 eyes (0.10%) underwent vertical rotation of ICL (3 eyes) or ICL exchange (7 eyes) due to excessive vault. After either vertical rotation or ICL exchange, vault decreased significantly ( P < .05). CONCLUSIONS The incidence of ICL realignment or exchange after ICL implantation is low. TICL misalignment and excessive vault are 2 main causes. Implant exchange may be performed for excessive vault or misalignment with an insufficient vault. In addition, vertical rotation of an ICL may be a less invasive method to treat excessive vault in certain cases.
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Monteiro T, Pinto C, Franqueira N, Faria-Correia F, Mendes J, Alfonso Sánchez J, Vaz F. Efficacy and Safety After Toric Posterior Chamber Implantable Collamer Lens and Toric Iris-Fixated Foldable Phakic Intraocular Lens for Myopic Astigmatism. J Refract Surg 2022; 38:339-347. [PMID: 35686710 DOI: 10.3928/1081597x-20220406-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare visual, refractive, and safety outcomes of toric posterior chamber Implantable Collamer Lens (T-ICL) (STAAR Surgical) and toric iris-fixated foldable phakic intraocular lens (IOL) (T-Artiflex; Ophtec BV) implantation for the correction of myopic astigmatism. METHODS This retrospective cohort study included 312 eyes of 312 patients who had phakic IOL implantation for myopic astigmatism. Two groups were defined: 205 eyes that underwent T-ICL implantation and 107 eyes that underwent T-Artiflex implantation. Safety, efficacy, and predictability outcomes were evaluated preoperatively and at 12 months postoperatively. Refractive and corneal astigmatic vector analysis were performed using the Alpins method. RESULTS One year postoperatively, uncorrected distance visual acuity was 0.05 ± 0.18 (T-ICL) and 0.10 ± 0.16 (T-Artiflex) logMAR, with efficacy indexes of 1.16 ± 0.27 and 1.05 ± 0.31, respectively (P < .001). Safety indexes were 1.28 ± 0.30 and 1.21 ± 0.31, respectively (P = .04). Spherical equivalent was within ±0.50 diopters (D) of emmetropia in 165 (80.5%) and 88 (82.2%) eyes, respectively. Refractive astigmatic analysis showed an index of success of 0.28 ± 0.33 (T-ICL) and 0.31 ± 0.26 (T-Artiflex) (P = .07). Surgically induced corneal astigmatism was 0.48 ± 0.74 and 0.81 ± 0.61 D, respectively (P < .001). Mean endothelial loss was 1.11% and 2.05%, respectively (P = .42). Six (2.9%) eyes in the T-ICL group and 1 (0.9%) eye in the T-Artiflex group had phakic IOL repositioning due to significant misalignment. No vision-threatening complications occurred. CONCLUSIONS Both the T-ICL and T-Artiflex groups showed high visual and refractive efficacy with a good safety profile for the correction of myopic astigmatism. T-ICL implantation demonstrated significantly better efficacy and safety indexes after 12 months. Vector analysis showed similar refractive astigmatic correction in both groups, but T-Artiflex implantation revealed higher surgically induced corneal astigmatism. [J Refract Surg. 2022;38(6):339-347.].
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Fairaq R, Almutlak M, Almazyad E, Badawi AH, Ahad MA. Outcomes and complications of implantable collamer lens for mild to advance keratoconus. Int Ophthalmol 2021; 41:2609-2618. [PMID: 33772698 DOI: 10.1007/s10792-021-01820-2] [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: 09/11/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the outcome and safety of implantable collamer lens (ICL; (Visian, STAAR Surgical, Monrovia, CA, USA) in mild to advance keratoconus patients with myopia and myopic astigmatism. METHODS This retrospective study evaluated all patients who underwent ICL implantation for the management of keratoconus at a tertiary care eye hospital from January 2012 to January 2018. The mean duration of follow-up was 15.3 months (range, 3.13 to 38.97 months). Data were collected on preoperative and postoperative uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction was compared, and adverse effects were evaluated. RESULTS Thirty-two eyes (32 patients) were evaluated. The median CDVA was 20/30 preoperatively and 20/20 at last follow-up. The median UDVA was 20/25 at last follow-up. Thirteen patients (40.6%) had 20/20 UDVA in comparison to none at baseline. The median spherical equivalent in diopters (D) was -7.875 D (-4.125 to -10.0 D) preoperatively and decreased to -0.3125 D at last follow-up. The median manifest refractive cylinder was 3.00 D (2.25 to 5.25 D) preoperatively and decreased to 1.125 D postoperatively. Cylinder axis rotation of 10° or greater occurred in 3 eyes (9.375%) and required repositioning of the ICL. One patient (3%) developed nonvisually significant anterior subcapsular cataract. One ICL (3.125%) had to be explanted due to residual refractive error and unsatisfactory vision. CONCLUSION ICLs are a suitable refractive option for the correction of refractive error associated with stable, nonprogressive keratoconus even in advance cases. However, the risk of ICL rotation and subsequent repositioning remain. Careful patient selection is necessary for achieving good outcomes and mitigating intraoperative and postoperative complications.
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Affiliation(s)
- Rafah Fairaq
- Ophthalmology Department, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia.,Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Mohammed Almutlak
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Enmar Almazyad
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Abdulrahman H Badawi
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Muhammad Ali Ahad
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia.
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Clinical Effect and Rotational Stability of TICL in the Treatment of Myopic Astigmatism. J Ophthalmol 2021; 2020:3095302. [PMID: 33489326 PMCID: PMC7803223 DOI: 10.1155/2020/3095302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/28/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the clinical outcomes and possible risk factors associated with rotational stability after the implantation of a V4c toric implantable Collamer lens (TICL) for the correction of moderate to high myopic astigmatism. Methods A total of 112 eyes of 66 patients with moderate to high myopic astigmatism underwent TICL implantation. All patients were followed up for more than 1 year. The uncorrected and best-corrected visual acuity (UCVA and BCVA), astigmatism and spherical equivalent, intraocular pressure, vault, endothelial cell morphometry, and rotation of the TICL axis were assessed at l day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. Postoperative rotation was defined as the angle between the intended axis and the achieved axis. Regression analysis was used to investigate the possible risk factors for TICL rotation postoperatively. Results The mean efficacy index and safety index 12 months postoperatively were 1.03 ± 0.09 and 1.05 ± 0.10, respectively. All patients had the same or better visual acuity than preoperatively. The mean astigmatism value decreased from -1.86 ± 0.79 D preoperatively to -0.37 ± 0.35 D. The mean absolute axis deviation of the TICL at the last follow-up was 2.75 ± 2.04° (range, 0°∼11°). The mean manifest refraction spherical equivalent (MRSE) changed from -9.04 ± 2.67 D preoperatively to -0.67 ± 0.51 D postoperatively. The logistic regression demonstrated that the absolute degree of TICL rotation had a significant association with the fixation angle of the TICL and the size of the lens (P=0.003, P=0.026, resp.). Conclusion The results of our study support that TICL implantation is safe, effective, and predictable in the treatment of moderate to high myopic astigmatism, with relatively good postoperative rotational stability.
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Nie D, Yan P, Yan Z, Zhang J, He W, Li M, Sun L, Huang M, Liu X, Lin H. Polar value analysis of astigmatic change and rotational stability after implantation of V4c toric implantable collamer lens. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:139. [PMID: 33569441 PMCID: PMC7867885 DOI: 10.21037/atm-20-7835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background To evaluate the clinical results and rotational stability of V4c toric implantable collamer lens (TICL, STAAR Surgical Company, Monrovia, CA, USA) in patients with moderate to high myopic astigmatism. Retrospective, interventional case series was performed at Shenzhen Eye Hospital, Shenzhen, Guangdong, China. Methods This study enrolled 43 patients (72 eyes) who received TICL implantation to correct myopia and myopic astigmatism. The patients underwent visual and refractive examinations before and 1 month after surgery. Astigmatic changes were estimated using polar value analysis. The difference between the achieved axis and the intended axis at the last follow-up was taken as the rotation of the V4c TICL. Results At 1 month postoperatively, the mean safety and efficacy indices were 1.17 and 1.13, respectively. A significant reduction of 8.92±2.58 D was observed in the spherical equivalent refraction (SER), which decreased from −9.29±2.41 D preoperatively to −0.37±0.55 D postoperatively. The astigmatic error of treatment in cylinder format was calculated to 0.50±0.41 @ 15.08° relative to the preoperative stronger meridian at 1 month, postoperatively. At 1 month postoperatively, the mean absolute rotation was 8.30±10.00 degrees (median =5.46 degrees; range, 0.00–58.88 degrees). Conclusions TICL could achieve good astigmatic outcomes for correcting moderate to high myopic astigmatism. After TICL implantation, corneal astigmatism remained unchanged. To optimize postoperative astigmatic outcomes in TICL, polar value analysis can be used to build a nomogram.
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Affiliation(s)
- Danyao Nie
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Pisong Yan
- Cloud Intelligent Care Technology (Guangzhou) Co. Ltd., Guangzhou, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Jing Zhang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Wenling He
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Ming Li
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Liangnan Sun
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Mingquan Huang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Xinhua Liu
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
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He X, Niu L, Miao H, Zhao F, Zhou X. Relative position of the central hole after EVO-ICL implantation for moderate to high myopia. BMC Ophthalmol 2020; 20:305. [PMID: 32723334 PMCID: PMC7385873 DOI: 10.1186/s12886-020-01569-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to evaluate the relative position of the central hole (CH) of EVO Implantable Collamer Lens (EVO-ICL), the pupil center (CP), and the corneal center (CC) after implantation of EVO-ICLs for moderate to high myopia. Methods Eighty-nine eyes of forty-seven patients with moderate to high myopia were evaluated. The mean preoperative spherical equivalent (SE) was − 12.58 ± 4.13D. A routine postoperative follow-up was performed within 1 ~ 12 months. Positions of the CH of EVO-ICLs, the CP and the CC were recorded using a slit lamp anterior segment photography system, and their relative distances were calculated with the Visio image analysis software. Results All surgeries were performed safely, and no complications were observed in follow-ups 4.3 ± 4.82 months after surgery. At the last follow-up, the safety index (postoperative CDVA/preoperative CDVA) was 1.23 ± 0.48, and the efficacy index (postoperative UDVA/preoperative CDVA) was 1.08 ± 0.31. The CH in 85 eyes (95.51%) was superior to the CC, with 47.19% (42/89) on the temporal side and 48.31% (43/89) on the nasal side. The CH in 84 eyes (94.38%) was located on the temporal side of the CP, with 56.18% (50/89) superior and 38.2% (34/89) inferior to the CP. The CP of 85 eyes (95.51%) was superior on the nasal side of the CC. On the defined x-axis, the average distance from the CH to CC was significantly shorter than the average distance from the CP to CC (p < 0.001). Conclusions An imperfect match between the central hole of EVO-ICLs and the pupil center does not necessarily indicate ICL dislocation. Compared to the pupil center, the position of the central hole of EVO-ICL is closer to the corneal center.
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Affiliation(s)
- Xiaojian He
- Department of Ophthalmology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Huamao Miao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Feng Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China. .,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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Wan T, Yin H, Wu Z, Yang Y. Vector analysis of small incision lenticule extraction and toric implantable collamer lens implantation for astigmatism correction. Eur J Ophthalmol 2020; 31:994-1001. [PMID: 32468871 DOI: 10.1177/1120672120930607] [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: 11/16/2022]
Abstract
OBJECTIVES To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis. METHODS In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis. RESULTS At 3-months postoperatively, the residual cylinder was -0.10 ± 0.21 D in the SMILE group and -0.30 ± 0.32 D in the TCL group (p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, -0.19 ± 0.25, -2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, -0.05 ± 0.20, -0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group (p < 0.05). CONCLUSION Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.
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Affiliation(s)
- Ting Wan
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Houfa Yin
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhiyi Wu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yabo Yang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Lee H, Kang DSY, Choi JY, Ha BJ, Kim EK, Seo KY, Kim TI. Rotational Stability and Visual Outcomes of V4c Toric Phakic Intraocular Lenses. J Refract Surg 2018; 34:489-496. [PMID: 30001453 DOI: 10.3928/1081597x-20180521-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/07/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the clinical outcomes and rotational stability following implantation of V4c toric implantable collamer lenses (ICLs) (STAAR Surgical Company, Monrovia, CA) and to analyze the factors that influence rotational stability. METHODS In this prospective observational case series, the authors analyzed the visual outcomes and rotational stability in 52 eyes of 52 patients immediately and 3 and 6 months after implantation. Postoperative rotation was defined as the angle between the adjusted axis and alignment axis. Central vaulting of the ICL was measured in a non-accommodative state using Visante optical coherence tomography (Carl Zeiss Meditec, Jena, Germany). Vector analysis of refractive astigmatism was performed. Regression analysis was used to investigate the association between the degree of rotation 6 months postoperatively and the associated variables. RESULTS The mean efficacy index and safety index 6 months postoperatively were 1.35 ± 0.19 and 1.38 ± 0.22, respectively. In vector analysis, the magnitude of error was -0.20 diopters (D), indicating slight undercorrection. Absolute degree of rotation was 2.81° ± 1.87° immediately after the operation and 3.75° ± 2.92° and 3.87° ± 3.07° at 3 and 6 months postoperatively, respectively (P = .009). Bonferroni-adjusted post-hoc comparison showed that the absolute degree of rotation immediately after the operation was significantly smaller than that after 3 (P = .043) and 6 (P = .023) months, with barely any change after 3 months. No explanatory variable relevant to the absolute degree of rotation was discovered. CONCLUSIONS The V4c toric ICL is predictable, safe, and effective in correcting low and high levels of astigmatism, showing relatively good postoperative rotational stability. [J Refract Surg. 2018;34(7):489-496.].
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Zhang X, Chen X, Wang X, Yuan F, Zhou X. Analysis of intraocular positions of posterior implantable collamer lens by full-scale ultrasound biomicroscopy. BMC Ophthalmol 2018; 18:114. [PMID: 29743110 PMCID: PMC5944172 DOI: 10.1186/s12886-018-0783-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background To analyze the positions of intraocular posterior Implantable Collamer Lens (ICL) and its possible relationship with vault. Methods This cross-sectional study included 72 patients with high myopia (134 eyes) who were followed up after phakic intraocular lens implantation. The postoperative time ranged from 1 week to 7 years. We obtained the images of ICL by using Compact Touch STS UBM and observed the position of ICL in posterior chamber and ciliary sulcus. The horizontal lines vault was measured and recorded. Results There were various positions in the posterior chamber as observed by full-scale ultrasound biomicroscopy and the haptics were inserted at different positions. -Eight seven eyes (64.9%) that obtained ideal vault, 29 eyes (21.6%) had insufficient vaults and 18 eyes (13.4%) had excessive vault. The vault with various positions of haptics was in ideal range (250 μm–750 μm) almost in each group. Three eyes in this study with haptics on the top of ciliary sulcus obtained excessive vault (mean vault, 850.00 ± 70.71 μm) and one eye appeared one side haptics pushing forward the iris. Among five eyes (3.7%) with iridociliary body cysts, three eyes (60%) obtained ideal vault. One eye (0.7%) with ICL decentralization after implantation surgery had an ideal vault, but the patient had serious glare. Conclusions Though ICL in the posterior chamber had different positions and the haptics in most cases were not in the ciliary sulcus, the postoperative vault was almost in the ideal range.
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Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China.
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
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A comparison of visual outcome and rotational stability of two types of toric implantable collamer lenses (TICL) : V4 versus V4c. PLoS One 2017; 12:e0183335. [PMID: 28846701 PMCID: PMC5573270 DOI: 10.1371/journal.pone.0183335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the efficacy and rotational stability after implantation of two types of toric implantable collamer lenses (Toric ICL™(TICL);V4 and V4c, STAAR Surgical Co.). STUDY DESIGN Retrospective case series. METHODS This retrospective study evaluated total 48 eyes of 48 patients who underwent the implantation with V4 and V4c TICL with a central hole; A twenty-four eyes of 24 patients with V4 TICL and 24 eyes of 24 patients with V4c TICL with a central hole. Visual acuity, manifest refraction, and intraocular pressure were evaluated before and after surgery. Rotational stability (disparity between the intended axis and achieved axis) was assessed in both groups using digital anterior segment photographs, and vector analysis was also performed. RESULTS Uncorrected visual acuity improved in both groups without significant difference (P = .111). There were no statistical differences between two groups in postoperative SE and cylindrical errors (P = .067 and .384, respectively). The mean value of rotation was 4.17±3.31° and 3.39±2.36° in the V4 and V4c TICL groups, respectively without significant difference (P = .364). Vector analysis of astigmatic correction showed no significant diffrence between two groups. CONCLUSION V4 and V4c TICL have similar efficacy with regard to visual acuity and refractive outcomes and rotational stability.
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Ganesh S, Brar S, Pawar A. Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism. Clin Ophthalmol 2017; 11:1253-1263. [PMID: 28740361 PMCID: PMC5505606 DOI: 10.2147/opth.s127101] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose To compare toric implantable collamer lens (T-ICL), femto-LASIK, and ReLEx SMILE for the treatment of low to moderate myopic astigmatism in terms of long-term visual and refractive outcomes and predictability of astigmatic correction. Materials and methods The study included 30 eyes from 30 patients between the age groups of 21 and 40 years, undergoing bilateral surgery with any of the three procedures – T-ICL, femto-LASIK, or ReLEx SMILE – for correction of myopic astigmatism within the range of −3 to −8 D spherical equivalent (SE), with a minimum astigmatism of −0.75 D. Patients were followed up at day 1, 1 month, 6 months, and 1 year. Results At 1 year, the mean cylinder reduced to −0.21±0.28, −0.17±0.36, and −0.22±0.28 D in the T-ICL, femto-LASIK, and ReLEx SMILE group, respectively. The predictability of astigmatism correction was comparable, with no statistically significant difference between the 3 groups (P>0.05). A total of 97% of eyes in ReLEx SMILE achieved a uncorrected distance visual acuity of 20/20 or better, compared to T-ICL (93%) and FS-LASIK (90%). However, gain in lines of corrected distant visual acuity (CDVA) was maximum in T-ICL group (60%). Four eyes in the femto-LASIK group had loss of CDVA by one line. Three eyes required exchange due to high vault and rotation of the T-ICL, which did not affect the final outcome. Conclusion All 3 modalities were effective for myopic astigmatism at the end of 1 year. Quality of vision and patient satisfaction with T-ICL and ReLEx SMILE were similar and better than FS-LASIK. However, slight chances of postoperative rotation and exchange exist with T-ICL, which warrant thorough preoperative planning.
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Affiliation(s)
- Sri Ganesh
- Phacorefractive Department, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Sheetal Brar
- Phacorefractive Department, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Archana Pawar
- Phacorefractive Department, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
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Kim B, Mun S, Choi H, Chung Y. Short-term Clinical Outcomes of Implantable Collamer Lens Implantation with Simultaneous Full Thickness Astigmatic Keratotomy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.8.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Buki Kim
- Onnuri Smile Eye Clinic, Seoul, Korea
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Implantable collamer lens V4b and V4c for correction of high myopia. J Curr Ophthalmol 2016; 27:76-81. [PMID: 27239582 PMCID: PMC4881151 DOI: 10.1016/j.joco.2016.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To evaluate the visual outcome and intraocular pressure changes after Visian Implantable Collamer Lens (ICL) implantation V4b and V4c (with central hole) for correction of high myopia. METHODS A prospective, consecutive, interventional comparative case series of V4b and V4c ICL implantation was done in high myopic patients who were unsuitable for laser vision. The main outcome measures studied were uncorrected and corrected distant visual acuity (UDVA, CDVA), ICL vault, intraocular pressure (IOP), endothelial cell count (ECC), and development of subcapsular lens opacities. The patients were evaluated at postoperative 1,3,6, and 9 months. RESULTS A total of 62 eyes of 32 patients (24.56 ± 4.8 years) underwent V4b ICL implantation (21 non-toric, 41 toric ICL-TICL) with intraoperative peripheral iridectomy (PI), and 10 eyes of 5 patients (26.13 ± 3.8 years) had implantation of V4c ICL (4 non-toric, 6 TICL). The mean preoperative manifest spherical equivalent (MSE) was -9.98 ± 2.8 D and -9.14 ± 2.4 D in the V4b and V4c groups, respectively, which reduced to postoperative values of -0.24 ± 1.3 D and -0.2 ± 1.18 D, respectively. At the end of 9 months follow-up, mean ECC loss was 6.4% and 6.1%, mean vault was 573.13 ± 241.13 μ, and 612 ± 251.14 μ, respectively, in the V4b and V4c groups. Anterior subcapsular opacities were present in 6.9% and 3.14% of eyes with V4b and V4c groups, respectively. Four eyes from V4b (9.75%) and 1 eye from V4c (16.66%) had rotation of more than 30° and required realignment surgery, which was done successfully. Two eyes (3.22%) with V4b ICL implantation had high postoperative IOP (>35 mm Hg) due to blocked PI and required Nd:Yag laser iridotomy, which was done with successful control of IOP. The safety indices were 1.11 and 1.14, and efficacy indices were 1.4 and 1.5 in the V4b and V4c groups, respectively, at the end of 9 months. CONCLUSION ICL implantation is a safe and effective surgery for correction of high myopia. Implantation of ICL with a central hole showed negligible postoperative IOP fluctuations without a peripheral iridectomy.
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Lee D, Lee SJ, Kyung H. Rotational Stability after Toric Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.4.477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Seung Jae Lee
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Haksu Kyung
- Department of Ophthalmology, National Medical Center, Seoul, Korea
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Anterior segment variations after posterior chamber phakic intraocular lens implantation in myopic eyes. J Cataract Refract Surg 2013; 39:730-8. [PMID: 23499067 DOI: 10.1016/j.jcrs.2012.12.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 12/05/2012] [Accepted: 12/06/2012] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate anterior segment variations after posterior chamber phakic intraocular lens (pIOL) implantation in myopic eyes. SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Cohort study. METHODS Patients with high myopia were scheduled for nontoric Implantable Collamer Lens pIOL or toric Implantable Collamer Lens pIOL implantation. Anterior segment optical coherence tomography was performed to evaluate the anterior segment variations over time and the impact of physiologic accommodation and change in brightness after pIOL implantation. Slitlamp photography of the anterior segment was taken after pupil dilation to calculate pIOL rotation. RESULTS There was significantly improved visual acuity and refractive status after implantation of both pIOLs. Anterior segment axial variations had good stability 6 months postoperatively. However, nontoric pIOL rotation occurred in 1 eye 7 months postoperatively and rotation of the toric pIOL occurred in 2 eyes at 3 months and 6 months. Stimulations of -4.0 diopters (D) and -8.0 D led to significant changes in anterior chamber depth (ACD) based on the lens (ACD-lens), ACD after pIOL implantation, distance between the pIOL posterior surface and the lens anterior surface (pIOL-lens), and pupil diameter. Increasing ambient light brightness could reduce the ACD-lens and pIOL-lens. CONCLUSIONS Both pIOLs had good axial stability in myopic eyes 6 months postoperatively; however, rotational stability over time could not be determined. The physiologic adjustment and change in brightness could influence the anterior segment significantly in eyes with a pIOL.
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