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Wei Q, Chang W, Jiang R, Zhou X, Yu Z. Comprehensive assessment of corneal microstructural changes following V4c implantable collamer lens surgery using in vivo confocal microscopy. BMC Ophthalmol 2024; 24:408. [PMID: 39300374 DOI: 10.1186/s12886-024-03677-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 09/11/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Implantable Collamer Lense (ICL) presents a viable alternative to conventional refractive surgeries, but their impact on corneal microstructure remains unclear. By employing in vivo confocal microscopy (IVCM), we examined changes in stromal and endothelial cells following the insertion of V4c ICLs, with the goal of enhancing post-surgical care and outcomes. METHODS In this longitudinal investigation, we conducted detailed preoperative assessments on 103 eyes from 53 participants. Follow-up evaluations were carried out after surgery at set intervals: one day, one week, one month, three months, six months, and twelve months. We used IVCM to analyze changes in stromal and endothelial cells. To assess differences between pre- and post-surgery variables and to investigate correlations with age, axial length (AL), and spherical equivalent refraction (SER), we applied a repeated measures mixed-effects model, with statistical significance set at P < 0.05. RESULTS No vision-threatening complications were reported post-surgery. Significant reductions in stromal cell density (SCD) were observed postoperatively, with anterior and mid- SCD reaching their lowest values at 3 months and posterior SCD at 1 month, remaining below baseline at 12 months. endothelial cell density (ECD) and percentage of hexagonal cells (PHC) decreased initially, recovering by 12 months. Conversely, endothelial cellular area (ECA) and coefficient of variation of cell size (CoV) increased postoperatively, with the most significant change at 1 week. Endothelial deposits were detected in 49 of 101 eyes on postoperative day 1, half of them were absorbed within 3 months post-surgery. Changes in posterior SCD were negatively related to AL, while AL, SER, lens thickness showed associated with endothelium changes. CONCLUSION Our findings elucidate the corneal microstructural changes following V4c ICL implantation, particularly the significant early reductions in stromal and endothelial cell densities. We recommend careful management of viscoelastics during surgery to minimize endothelial deposits that may harm the endothelium. Enhanced early postoperative monitoring and these surgical adjustments can lead to improved surgical and post-surgical care, ultimately supporting better patient recovery.
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Affiliation(s)
- Qiaoling Wei
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- Ocular Trauma Center, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weiteng Chang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Rui Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- Ocular Trauma Center, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
| | - Zhiqiang Yu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
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Kodali S, Murthy S, Banad N, Dongre P, Senthil S. Glaucoma and refractive surgery: A comprehensive review. Indian J Ophthalmol 2024; 72:1244-1253. [PMID: 39185827 DOI: 10.4103/ijo.ijo_3236_23] [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: 12/11/2023] [Accepted: 04/03/2024] [Indexed: 08/27/2024] Open
Abstract
The global surge in refractive surgeries, particularly among myopic individuals, has elicited concerns regarding potential inaccuracies in the measurement of intraocular pressure (IOP) post surgery, primarily associated with central corneal thinning. The incidence of elevated IOP after intraocular refractive surgeries is higher than expected and is multifactorial. Myopic eyes have a higher susceptibility to both primary and secondary glaucoma. Consequently, meticulous preoperative screening for glaucoma is imperative, coupled with systematic postoperative follow-up and evaluation. This comprehensive review analyses the etiology, mechanisms, and therapeutic strategies for managing elevated IOP following refractive surgery. We propose an algorithm to summarize the causative factors of elevated IOP and formulate effective interventions in these instances.
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Affiliation(s)
- Sivani Kodali
- Glaucoma Services, GMRV Campus, LV Prasad Eye Institute, Visakhapatnam, India
| | - Somasheila Murthy
- Shantilal Shanghvi Eye Institute, Wadala, Mumbai, Maharashtra, India
| | - Nandini Banad
- Shantilal Shanghvi Eye Institute, Wadala, Mumbai, Maharashtra, India
| | - Pankaj Dongre
- Cataract and Refractive Services, GMRV Campus, LV Prasad Eye Institute, Visakhapatnam, India
| | - Sirisha Senthil
- VST Center for Glaucoma, KAR Campus, LV Prasad Eye Institute, Hyderabad, India
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Lee Y, Han SB, Auffarth GU, Son HS, Khoramnia R, Choi CY, Moon K, An SI, Lee JM, Lee JH. Vertical implantable collamer lens as a novel method to increase rotational stability. PLoS One 2024; 19:e0308830. [PMID: 39159219 PMCID: PMC11333007 DOI: 10.1371/journal.pone.0308830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
PURPOSE We investigated the vertical implantation of a toric implantable collamer lens (ICL) and compared the rotational stability with that of horizontal implantation. METHODS This matched comparative study retrospectively reviewed and analyzed data from patients who underwent ICL implantation from 2003-2022 by 1:1 matching vertical and horizontal (V and H toric groups, respectively) implantation patients according to preoperative astigmatism, spherical equivalent, sulcus-to-sulcus, anterior chamber depth, and ICL size. Visual acuity, manifest refraction, vaulting, and rotation were measured 3 months postoperatively. RESULTS We included 646 eyes (323 each in the V and H toric groups). No statistically significant difference was observed between groups in postoperative visual acuity, refractive error, and astigmatism. Vaulting was lower in the V toric group. (P < 0.001). The mean lens rotation in the V toric group was less than that in the H toric group (1.11 ± 2.84° versus 3.02 ± 10.34°, P = 0.001). The proportion of eyes in the V and H toric groups showing ≥10° of rotation was 2.5% (8 eyes) and 6.5% (21 eyes), respectively (P = 0.014). Despite repositioning from rotation, three (0.9%) and eight (2.5%) eyes required removal owing to lens re-rotation in the V and H toric groups, respectively. CONCLUSION Toric ICL vertical implantation showed good rotational stability, and appropriate visual acuity correction results with relatively low vaulting. This procedure therefore presents an effective novel method that could replace horizontal toric ICL implantation.
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Affiliation(s)
- Yongwoo Lee
- Department of Ophthalmology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | | | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kun Moon
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Sang Il An
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Je Myung Lee
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Jong Ho Lee
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
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Zhang Q, Gong D, Li K, Dang K, Wang Y, Pan C, Yan Z, Yang W. From inception to innovation: bibliometric analysis of the evolution, hotspots, and trends in implantable collamer lens surgery research. Front Med (Lausanne) 2024; 11:1432780. [PMID: 39224608 PMCID: PMC11366652 DOI: 10.3389/fmed.2024.1432780] [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: 05/14/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Background As one of several refractive surgeries, Implant Collamer Lens (ICL) surgery offers stable biocompatibility and consistent, high-quality visual outcomes. ICL has become an effective complement to corneal refractive surgery, gradually becoming one of the mainstream methods for correcting refractive errors. This study employs bibliometric methods to analyze research on ICL surgery to understand the progress, hotspots, and potential future trends in this field. Methods This study performed a bibliometric analysis of all ICL-related articles collected from the Web of Science Core Collection database between January 1st, 1996, and December 31st, 2023. The CiteSpace 6.2.R4 tool, Excel and the Web of Science website were used to analyze data by country, institution, keywords, and clusters of keywords. Additionally, an in-depth interpretation and analysis were conducted on the field's high-impact articles. Results Since the first clinical application report of ICL, there have been a total of 875 studies. The number of papers published annually has shown an overall increasing trend. Studies published from China are the most numerous, accounting for 29.14% (n = 255) of the total. Among the institutions, Fudan University and Kitasato University both have published more than 50 papers, with Kitasato University having the highest H-index of 26. The journals with the top 10 publication volumes are all specialized in ophthalmology. The burst keywords since the introduction of ICL surgery have been "intraocular lens," "refractive surgery," and "cataract surgery." The current burst keywords include "visual quality," "vector analysis," "axial length," etc. The results of keyword clustering included ICL, pIOL, high myopia, axial length, optical quality, refractive surgery, ICL implantation, and pupil size. In the High-impact Articles, it was found that the high-impact articles predominantly focus on the safety, efficacy, and predictability of ICL surgery. Conclusion Research on ICL has grown since its clinical introduction, with the advent of the central hole ICL sparking a surge in recent hotspots, particularly in China. Current hotpots in the field of ICL surgery are "visual quality," "ICL implantation," "vector analysis," "axial length," "evo ICL," "ICL v4c," and "ICL." ICL surgery research trends have evolved from implantation techniques to biological parameters associated with ICL surgery and the benefits of new ICL designs.
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Affiliation(s)
- Qing Zhang
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang Medical University, Xinxiang, China
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Di Gong
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kunke Li
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Yun Wang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Changfeng Pan
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Zonghui Yan
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
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Li Y, Zhang F, Xiong Y. Clinical observations of EVO-ICL implantation with single incision without viscoelastic agent. BMC Ophthalmol 2024; 24:344. [PMID: 39143510 PMCID: PMC11323695 DOI: 10.1186/s12886-024-03587-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND To investigate the safety and effectiveness of non-viscoelastic agent technique for EVO-ICL implantation. METHODS A total of 181 myopia eyes that underwent non-toric ICL without viscoelastic agent through single incision from Beijing Tongren Hosipital were included. An analysis was conducted on the quantity of haptics that were initially implanted intraoperatively into the posterior chamber. Intraocular pressure (IOP) was evaluated at before and 2 h,24 h,1week,6month after surgery. Anterior chamber volume(ACV), anterior chamber depth(ACD), anterior chamber angle(ACA), pupil diameter(PD) and corneal densitometry density (ECD) were evaluated at before and 24 h postoperatively. Refractive outcomes were investigated at before, 24 h ,7 days and 6months. Vault was evaluated at 24 h ,7 days and 6months. RESULTS The efficacy and safety indices were 1.30 ± 0.32 and 1.31 ± 0.32, respectively. Of 181 eyes, 99 eyes received 4 haptics on the first attempt without any adjustment, and 72 eyes received lens alignment without an viscoelastic agent. The success rate of the viscoelastic agent free procedure was 94.5%. Two hours postoperatively, IOP was 17.41 ± 3.77 mmHg, which was significantly higher than baseline value (t = 8.930, P < 0.000), however there was no significant difference between preoperative IOP and IOP at 1 day ,1 week and 6 months postoperatively. The ECD changed from 2895.52 ± 253.73 cells/mm2 preoperatively to 2873.66 ± 244.17 cells/mm2 at 1 day and 2882.63 ± 239.97 postoperatively, and the difference was not statistically significant (t = 1.811, P = 0.072). The ACA was narrowed by 42% on the first day. CONCLUSION The pure viscoelastic agent free technique is an efficient and safe way for ICL implantation. It can be a safer method of ICL implantation because of it reduces the risk of complications associated with ocular hypertension at the early postoperative stages. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2000036335) at August 20, 2020.
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Affiliation(s)
- Yu Li
- Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, 100730, China
| | - Fengju Zhang
- Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, 100730, China
| | - Ying Xiong
- Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, 100730, China.
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Chung B, Choi JY, Kang DSY, Kim K, Kim BY, Kim TI. Ten-Year Clinical Outcomes of V4c Implantable Collamer Lens Implantation: Longitudinal Analysis of Visual Acuity, Endothelial Cell Density, and Vault Dynamics. Am J Ophthalmol 2024; 269:1-10. [PMID: 39142448 DOI: 10.1016/j.ajo.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE This study aimed to evaluate the long-term clinical outcomes of V4c Implantable Collamer Lens (ICL) implantation for myopia correction over a 10-year period. DESIGN Retrospective interventional case series METHODS: This retrospective interventional study involved 103 myopic eyes from 54 patients. Visual outcomes, including visual acuity and manifest refraction were assessed. Annual measurements of endothelial cell density (ECD), vault, anterior chamber depth, and intraocular pressure were analyzed using mixed-effects models. RESULTS At the 10-year follow-up, the mean Logarithm of the Minimum Angle of Resolution (logMAR) uncorrected distance visual acuity and corrected distance visual acuity (CDVA) were -0.037 ± 0.052 and -0.041 ± 0.046, respectively. The mean efficacy and safety indices were 1.11 ± 0.13 and 1.12 ± 0.12. A loss of one line of CDVA occurred in 2% of cases, while 59% gained one or more lines. Postoperative manifest refraction spherical equivalent (MRSE) was within ±0.5 diopters (D) and ±1.0 D in 74% and 99% of cases, respectively, with a mean MRSE of -0.19 ± 0.41 D. Data for ECD and vault fit an exponential decay model, demonstrating a continuous yet gradually slowing decrease over time. Decay rates were 0.012 ± 0.001 per year for ECD and 0.056 ± 0.003 per year for the vault. Notably, ECD lower outliers had significantly lower preoperative ECD values. There were no instances of cataract formation, angle closure, glaucoma, or ICL removal throughout the study. CONCLUSIONS The 10-year outcomes of V4c ICL implantation demonstrate effective and safe visual results. Both ECD and vault exhibit exponential decay patterns over the decade. Patients with lower preoperative ECD values require careful post-implantation monitoring.
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Affiliation(s)
- Byunghoon Chung
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - Jin Young Choi
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - David S Y Kang
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - Kangyoon Kim
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - Bo Yi Kim
- Corneal Dystrophy Research Institute, Department of Ophthalmology (B.Y.K., T.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Im Kim
- Corneal Dystrophy Research Institute, Department of Ophthalmology (B.Y.K., T.K.), Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Material Science and Engineering (T.K.), Yonsei University, Seoul, Republic of Korea; Affiliate faculty, Materials Research Center for Batteries (T.K.), Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea.
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Wan Q, He P, Wei R, Ma K, Yin H, Tang J, Deng YP. Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up. Eye (Lond) 2024; 38:1933-1940. [PMID: 38519715 PMCID: PMC11226664 DOI: 10.1038/s41433-024-03046-9] [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: 06/13/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia. METHODS We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was -11.50 D (interquartile range [IQR]: -13.00 to -9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation. RESULTS The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00-1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00-1.25), 1.20 (IQR: 1.00-1.33), and 0.8 (IQR: 0.65-1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery. CONCLUSION In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.
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Affiliation(s)
- Qi Wan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan He
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Health Management & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Ran Wei
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Hongbo Yin
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ying-Ping Deng
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Lwowski C, Van Keer K, Ruscher T, Van Keer L, Shajari M, Kohnen T. Five-year follow-up of a posterior chamber phakic intraocular lens with a central hole for correction of myopia. Int Ophthalmol 2023; 43:4933-4943. [PMID: 37936000 PMCID: PMC10724086 DOI: 10.1007/s10792-023-02896-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/27/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To evaluate intermediate and long-term visual outcomes and safety of a phakic intraocular posterior chamber lens with a central hole (ICL V4c) for myopic eyes. METHODS Retrospective, consecutive case study of patients that uneventfully received a ICL V4c for myopia correction, with a 5-year postoperative follow-up. Department of Ophthalmology, Goethe University Frankfurt, Germany. RESULTS From 241 eyes that underwent ICL implantation, we included 45 eyes with a mean age at surgery of 33 years ± 6 (18-48 years), with a 5 years follow-up. CDVA improved from 0.05logMAR ± 0.15 CDVA preoperatively to - 0.00 ± 0,07 at 5 years and did not change significantly from 3 to 5 years' time (p = 0.266). The mean spherical equivalent (SE) improved from -10.13D ± 3.39 to - 0.45D ± 0.69. The change in endothelial cell count showed a mean decrease of 1.9% per year throughout the follow-up. Safety and efficacy index were 1.16 and 0.78, respectively. Cataract formation was seen in 2 of 241 eyes (0.8%), but in none of the 45 eyes that finished the 5-year follow-up. CONCLUSIONS Our data show a good intermediate and long-term stability, efficiency, and safety of ICL V4c phakic lenses in myopic eyes comparable to other known literature.
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Affiliation(s)
- Christoph Lwowski
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Karel Van Keer
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
- Department of Ophthalmology, UZ Leuven, Leuven, Belgium
| | - Tim Ruscher
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Luisa Van Keer
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Mehdi Shajari
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
- Department of Ophthalmology, Ludwig Maximilian-University, Munich, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
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Caixia L, Yawen B, Yuxin F, Xiaoxia L, Yuhan W, Ke Y, Liya Q. Clinical outcomes of implantation of posterior chamber phakic intraocular lens for pathologic and non-pathologic myopia. BMC Ophthalmol 2023; 23:172. [PMID: 37085809 PMCID: PMC10120149 DOI: 10.1186/s12886-023-02890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 03/30/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND To compare the clinical outcomes of posterior chamber phakic intraocular lens (pIOL) implantation for non-pathological myopia and pathological myopia. METHODS This retrospective case series study which were conducted in Beijing Tongren Eye Center between July 2017 and Oct 2021 comprised 192 eyes of 100 consecutive patients undergoing pIOL implantation. Eyes were divided into two groups based on having pathological myopia or not. Predictability, efficacy, safety, and adverse events were compared at 6 months after pIOL implantation. RESULTS Our study included 86 non-pathological myopes (171 eyes, group1) and 14 pathological myopes (21eyes, group2) to analysis. The average ages were 25.5 and 33.0, respectively, and the spherical equivalent (SE) were -9.31D and -17.50D pre-operation. Six months after pIOL implantation, the SE were 0.00 and -0.50, respectively, and the refraction changes were statistically significant (P ≤ 0.05). Six months after surgery, 76.92% and 80.41% were within ± 0.50 D of the target and 92.31% and 95.88% were within ± 1.00 D. All eyes had unchanged BCVA or gained 1 or more lines in both groups and mean BCVA both improved a line 6m after operation. The efficacy index in the two groups were 0.95 and 0.88 and the safety index were 1.20, 1.33, respectively which was significantly different (P ≤ 0.05). Over the 6-month follow-up, no cataract, pigment dispersion glaucoma, pupillary block, or other vision-threatening complications happened, either. CONCLUSIONS The pIOL performed well for the correction of both non-pathological and pathological myopia throughout the 6-month observation period. The clinical outcomes of pIOL implantation for non-pathological myopia are essentially equivalent to those for pathological myopia.
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Affiliation(s)
- Lin Caixia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Bai Yawen
- Ophthalmology Department, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Fang Yuxin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Li Xiaoxia
- Ophthalmology Department, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Wang Yuhan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Yang Ke
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Qiao Liya
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China.
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Zhang Z, Niu L, Liu T, Shen Y, Shang J, Zhao J, Wei R, Zhou X, Yao P. Primary observations of EVO ICL implantation for high myopia with concave iris. EYE AND VISION (LONDON, ENGLAND) 2023; 10:18. [PMID: 37005642 PMCID: PMC10068169 DOI: 10.1186/s40662-023-00335-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/07/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To investigate the morphological changes of concave iris in myopic patients after EVO implantable collamer lens (ICL) implantation. METHODS EVO ICL candidates with posterior bowing iris were observed using ultrasound biometric microscopy (UBM) in this prospective nonrandomized observational study. Forty patients were enrolled, with 20 patients in the concave iris group and the other 20 patients in the control group. None of the patients underwent laser peripheral iridotomy. All patients received preoperative and postoperative examinations, which included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), subjective manifest refraction and intraocular pressure. UBM was used to observe iris curvature (IC), irido-corneal angle (ICA), posterior chamber angle (PCA), iris-lens contact distance (ILCD), iris-zonule distance (IZD) and ciliary process length (CPL). Anterior chamber angle pigment was observed by gonioscopy. The preoperative and postoperative data were analyzed using SPSS. RESULTS The average follow-up period was 13.3 ± 5.3 months. The mean efficacy indices were 1.10 ± 0.13 and 1.07 ± 0.11 (P = 0.58), and the safety indices were 1.19 ± 0.09 and 1.18 ± 0.17 in the control group and the concave iris group (P = 0.93), respectively. The IOP postoperatively were 14.13 ± 2.02 mmHg and 14.69 ± 1.59 mmHg in control and concave iris groups (P = 0.37). Preoperatively, the concave iris group was presented with greater IC (P < 0.0001), longer ILCD (P < 0.0001), wider ICA (P = 0.004), narrower PCA (P = 0.01), and shorter IZD (P = 0.03) than the control group. In the concave iris group, IC, ILCD and ICA were significantly decreased after ICL implantation (P < 0.0001), while PCA and IZD were significantly increased (P = 0.03 and P = 0.04, respectively). Postoperative IC, ILCD, ICA, PCA and IZD were not statistically different between groups (P > 0.05). There was no significant difference in pigment deposition grades between the two groups (P = 0.37). CONCLUSION After EVO ICL implantation, the morphology of concave iris was significantly improved, which may reduce the risk of intraocular pigment dissemination caused by iris concavity. The concave iris has no impact on the safety of EVO ICL surgery during the follow-up.
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Affiliation(s)
- Zhe Zhang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Tingting Liu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jianmin Shang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ruoyan Wei
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
| | - Peijun Yao
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
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Lisa Fernández C, Alió Del Barrio J, Alvarez-Rementería Capelo L, Cano Ortiz A, Castaño Manotas A, Fernández-Vega Cueto L, Hernández-Barahona Campos M, Lamarca Mateu J, López-Marín Espigares I, Monteiro T, Pastor Pascual F, Pérez Izquierdo R. State of refractive surgery with Visian ICL posterior chamber phakic lens in Spain. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:98-104. [PMID: 36115821 DOI: 10.1016/j.oftale.2022.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To analyse the state of refractive surgery with Visian ICL phakic lens implantation in Spain, indicating the mean ranges of implanted powers, visual and refractive outcomes obtained and safety and efficacy indices. METHOD This is a population-based, cross-sectional, descriptive, analytical, retrospective, multicentre study in which each co-author collected data from at least the last 10 patients (up to a maximum of 30) with Visian ICL phakic lens implantation. One eye from each subject was randomly selected for study inclusion, and the variables analysed were: age, gender, visual acuities with and without correction pre and post-surgery, preoperative and residualrefraction, keratometry, endothelial cellular density, anterior chamber depth from endothelium, central corneal pachymetry, intraocular pressure, white-white, implanted lens (power and size), expected and achieved spherical equivalent (SEQ) post-surgery at one month after surgery. RESULTS A sample of 140 eyes was obtained from 140 patients with a mean age of 31.35 ± 7.28 years. Mean preoperative SEQ was -6.33 ± 3.69D, mean CDVA was 0.96 ± 0.16, ACD was 3.30 ± 0.29 mm, WTW 12.02 ± 0.40 mm, CCT 535.03 ± 37.68 µm, ECD 2684.37 ± 313.74 cels/mm2 and IOP 14.84 ± 2.59 mmHg. 66.4% of the implanted lenses were spherical ICLs and 33.6% toric, with a mean power of -7.81 ± 4.09D and a mean cylinder of 2.27 ± 1.23D. 5.7% of the implanted lenses were hypermetropic. The mean SEQ target selected was +0.04 ± 0.27D. 48.92% of the implanted lenses were of size 13.2 mm, with the remaining 36.69, 10.79 and 3.60% being of sizes 12.6, 12.1 and 13.7 mm, respectively. At one month after surgery a residual SEQ of -0.01 ± 0.31D was obtained. The efficacy and safety indices were 1.06 ± 0.18 and 1.10 ± 0.19, respectively. The mean central vault was 508.80 ± 201.04 µm. The accuracy between the calculated SEQ and the obtained SEQ was 99.3% for spherical lenses and 88.2% for Cyl correction. The mean ECD at 1 month after surgery was 2805.53±273.30céls/mm2, which was a difference from preoperative of 0.11% (p = 0.922), similarly, the mean IOP was 13.98 ± 2.57 mmHg, which was a difference of -0.92 ± 2.80 mmHg. CONCLUSIONS ICL phakic lens surgery is an effective, safe and predictable procedure. There were no significant changes in endothelial cell count or intraocular pressure measurement one month after surgery.
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Affiliation(s)
- C Lisa Fernández
- Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain.
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Martínez-Plaza E, López-de la Rosa A, López-Miguel A, Holgueras A, Maldonado MJ. EVO/EVO+ Visian Implantable Collamer Lenses for the correction of myopia and myopia with astigmatism. Expert Rev Med Devices 2023; 20:75-83. [PMID: 36708714 DOI: 10.1080/17434440.2023.2174429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Intraocular lens implantation in phakic eyes for the correction of refractive error is currently a widespread procedure. The EVO and EVO+ Visian Implantable Collamer Lenses (ICL) are two of the most prevalent lenses implanted. They incorporate a central orifice to avoid the need for iridotomy. The main difference between both ICL is the higher optical diameter zone provided by the EVO+, allowing a better quality of vision at night. This review aims to provide an overview of the current ICL models available for correcting myopia and myopic astigmatism. AREAS COVERED During the last decade, more than 100 scientific papers analyzing the performance of EVO and EVO+ lenses have been published. This review describes the objective visual performance achieved with the implantation of central hole ICL lenses and the subjective perception of the patients implanted with these lenses. In addition, the safety and the potential complications associated with undergoing an EVO and EVO+ ICL implantation have been addressed. EXPERT OPINION Refractive surgeons and candidates to undergo ICL implantation should be aware of the excellent safety and visual outcomes provided by the implantation of central hole ICL lenses. However, future research could address minor issues currently not resolved.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | | | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Alfredo Holgueras
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
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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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Martínez-Plaza E, López-Miguel A, López-de la Rosa A, Maldonado MJ. Inter-eye and postoperative prediction of vault after implantation of EVO + Visian phakic implantable collamer lens. Int Ophthalmol 2022; 43:1501-1510. [PMID: 36260197 DOI: 10.1007/s10792-022-02546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess whether the postoperative outcomes of the implantation of an EVO + implantable collamer lens (ICL) in one eye can be used as a predictor of the vault of the fellow eye, and to evaluate the vault changes of the implantation in both eyes during the postoperative period. METHODS A prospective study including 40 eyes of 20 patients with a bilateral EVO + ICL implantation was performed. Subjects were evaluated before the surgery and 1 day, 1 week and 1, 3 and 6 months postoperatively. Central vault was assessed using spectral-domain optical coherence tomography. The inter-eye and follow-up analyses were performed using lineal models and the Bland-Altman method. RESULTS The vault of the first implanted eye at the 1-day visit highly predicts the vault of the second eye (R2 = .87; P < .001); the mean inter-eye difference was - 0.95 μm, and the superior and inferior limits of agreement were -50.27 μm and 148.37 μm, respectively. This relationship was maintained during the medium-term follow-up, not finding differences in the slopes among visits (P ≥ .09). A progressive decrease of vault was found during the follow-up (P < .001). Larger vault change 6 months after the surgery was associated with higher vault 1 day after the ICL implantation (R2 = .19;P = .005). CONCLUSION One-day postoperative vault in the first eye can help to predict the optimal ICL sizing in the second eye. Vault tends to decrease during the first 6 months after EVO + ICL implantation. Eyes with higher initial vaults will also show larger reductions during the medium-term follow-up.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain.
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
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Factors leading to realignment or exchange after implantable collamer lens implantation in 10 258 eyes. J Cataract Refract Surg 2022; 48:1190-1196. [PMID: 35351844 PMCID: PMC9514736 DOI: 10.1097/j.jcrs.0000000000000950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/24/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the incidence, causes, and outcomes of implantable collamer lens (ICL) realignment or exchange after implantation of the EVO-ICL. SETTING Eye and ENT Hospital of Fudan University, China. DESIGN Retrospective study. METHODS The study included 10 258 consecutive eyes after ICL implantation. Preoperative refractive and biometric measurements were compared between eyes with and without realignment or exchange. For eyes with ICL realignment or exchange, visual and biometric outcomes were also compared before and after ICL realignment or exchange. RESULTS The overall incidence of ICL realignment or exchange was 0.21% 22 eyes. 12 eyes (0.12%) underwent ICL realignment by axis rotation (10 eyes) or ICL exchange (2 eyes) due to toric ICL (TICL) misalignment. After realignment, uncorrected distance visual acuity improved, and residual cylinder decreased from -1.75 ± 0.48 diopters (D) to -0.87 ± 0.59 D ( P = .01). 10 eyes (0.10%) underwent vertical rotation of ICL (3 eyes) or ICL exchange (7 eyes) due to excessive vault. After either vertical rotation or ICL exchange, vault decreased significantly ( P < .05). CONCLUSIONS The incidence of ICL realignment or exchange after ICL implantation is low. TICL misalignment and excessive vault are 2 main causes. Implant exchange may be performed for excessive vault or misalignment with an insufficient vault. In addition, vertical rotation of an ICL may be a less invasive method to treat excessive vault in certain cases.
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Baamonde B, Madrid-Costa D, Alfonso JF. Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty. EYE AND VISION 2022; 9:34. [PMID: 36068603 PMCID: PMC9450313 DOI: 10.1186/s40662-022-00306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up.
Methods
This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed.
Results
The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery (P < 0.0001) and remained unchanged throughout the whole follow-up (P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up (P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%.
Conclusions
The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.
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Alonso-Juárez E, Velázquez-Villoria D. Low Diopter Phakic Implantable Collamer Lens: Refractive and Visual Outcomes in Low Myopia and Myopic Astigmatism. Clin Ophthalmol 2022; 16:2969-2977. [PMID: 36081600 PMCID: PMC9447455 DOI: 10.2147/opth.s373378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ernesto Alonso-Juárez
- INSADOF Clinic, Salamanca, Spain
- Correspondence: Ernesto Alonso-Juárez, INSADOF, Calle Doctrinos, 4, 1, Salamanca, 37002, Spain, Email
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Mahmoud MSED, AttaAllah HR. Clinical Outcomes of Toric Implantable Collamer Lens (T-ICL) and Toric Implantable Phakic Contact Lens (IPCL) for High Myopia with Astigmatism: A Comparative Study. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2204050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Our study aimed to compare the clinical, visual outcomes, and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) in patients with high myopia and astigmatism over a follow-up period of 6 months.
Methods:
A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B, including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, central corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1 and 6 months post-surgery. Any complications either during or after surgery were assessed.
Results:
In both study groups, the mean central corneal endothelial cell count was significantly decreased after 1 month and improved to reach near pre-operative values after 6 months postoperatively, indicating good lens biocompatibility. A statistically significant increase in IOP was found in both groups during the early follow-up, and a significant decrease after 6 months postoperatively (p=0.036) was reported in group A. A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with pre-operative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.3 D & - 0.3 D) at the end of 6 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.3 D & - 0.3 D) by the end of follow up period. A statistically significant improvement of UCDVA at 6 months postoperatively was found in both groups, as median preoperative LogMAR UCDVA was 1.1 and 1.3 in groups A and B respectively, which was improved to 0.3 in both groups at the end of follow-up period. There were no reported intra- or postoperative complications such as cataract, keratitis, or lens decentration.
Conclusion:
Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier to implant than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.
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Fu M, Li M, Xian Y, Yu Z, Zhang H, Choi J, Niu L, Wang X, Zhou X. Two-Year Visual Outcomes of Evolution Implantable Collamer Lens and Small Incision Lenticule Extraction for the Correction of Low Myopia. Front Med (Lausanne) 2022; 9:780000. [PMID: 35492322 PMCID: PMC9043127 DOI: 10.3389/fmed.2022.780000] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/07/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To investigate the 2-year visual quality of Evolution Implantable Collamer Lens (EVO-ICL) and small incision lenticule extraction (SMILE) for the correction of low myopia. Methods In this prospective study, we included 25 eyes of 25 patients (7 men) who underwent EVO-ICL and 36 eyes of 36 patients (16 men) who underwent SMILE between January 2018 and December 2018. Subjective and objective visual outcomes were compared between ICL and SMILE. All patients were followed for 2 years. Results At the postoperative 2-year visit, the percentage of patients with uncorrected distance visual acuity (UDVA) greater than or equal to preoperative corrected distance visual acuity (CDVA) was comparable in the ICL group (80%, 20/25) and SMILE group (88.89%, 32/36). Spherical equivalent (SE) was within ± 0.50 D in 96% (24/25) of the ICL group and 94.44% (34/36) of the SMILE group. No eyes lost more than 2 lines of CDVA. Postoperative high-order aberrations (HOAs) were significantly increased in the ICL group (p < 0.01) and in the SMILE group (p < 0.01). The most common visual complaint was halo after ICL and starburst after SMILE. There was no correlation between HOAs and visual complaints (p > 0.05). Conclusion Evolution Implantable Collamer Lens provides comparable safety, efficacy, long-term visual stability, and high patient satisfaction when compared to SMILE in correcting low myopia. EVO-ICL could be a favorable alternative for low myopia. Key messages What was known? What this paper adds?
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Affiliation(s)
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yiyong Xian
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhiqiang Yu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | | | - Joanne Choi
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Branger GA, Baenninger P. Late-Onset Toric Implantable Collamer Lens Rotation: A Case Report. Klin Monbl Augenheilkd 2022; 239:416-417. [PMID: 35472781 DOI: 10.1055/a-1785-4276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chen Z, Niu L, Zhao J, Yao P, Wang X, Zhou X. One-year Observation of Safety of Implantable Collamer Lens V4c Implantation Without Using an Ophthalmic Viscosurgical Device. Front Med (Lausanne) 2022; 9:790137. [PMID: 35237622 PMCID: PMC8882649 DOI: 10.3389/fmed.2022.790137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/24/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the feasibility and safety of the implantable collamer lens V4c (ICL V4c) implantation without using an ophthalmic viscosurgical device (OVD-free technique). Methods This prospective consecutive case study enrolled 118 eyes of 60 patients (15 eyes were of male patients, 103 eyes were of female patients, age 26.19 ± 5.03 years, spherical equivalent −10.05 ± 2.73 D). Eyes were considered for OVD-free or OVD-using ICL V4c implantation based on the maintenance of the anterior segment during the surgery. The follow-up lasted for 12 months. The main measurements were visual acuity and changes in endothelial cell density (ECD) at 12 months. Results A total of 75 eyes were included in the OVD-free group and 43 in the OVD group. No infection or other complications were observed in any eye. In the OVD-free group, the safety and efficacy indices were 1.19 ± 0.15 and 1.05 ± 0.20, respectively. 74.5% of the eyes gained one or two lines of corrected distance visual acuity (CDVA), and 25.5% were stable. In the OVD group, the safety and efficacy indices were 1.17 ± 0.17 and 1.03 ± 0.15, respectively; 65.7% of the eyes gained one or two lines of CDVA, and 34.3% were stable. The mean change of ECD was 65.34 cell/ mm2 compared to the baseline in the OVD-free group and 25.94 cell/ mm2 compared to baseline in the OVD group (P = 0.038). Conclusions The ICL V4c implantation with an OVD-free technique is a safe and feasible method in eyes with good maintenance of the anterior segment.
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Affiliation(s)
- Zhuoyi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- *Correspondence: Xingtao Zhou
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Changes of ocular biometry in eyes with posterior chamber phakic intraocular lens implantation. J Fr Ophtalmol 2022; 45:377-383. [PMID: 35093264 DOI: 10.1016/j.jfo.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/17/2021] [Accepted: 10/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate changes in biometric variables and intraocular lens (IOL) calculation results after posterior chamber phakic IOL (PCPIOL) implantation. METHODS This retrospective, observational study included 65 eyes of 38 patients who underwent PCPIOL (EVO Visian ICL) implantation for correction of myopia. Prior to and a minimum of one year (mean 14.9 months) after EVO Visian ICL implantation, biometric variables and IOL calculation results were compared. Optical biometry, including anterior chamber depth, axial length, flat, steep, and mean keratometry values and IOL calculation results for the Holladay 2, Hoffer Q, Haigis, and SRK/T formulas were measured using the IOLMaster 700 SWEPT Source OCT biometer. MAIN RESULTS The mean anterior chamber depth decreased from 3.70±0.22mm to 3.34±0.39mm, the mean axial length increased from 26.61±1.61mm to 26.71±1.66mm, and the mean flat keratometry changed from 42.82±1.86 D to 42.73±1.83 D. These changes were statistically significant. The mean IOL power calculation also revealed a statistically significant decrease with all four formulas (ranging from 0.19 D to 0.30 D) after PCPIOL implantation. CONCLUSIONS Biometric variables and IOL calculation results showed statistically significant changes one year after EVO Visian ICL implantations. However, IOL power calculations yielded a decrease of less than 0.50 D, inducing much less refractive deviation in the spectacle plane; and the change was primarily related to an increase in AL measurements. IOL power calculations in eyes with EVO Visian ICL in situ provided satisfactory and reliable results.
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Chen X, Wang X, Xu Y, Cheng M, Han T, Wang X, Zhou X. Long-term Comparison of Vault and Complications of Implantable Collamer Lens with and without a Central Hole for High Myopia Correction: 5 Years. Curr Eye Res 2021; 47:540-546. [PMID: 34894946 DOI: 10.1080/02713683.2021.2012202] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the long-term safety, efficacy, stability, vault, and complications of implantable collamer lens with (ICL V4c) and without (ICL V4) a central hole for correcting high myopia. METHODS 78 eyes (40 patients) underwent ICL V4c implantation and 78 eyes (48 patients) underwent ICL V4 implantation were enrolled. They were followed up for 5 years of the uncorrected and corrected distance visual acuity, spherical equivalent (SE), axial length, intraocular pressure, endothelial cell density and vault. RESUITS The safety indices of the ICL V4c and V4 groups at 5 years were 1.25 ± 0.40 and 1.31 ± 0.40, respectively (P = .353). The efficacy indices were 0.90 ± 0.29 and 1.00 ± 0.44, respectively (P = .098). The preoperative, 1 month and 5 year postoperative logMAR UDVAs were respectively 1.54 ± 0.48, 0.11 ± 0.17, and 0.20 ± 0.26 in the V4c group and 1.56 ± 0.44, 0.14 ± 0.19, and 0.22 ± 0.26 in the V4 group (P = .703, 0.329, 0.585). The logMAR CDVAs were resepectively 0.13 ± 0.18, 0.02 ± 0.11, and 0.05 ± 0.16 in the V4c group and 0.18 ± 0.22, 0.05 ± 0.14, and 0.09 ± 0.21 in the V4 group (P = .128, 0.169, 0.229). The SE were resepectively -15.10 ± 4.32 D, -0.71 ± 1.31 D and -1.65 ± 1.30 D in the V4c group and -15.44 ± 3.51 D, -0.61 ± 1.12 D and -1.40 ± 1.30 D in the V4 group (P = .585, 0.637, 0.296). The mean vault reduced by 97.31 ± 136.61 μm in the V4c group and by 99.74 ± 245.83 μm in the V4 group. Three eyes (3.85%) with mid-periphery anterior subcapsular opacification in the V4c group and two (2.56%) with cataract, one (1.28%) with central anterior subcapsular opacification in the V4 group were observed. The CDVA of 20/40 was obtained in the two cataract eyes after phacoemulcification and intraocular lens implantation. CONCLUSION Long-term ICL V4c and ICL V4 implantations are safe, effective, and stable for high myopia correction. ICL V4c can potentially reduce the risk of lens opacification and may be more tolerant to low vault than ICL V4.
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Affiliation(s)
- Xun Chen
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqi Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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A Comparative Study of Two Types of Implantation Surgery Methods for Implantable Collamer Lenses. J Ophthalmol 2021; 2021:4074773. [PMID: 34845422 PMCID: PMC8627330 DOI: 10.1155/2021/4074773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/09/2021] [Accepted: 11/06/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate the effects of two different surgical methods of implantable collamer lens (ICL) implantation on the operation time, visual outcomes, corneal endothelial cell count, and intraocular pressure (IOP). Methods This was a contralateral eye comparison study, a total of 192 eyes from 96 patients were included, and the two eyes from the same patient were randomly assigned to two groups (group 1 and group 2, with 96 eyes in each group). In group 1, after making the corneal incision, ophthalmic viscosurgical devices (OVDs) were first injected into the anterior chamber followed by ICL implantation. In group 2, the ICL was first implanted into the anterior chamber followed by OVDs injection. The operation time, uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, corneal endothelial cell count, and IOP were recorded and analyzed. Results The operative time in group 1 was significantly longer than that in group 2 (P = 0.002 < 0.05). There were significant differences between IOP measured 2 hours following surgery of the two groups (P = 0.026 < 0.05), Furthermore, the rate of IOP change 2 hours following the operation was significantly higher in group 1 than in group 2 (P = 0.019 < 0.05). There were significant differences in the anterior chamber angle 2 hours after surgery compared with that before surgery in both groups (P = 0.014 < 0.05 and P = 0.029 < 0.05, respectively). No significant differences were observed in the other parameters measured (all P > 0.05). Conclusion The two ICL implantation methods had similar clinical outcomes and effects on the corneal endothelial cell count. Additionally, the implantation of an intraocular lens prior to injecting OVDs reduces the operation time and lowers the rate of IOP rise in the early postoperative period, making it safe and effective for ICL implantation.
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Long-term efficacy and safety results after iris-fixated foldable phakic intraocular lens for myopia and astigmatism: 6-year follow-up. J Cataract Refract Surg 2021; 47:211-220. [PMID: 32925647 DOI: 10.1097/j.jcrs.0000000000000419] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/04/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the long-term efficacy and safety of iris-fixated foldable phakic intraocular lenses (pIOLs) for the management of myopia and astigmatism after 6-year follow-up. SETTING Ophthalmology Department, Hospital Braga, Portugal. DESIGN Retrospective cohort study. METHODS Patients included underwent iris-fixated foldable Artiflex pIOL implantation between January 2010 and December 2013. Follow-up evaluations were performed 6 months postoperatively and every 12 months until 72 months. Preoperative and follow-up data on uncorrected and corrected distance visual acuity (CDVA), manifest refraction, endothelial cell density (ECD), and anterior chamber depth (ACD) were analyzed. RESULTS A total of 177 eyes of 98 patients with a mean age of 32.33 ± 7.13 years were analyzed. There was a statistically significant improvement in CDVA from 0.09 ± 0.02 logMAR preoperatively to 0.04 ± 0.02 logMAR (P < .0001) at 6 years postoperatively. The spherical equivalent demonstrated a statistically significant improvement from -9.50 ± 2.93 diopters (D) to -0.41 ± 0.45 D at 6 years. At 72 months, the efficacy and safety indexes were 0.94 and 1.15, respectively. A mean loss of 31.77 cells/mm2 (1.19%) was observed each year until the sixth year. The overall mean ECD loss after correction for the physiological loss was 3.02% after 6 years. No correlations were observed between the mean ECD loss and the preoperative ACD. CONCLUSIONS The Artiflex pIOL was a safe, effective, and a stable option to correct myopia. A mean ECD loss of 3.02% was observed over 6 years. No pIOL was explanted due to corneal decompensation.
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Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Lisa C, Madrid-Costa D, Alfonso JF. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. EYE AND VISION 2021; 8:23. [PMID: 34112241 PMCID: PMC8194243 DOI: 10.1186/s40662-021-00247-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. METHODS Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. RESULTS The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was - 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.
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Affiliation(s)
| | | | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, University Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
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Montés‐Micó R, Ruiz‐Mesa R, Rodríguez‐Prats JL, Tañá‐Rivero P. Posterior-chamber phakic implantable collamer lenses with a central port: a review. Acta Ophthalmol 2021; 99:e288-e301. [PMID: 32841517 PMCID: PMC8246543 DOI: 10.1111/aos.14599] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023]
Abstract
We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow‐up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time‐points post‐surgery. In addition, adverse events and other parameters such as endothelial cell density, intraocular pressure and vault measurements—which were evaluated in some of the studies—were also compared. This review encompassed a total of 2904 eyes. The outcomes reported in this review lead us to conclude that ICL V4c implantation for myopia correction is a safe and efficient procedure, with stable visual and refractive outcomes and low adverse event rates. The patient’s anterior segment should be thoroughly characterized, and the ICL parameters should be carefully selected so as to achieve good outcomes and avoid complications.
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Affiliation(s)
- Robert Montés‐Micó
- Oftalvist Alicante Spain
- Optics and Optometry and Vision Sciences Department University of Valencia Valencia Spain
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The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation. J Ophthalmol 2020; 2020:4014512. [PMID: 32774903 PMCID: PMC7391088 DOI: 10.1155/2020/4014512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/11/2020] [Accepted: 06/24/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP ≥ 21 mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (χ2 = 7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher (p < 0.001) in the right eyes, and TIA and AOD were significantly lower (p < 0.05) in the right eyes than in the left eyes. There was no significant difference at 24 h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (β = −23.707 and 1.731, respectively; p = 0.013 and 0.002, respectively). Conclusion The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes.
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Yang W, Zhao J, Sun L, Zhao J, Niu L, Wang X, Zhou X. Four-year observation of the changes in corneal endothelium cell density and correlated factors after Implantable Collamer Lens V4c implantation. Br J Ophthalmol 2020; 105:625-630. [PMID: 32546550 PMCID: PMC8077217 DOI: 10.1136/bjophthalmol-2020-316144] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 11/23/2022]
Abstract
Background To evaluate the changes in corneal endothelium cell density (ECD) and the correlated factors after Implantable Collamer Lens (ICL) V4c implantation. Methods In this retrospective, consecutive study, 48 eyes of 25 patients with myopia who underwent ICL V4c implantation were enrolled. Patients were followed up for at least 4 years, during which manifest refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, ECD, anterior chamber depth, anterior chamber volume (ACV), anterior chamber angle (ACA), vault and distance from the corneal endothelium to the central ICL (C-ICL) were measured. Spearman’s correlation analysis was used to identify variables correlated with changes in ECD, and generalised estimating equation model adjusting within-patient intereye correlations was used to predict changes in ECD. Results All surgeries were performed safely with no complications during follow-up (average 52±2.9 months). Safety and efficacy indices were 1.23±0.22 and 1.04±0.16, respectively. No eyes had decreased CDVA, and 67% gained one or more lines. Further, 79% were within ±0.50 D, and 100% were within ±1.0 D of the attempted refraction. Additionally, a 4.03%±2.2% reduction in ECD compared with the preoperative value was observed at the last follow-up visit. Changes in ECD were significantly correlated with vault, C-ICL, change in ACA and change in ACV. Vault was the most significant factor for changes in ECD. Conclusions ICL V4c implantation is safe and effective for myopia correction. Anterior segment biometric parameters including the vault, ACA and C-ICL may influence changes in ECD; specifically, the vault plays a major role.
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Affiliation(s)
- Wen Yang
- Department of Ophthalmology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jing Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ling Sun
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jiao Zhao
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
| | - Lingling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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30
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Anterior chamber angle width, central vault and intraocular pressure changes after 12 months of Visian collamer lens implantation. Int Ophthalmol 2020; 40:2047-2053. [DOI: 10.1007/s10792-020-01381-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/10/2020] [Indexed: 12/30/2022]
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Pan AP, Wen LJ, Shao X, Zhou KJ, Wang QM, Qu J, Yu AY. A novel ophthalmic viscosurgical device-free phakic intraocular lens implantation makes myopic surgery safer. EYE AND VISION 2020; 7:18. [PMID: 32280722 PMCID: PMC7137322 DOI: 10.1186/s40662-020-00185-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 03/16/2020] [Indexed: 11/18/2022]
Abstract
Purpose To assess the efficacy and safety of a novel ophthalmic viscosurgical device-free (OVD-free) method for posterior chamber phakic intraocular lens (PIOL) implantation in myopic eyes. Methods In this retrospective cohort study, the medical records of myopic eyes that underwent PIOL (Implantable Collamer Lens, ICL) implantation for myopia correction at the Eye Hospital of Wenzhou Medical University between May 2015 and March 2017 were reviewed. A total of 49 eyes with complete data that met follow up requirements (2 h, 1 day, 1 week, 3 months postoperatively) were recruited. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the standard method group. The clinical data, including intraocular pressure (IOP), corrected distance visual acuity (CDVA) and spherical equivalent (SE), at each follow-up were collected for comparison. Endothelial cell loss and complications were also investigated. Results Twenty-one eyes received the standard method, and 28 eyes received the OVD-free method. A rise in IOP > 22 mmHg at 2 h was noted in 14 eyes (66.7%) in the standard group and none (0%) in the OVD-free group (p < 0.001). The rise in IOP from baseline was significantly higher at 2 h in the standard group (10.5 ± 5.2 mmHg vs. 2.2 ± 3.3 mmHg, difference: 8.3, 95% CI 5.8 to 10.8; p < 0.001). There was a significant difference in the time course of LogMAR CDVA changes between the two groups (p = 0.047). The LogMAR CDVA was significantly better in the OVD-free method group compared to the standard group at 1 day (− 0.076, 95% CI − 0.134 to − 0.018; p = 0.012), 1 week (− 0.071, 95% CI − 0.135 to − 0.007; p = 0.03), but not at 3 months (− 0.046, 95% CI − 0.107 to 0.015; p = 0.134). There was no significant difference in the time course of SE changes between the two groups (p = 0.471; p = 0.705). In the OVD-free group, mean endothelial cell loss was 4.6% at 3 months (2522 ± 281 vs. 2407 ± 226 cells/mm2, difference: -115, 95% CI − 295 to 65; p = 0.187). No complications were reported in both groups except for the early IOP elevation in the standard group during the observation period. Conclusions The OVD-free method is safe and efficient for ICL implantation. It can be a safer method of ICL implantation compared to the standard method in that it completely eliminates ophthalmic viscoelastic devices-related complications without causing additional complications.
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Affiliation(s)
- An-Peng Pan
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
| | - Li-Jin Wen
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
| | - Xu Shao
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
| | - Kai-Jing Zhou
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
| | - Qin-Mei Wang
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
| | - Jia Qu
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
| | - A-Yong Yu
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang P. R. China
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Chen X, Shen Y, Xu H, Wang X, Zhou X. One-year natural course of corneal densitometry in high myopic patients after implantation of an implantable collamer lens (model V4c). BMC Ophthalmol 2020; 20:50. [PMID: 32050942 PMCID: PMC7017626 DOI: 10.1186/s12886-020-1320-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/17/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Corneal densitometry, which is also known as corneal backscattering, is a surrogate measure of corneal clarity. The purpose of the study was to investigate the changes in corneal densitometry (CD) after implanting an implantable collamer lens (ICL-V4c). METHOD Twenty-six high myopic patients (aged 29.3 ± 6.6 years, 6 males and 20 females) who underwent ICL-V4c implantation were enrolled. Intraocular pressure (IOP), corneal topography, corneal densitometry, uncorrected distance visual acuity (UCDVA), manifest refraction, and best corrected distance visual acuity (BCDVA) were evaluated pre-operatively and at 1 day, 1 week, and 1, 3, 6, and 12 months post-operatively. Endothelial cell density (ECD) was measured pre-operatively and at 3, 6, and 12 months post-operatively. The efficacy index (mean post-operative UCDVA / mean pre-operative BCDVA) and the safety index (mean post-operative BCDVA / mean pre-operative BCDVA) were evaluated at 1 month, 3 months, 6 months and 12 months post-operatively. RESULTS Over the annular diameters of 0-2 mm, the pre-operative densitometry values of the anterior layer, central layer, posterior layer, and total layer were 20.1 ± 2.8, 11.8 ± 1.1, 10.5 ± 0.9 and 14.1 ± 1.5, respectively. From pre-operatively to post-operative Month 12, the values changed insignificantly (P = 0.177, P = 0.153, P = 0.543 and P = 0.207, respectively). Over the annular diameters of 2-6 mm, the pre-operative mean densitometry values were 17.9 ± 2.2, 10.5 ± 0.9, and 12.6 ± 1.2, respectively. From pre-operatively to post-operative Month 12, the values decreased to 16.5 ± 2.1, 10.0 ± 0.9, and 11.9 ± 1.2, respectively, which were similar to the pre-operative values (all P > 0.05) but significantly lower than the values obtained at post-operative Day 1 (P = 0.013, P = 0.002 and P = 0.010, respectively). The densitometry value of the posterior layer over the annular diameters of 2 to 6 mm remained unchanged (from 9.4 ± 0.7 to 9.1 ± 0.7) over time (P = 0.372). The efficacy and safety indices assessed at 12 months post-operatively were 1.04 ± 0.27 and 1.19 ± 0.23, respectively. The changes in IOP and ECD values were statistically insignificant (P = 0.896 and P = 0.968, respectively). CONCLUSION ICL-V4c implantation may be safe and efficient for high ametropia correction. The corneal densitometry values obtained over the annulus of 0-6 mm increased slightly from before the operation to post-operative Day 1 and then decreased gradually, which indicates that ICL-V4c implantation may not compromise corneal clarity.
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Affiliation(s)
- Xun Chen
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yang Shen
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Haipeng Xu
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China. .,NHC Key Lab of Myopia (Fudan University), Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| | - Xingtao Zhou
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Wan T, Yin H, Wu Z, Yang Y. Comparative Study of Implantable Collamer Lens Implantation in Treating Four Degrees of Myopia: Six-Month Observation of Visual Results, Higher-Order Aberrations, and Amplitude of Accommodation. Curr Eye Res 2019; 45:839-846. [PMID: 31801031 DOI: 10.1080/02713683.2019.1701690] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare the visual and refractive outcomes, higher-order aberrations (HOAs), and amplitude of accommodation (AA) after implantable collamer lens (ICL) model V4c implantation in four degrees of myopia. METHODS One hundred and thirty-seven myopic eyes (137 patients) undergoing ICL implantation were included and divided into four groups: Group 1 with spherical equivalent (SE) ≤-6.0D, Group 2 with SE from -6.13D to -9.0D, Group 3 with SE from -9.13D to -12.0D, and Group 4 with SE from -12.13D to -18.0D. The postoperative visits were scheduled at 1 day, 1 week, 1 month, 3 months, and 6 months. Visual and refractive outcomes, HOAs and AA were observed and compared. RESULTS At 6 months postoperatively, the uncorrected distance visual acuity (UDVA) in Group 4 was worse than the values in the other groups (all p < .05). Meanwhile, Group 4 had more eyes with corrected distance visual acuity (CDVA) improvement than the other groups. Furthermore, 96%, 100%, 100%, and 81% of eyes had an SE within ±0.5D in Group 1, Group 2, Group 3, and Group 4 (p < .05 between Group 4 and the other groups), respectively. The postoperative UDVA and SE remained stable in all groups. No significant change in total HOAs was found between preoperative and postoperative values for each group. However, quatrefoil increased in each group, whereas trefoil was induced in all groups except for Group 1. Negative spherical aberration was induced in Group 3 and Group 4. AA significantly decreased 1 week postoperatively and gradually improved in each group. Although AA improved to the preoperative level in Group 1 at 3 months postoperatively, it was still lower than the preoperative level in the other groups. CONCLUSIONS In treating different degrees of myopia with ICL implantation, differences were observed in terms of CDVA improvement, SE predictability, HOAs induction, and accommodation recovery.
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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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Repplinger B, Kohnen T. [Intraocular pressure after implantation of an ICL with aquaport : Development of intraocular pressure after implantation of an ICL (model V4c) with aquaport without iridotomy]. Ophthalmologe 2019; 115:29-33. [PMID: 28887673 DOI: 10.1007/s00347-017-0556-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The latest version of the intraocular lens (ICL V4c) has a central hole (aquaport) that avoids a pupillary block. Due to this laser iridotomy or intraoperative surgical peripheral iridectomy are no longer required. In this study, we examined the intraocular pressure (IOP) after implantation of the ICL with aquaport, with special reference to the development of a possible pupillary block glaucoma. MATERIAL AND METHODS This retrospective non-randomized study included 87 eyes from 46 patients (consecutive case series). These patients had the ICL model V4c (without a laser iridotomy or peripheral iridectomy) implanted between January 2013 and October 2014. The preoperative IOP values were compared with the postoperative values 1-2 h, 1 day, 1 week and 1 month after implantation. RESULTS The median intraocular pressure was 14 ± 2 mm Hg before implantation of the ICL, palpatory normotensive 1-2 h after implantation, 13 ± 3 mm Hg 1 day after implantation, 15 ± 3 mm Hg 1 week after implantation and 16 ± 4 mm Hg 1 month after implantation (a slight statistically significant increase of the intraocular pressure, p < 0.05). In 2 patients there was a steroid response in both eyes with IOP reaching up to a maximum of 28 mm Hg. There were no peaks of intraocular pressure due to a pupillary block. CONCLUSION It is possible to implant the latest ICL V4c with a central hole (Aquaport) without a laser iridotomy or peripheral iridectomy or development of a pupillary block.
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Affiliation(s)
- B Repplinger
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
| | - T Kohnen
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
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Alfonso JF, Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Montés-Micó R, Fernández-Vega L. Five-Year Follow-up of Correction of Myopia: Posterior Chamber Phakic Intraocular Lens With a Central Port Design. J Refract Surg 2019; 35:169-176. [PMID: 30855094 DOI: 10.3928/1081597x-20190118-01] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 01/14/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the long-term correction of moderate to high myopia using a posterior chamber phakic intraocular lens with a central port design. METHODS Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events over a 5-year period were evaluated retrospectively. RESULTS A total of 147 eyes (83 patients) were evaluated. Mean postoperative UDVA and CDVA were 0.05 ± 0.11 and 0.02 ± 0.08 logMAR at 1 year and 0.13 ± 0.18 and 0.02 ± 0.09 logMAR at 5 years, respectively. More than 95% of eyes achieved CDVA of 20/25 or better at both follow-up periods. CDVA was unchanged or improved from one to three or more lines in all eyes. Preoperatively, mean spherical equivalent (SE) was -9.20 ± 3.02 diopters (D). At 1 year, the mean SE was -0.17 ± 0.26 D, with 91.53% of eyes within ±0.50 D and 100% of eyes within ±1.00 D of the target. At 5 years, the mean SE was -0.44 ± 0.47 D, with 67.4% of eyes within ±0.50 D and 90.1% of eyes within ±1.00 D of the target. Mean IOP was 12.74 ± 1.65 and 13.0 ± 2.03 mm Hg, at 1 and 5 years, respectively. No significant rise in IOP (> 20 mm Hg) occurred during the follow-up period. Mean ECD was 2,696 ± 358 and 2,645 ± 359 cells/mm2 at 1 and 5 years, respectively, representing a non-significant loss of 0.43% from preoperative values (P = .304). Mean vault changed significantly from 398 ± 187 µm at 1 year to 340 ± 163 µm at 5 years (P < .001). No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The good long-term outcomes found in this study support the use of this lens with a central port design for the correction of moderate to high myopia. [J Refract Surg. 2019;35(3):169-176.].
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Fernández J, Rodríguez-Vallejo M, Martínez J, Tauste A, Hueso E, Piñero DP. Confounding sizing in posterior chamber phakic lens selection due to white-to-white measurement bias. Indian J Ophthalmol 2019; 67:344-349. [PMID: 30777951 PMCID: PMC6407395 DOI: 10.4103/ijo.ijo_613_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: To assess the agreement in the white-to-white (WTW) measurement with two different devices, the reproducibility and the probability of confusing sizing (PCS) in selecting a different implantable collamer lens (ICL). Study Design: Retrospective observational case series. Methods: Images of 192 eyes were captured with both devices. The WTW was measured automatically (OA) and manually (OM) with the Orbscan and Keratograph (KA and KM) by one examiner who repeated a total of four measures. A second examiner conducted a single manual measure for each device over the same image. The ICL sizing was computed for each measure of WTW and the PCS was calculated as the percentage of cases for which the confronted or repeated measure resulted in a different size of the ICL. The critical WTWs with highest PCS were identified. Results: KM overestimated the WTW versus OM in 0.13 ± 0.18 mm (P < 0.001) but not in the automated method comparison, 0.01 ± 0.19 mm (P = 0.58). Inter-examiner reproducibility (R) was higher with OM than with KM, and the intra-examiner R decreased with the average of two measures in both cases. The PCS was higher with the increase of mean differences, the limits of agreement (LoAs), and R. WTWs from 11.1 to 11.2 mm, 11.6 to 11.7 mm, and 12.3 to 12.4 mm resulted in higher PCS. Conclusion: The mean difference is not enough to apply conversions between devices and the LoAs and R should be considered. Special attention should be taken for WTWs with higher PCS.
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Affiliation(s)
- JoaquIn Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120; Department of Ophthalmology, Torrecárdenas Hospital Complex, 04009, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - Ana Tauste
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - Elisa Hueso
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante; Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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Abstract
The purpose of this review is to summarize preclinical and clinical data from publications appearing in the peer-reviewed scientific literature relevant to the safety and effectiveness of the EVO Implantable Collamer Lens (ICL) posterior chamber phakic refractive lens with a central port (V4c Visian ICL with KS Aquaport, STAAR Surgical, Inc.). A literature search was conducted using PubMed.gov to identify all articles relating to the EVO ICL. Articles were examined for their relevance, and the references cited in each article were also searched for additional relevant publications. On the basis of a total of 67 preclinical studies and clinical reports, including effectiveness data on 1,905 eyes with average weighted follow-up of 12.5 months and safety data on 4,196 eyes with weighted average follow up of 14.0 months, the EVO ICL is safe and effective for the correction of a broad range of refractive errors. High levels of postoperative uncorrected visual acuity, refractive predictability, and stability demonstrate the effectiveness of the EVO ICL. Safety data suggest reduced rates of anterior subcapsular cataract and pupillary block compared with earlier models. Improved safety and proven effectiveness make EVO an attractive option for surgeons and patients.
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Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA,
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Zhang J, Zhuang J, Yu KM. Posterior chamber phakic intraocular lens for the correction of high myopic anisometropic amblyopia in adults. Int J Ophthalmol 2018; 11:1870-1874. [PMID: 30450321 DOI: 10.18240/ijo.2018.11.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/23/2018] [Indexed: 11/23/2022] Open
Abstract
This study aims to evaluate the clinical results of posterior chamber implantable collamer lens (ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24y (range 19.2 to 42.5) were studied. ICL implantation was performed in 13 amblyopic eyes. The mean myopic anisometropia was significantly dropped from -10.70±3.02 D preoperatively to +0.09±1.67 D at 1mo postoperatively. The logMAR CDVA at 3d, 1, 3 and mean 9mo postoperatively improved by a mean of 1.69, 2.50, 3.01 and 3.00 lines and gained more than 2 lines accounted for 23.08% (3 eyes), 41.67% (5 eyes), 63.63% (7 eyes) and 55.56% (5 eyes), respectively. The contrast sensitivity of amblyopic eyes was significantly increased after surgery. Four patients partially recovered near stereopsis (400″ to 100″). There was no severe complications were observed. ICL implantation alone can improve vision, contrast sensitivity, and partial restoration of binocular vision in adult patients with high myopic anisometropia.
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Affiliation(s)
- Jing Zhang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Ke-Ming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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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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Kamiya K, Shimizu K, Igarashi A, Kitazawa Y, Kojima T, Nakamura T, Ichikawa K. Posterior Chamber Phakic Intraocular Lens Implantation in Eyes with an Anterior Chamber Depth of Less Than 3 mm: A Multicenter Study. Sci Rep 2018; 8:13322. [PMID: 30190562 PMCID: PMC6127101 DOI: 10.1038/s41598-018-31782-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022] Open
Abstract
This study was aimed to assess the clinical outcomes of Visian ICL (hole ICL; STAAR Surgical, Inc.) implantation for the correction of myopic refractive errors in eyes having an anterior chamber depth (ACD) below the current manufacturer's recommendation (<3.0 mm). We comprised 365 eyes of 201 consecutive patients (mean age ± standard deviation, 35.7 ± 7.5 years) with spherical equivalents of -8.66 ± 3.54 D. We evaluated the safety, efficacy, predictability, stability, intraocular pressure (IOP), endothelial cell density (ECD), and complications. The safety and efficacy indices were 1.12 ± 0.22 and 0.98 ± 0.22. At 1 year, 90% and 98% of eyes were within ± 0.5 and 1.0 D of the attempted correction, respectively. Changes in the manifest refraction from 1 week to 1 year postoperatively were -0.08 ± 0.34 D. The mean ECD loss was 0.2 ± 8.7%. No eyes showed a significant ECD loss (≥30%). We found no significant correlation between the ACD and the change in ECD (Pearson correlation coefficient r = -0.048, p = 0.360). No significant IOP rise or vision-threatening complication occurred at any time. These findings indicate that the surgical indication of ICL implantation should be reconsidered in terms of ACD.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Sagamihara, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | | | - Takashi Kojima
- Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan
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Fernández-Vigo JI, Marcos AC, Agujetas R, Montanero JM, Sánchez-Guillén I, García-Feijóo J, Pandal-Blanco A, Fernández-Vigo JÁ, Macarro-Merino A. Computational simulation of aqueous humour dynamics in the presence of a posterior-chamber versus iris-fixed phakic intraocular lens. PLoS One 2018; 13:e0202128. [PMID: 30102728 PMCID: PMC6089426 DOI: 10.1371/journal.pone.0202128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare aqueous humour (AH) dynamics in the presence of a precrystalline (Implantable Collamer Lens®; ICL) or iris-fixed (Artiflex®) phakic intraocular lens (PIOL). Methods By computational fluid dynamics simulation, AH flow was modelled through a peripheral iridotomy (PI) or central lens hole (both 360 μm) in the presence of an Artiflex or ICL lens, respectively. The impacts of AH flow were then determined in terms of wall shear stress (WSS) produced on the endothelium or crystalline lens. Effects were also modelled for different scenarios of pupil diameter (PD 3.5 or 5.5 mm), ICL vault (100, 350, 800 μm) and number of Artiflex iridotomies (1 or 2) and location (12 or 6 o’clock). Results For a PD of 3.5 mm, AH volumes flowing from the posterior to the anterior chamber were 37.6% of total flow through the lens hole (ICL) and 84.2% through PI (Artiflex). For an enlarged PD (5.5 mm), corresponding values were 10.3% and 81.9% respectively, so PI constitutes a very efficient way of evacuating AH. Central endothelial WSS in Pa was lower for the large vault ICL and the Artiflex (1−03 and 1.1−03 respectively) compared to the PIOL-free eye (1.6−03). Crystalline lens WSS was highest for the lowest vault ICL (1−04). Conclusions AH flow varied according to the presence of a precrystalline or iris-fixed intraocular lens. Endothelial WSS was lower for an implanted ICL with large vault and Artiflex than in the PIOL-free eye, while highest crystalline WSS was recorded for the lowest vault ICL.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Departamento de Oftalmología, Hospital Universitario Clínico San Carlos, Instituto de Investigación sanitaria San Carlos, Madrid (Spain)
- Centro Internacional de Oftalmología Avanzada, Madrid (Spain)
- * E-mail:
| | - Alfonso C. Marcos
- Departamento de Expresión Gráfica, Universidad de Extremadura, Badajoz (Spain)
| | - Rafael Agujetas
- Departamento de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación científica avanzada (ICCAEx), Universidad de Extremadura, Badajoz (Spain)
| | - José María Montanero
- Departamento de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación científica avanzada (ICCAEx), Universidad de Extremadura, Badajoz (Spain)
| | | | - Julián García-Feijóo
- Departamento de Oftalmología, Hospital Universitario Clínico San Carlos, Instituto de Investigación sanitaria San Carlos, Madrid (Spain)
| | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid (Spain)
- Facultad de Medicina, Universidad de Extremadura, Badajoz (Spain)
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Two-Year Outcomes of Visian Implantable Collamer Lens with a Central Hole for Correcting High Myopia. J Ophthalmol 2018; 2018:8678352. [PMID: 30057804 PMCID: PMC6051026 DOI: 10.1155/2018/8678352] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/21/2018] [Accepted: 05/30/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose To investigate two-year outcomes of Visian Implantable Collamer Lens with a central hole (ICL V4c) implantation for correcting high myopia. Methods Sixty-one eyes of 32 patients went through ICL V4c implantation. Safety, efficacy, predictability, and intraocular pressure were evaluated 2 years postoperatively. Anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle width (ACAW), and vault were measured using a Scheimpflug tomography imaging system. Results At 2 years, the spherical equivalent refraction decreased from preoperative −14.62 ± 4.29 D to −0.90 ± 0.95 D, with 79% of the eyes within ±0.50 D and 98% within ±1.00 D of the intended correction. The efficacy index was 1.03 ± 0.23, and the safety index was 1.24 ± 0.26. Corrected distance visual acuity (CDVA) remained unchanged in 23% of the eyes, 75% gained one or more lines of CDVA, and 2% lost one line. The ACV, ACD, and ACAW, respectively, decreased from 193.28 ± 29.15 mm3, 3.15 ± 0.23 mm, and 36.51 ± 6.54 degree to 112.48 ± 17.01 mm3, 2.99 ± 0.23 mm, and 22.54 ± 5.27 degree (p=0.0008, 0.008, and 0.0003, resp.). Intraocular pressure was 15.39 ± 2.88 mmHg before surgery and was 15.86 ± 4.11 mmHg at 2 years (p=0.11). Conclusion Implantation of ICL V4c is a safe, effective, and predictable procedure for correcting high myopia. Reduction of anterior chamber space after surgery did not induce intraocular pressure increase during the 2-year follow-up.
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Miao H, Chen X, Tian M, Chen Y, Wang X, Zhou X. Refractive outcomes and optical quality after implantation of posterior chamber phakic implantable collamer lens with a central hole (ICL V4c). BMC Ophthalmol 2018; 18:141. [PMID: 29898694 PMCID: PMC6001218 DOI: 10.1186/s12886-018-0805-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 05/30/2018] [Indexed: 02/03/2023] Open
Abstract
Background To investigate refractive outcomes and optical quality after implantation of posterior chamber phakic implantable collamer lens with a central hole (ICL V4c) to correct high myopia. Methods Sixty seven eyes of 38 patients who underwent ICL V4c implantation were enrolled. The mean preoperative spherical equivalent (SE) was − 12.44 ± 3.15 D (range: − 6.63 to − 20.50 D). The refractive outcomes and optical quality of the eyes at postoperative 1 and 3 months were evaluated and compared. Results At 3 months postoperatively, the mean safety and efficacy indexes were 1.33 ± 0.22 and 1.14 ± 0.23, respectively. The mean SE was − 0.32 ± 0.52 D; no patient lost 1 or more lines of corrected distance visual acuity (CDVA), 13% remained unchanged, 45% gained 1 line and 42% gained 2 or more lines. The mean modulation transfer function cutoff frequency (MTFcutoff), Strehl in two dimensions ratio, and objective scatter index (OSI) were 38.20 ± 9.96 cycles per degree, 0.21 ± 0.06, and 1.00 ± 0.73, respectively. No significant difference was found in any of the above parameters (P > 0.05) between 1 and 3 months. The postoperative intraocular pressure (IOP) did not change when compared with preoperative values (P > 0.05). Conclusions ICL V4c implantation is a safe, effective, and stable solution for high myopia. Patients will acquire high and stable postoperative optical quality. ICL V4c implantation has little influence on IOP.
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Affiliation(s)
- Huamao Miao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Mi Tian
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Yingjun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China.
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China.
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Rodríguez-Una I, Rodríguez-Calvo PP, Fernández-Vega Cueto L, Lisa C, Fernández-Vega Cueto A, Alfonso JF. Intraocular Pressure After Implantation of a Phakic Collamer Intraocular Lens With a Central Hole. J Refract Surg 2018; 33:244-249. [PMID: 28407164 DOI: 10.3928/1081597x-20170110-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/08/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the middle-term intraocular pressure (IOP) results after implantation of a posterior chamber collagen copolymer phakic intraocular lens (IOL) (V4c Visian; STAAR Surgical Co., Nidau, Switzerland) with a central hole in patients with myopia. METHODS This retrospective study enrolled patients who had implantation of a phakic IOL with a central hole. IOP, central vault, and adverse events were evaluated 1, 3, 6, 12, and 24 months postoperatively. RESULTS The study enrolled 763 eyes (384 patients, 128 men and 256 women). Mean follow-up was 7.0 ± 7.2 months (range: 1 to 24 months). The mean IOP was 13.2 ± 2.1 mm Hg preoperatively. Postoperatively, the mean IOP was 12.4 ± 1.7 mm Hg at 1 month, 12.5 ± 1.8 mm Hg at 3 months, 12.6 ± 1.3 mm Hg at 6 months, 12.6 ± 1.4 mm Hg at 12 months, and 12.7 ± 1.1 mm Hg at 24 months. Only one case (0.13%) presented an increased IOP (> 21 mm Hg) during the observation period. No pupillary block or acute angle closure was recorded. IOP at the final follow-up visit was 12.8 ± 1.3 mm Hg. CONCLUSIONS Implantation of central hole phakic IOL in myopic patients provided good and safe IOP outcomes throughout the 24-month observation period. [J Refract Surg. 2017;33(4):244-249.].
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Zhao J, Luo D, Sun Y, Niu L, Zhao F, Wang X, Wang H, Chen Q, Zhou X. Implanting a posterior chamber phakic intraocular lens in highly myopic eyes with peripheral primary iris and ciliary body cysts. Eur J Ophthalmol 2018; 29:171-177. [PMID: 29607656 DOI: 10.1177/1120672118766445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: To investigate the safety and efficacy of implanting a posterior chamber implantable collamer lens with a central hole in cases of high myopia with peripheral primary iris or ciliary body cysts. METHODS: A total of 37 eyes of 19 patients with primary iris or ciliary body cysts detected by ultrasonic biological microscope were included, with spherical powers of -10.26 ± 3.28 D and cylinder powers of -1.71 ± 1.18 D. Each patient received ultrasonic biological microscope and a routine examination before implantation of the implantable collamer lens. A routine postoperative follow-up was performed to observe changes in the iris or ciliary body cyst, ranging from 3 to 18 months. RESULTS: There were no complications. At the last follow-up, 56.8% (21/37) of eyes achieved the same corrected distance visual acuity as their preoperative measurements, 43.2% of eyes were enhanced by ≥1 line, and no patients' corrected distance visual acuity declined. The efficacy index and safety index were 0.95 and 1.11, respectively. After 18 months, 66.7% of the spherical equivalents were between ±0.5 D with 100% between ±1.0 D. The postoperative mean spherical equivalents at 1, 3, 6, 12, and 18 months were -0.45 ± 0.31 D, -0.39 ± 0.29 D, -0.36 ± 0.30 D, -0.39 ± 0.38 D, and -0.48 ± 0.23 D (p = 0.789). The vaults were 516 ± 140, 548 ± 124, 498 ± 133, 582 ± 161, and 557 ± 110 μm (p = 0.355). There were no changes in size (p > 0.05), number, or position of the iris or ciliary body cysts. CONCLUSION: Implantable collamer lens implantation is safe and effective for highly myopic patients with peripheral primary iris and ciliary body cysts. The cysts did not change after operation in this study.
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Affiliation(s)
- Jing Zhao
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Dongqiang Luo
- 2 Center of Ophthalmology and Optometric, People's Hospital of Hunan Province, Changsha, China
| | - Yong Sun
- 3 Department of Ophthalmology, The People's Hospital of Shajin in Baoan District, Shenzhen, China
| | - Lingling Niu
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Feng Zhao
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaoying Wang
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Hua Wang
- 2 Center of Ophthalmology and Optometric, People's Hospital of Hunan Province, Changsha, China
| | - Qian Chen
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xingtao Zhou
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Abstract
A 28-year-old lady with a refractive error of -11.0 D sphere/-1.50 D cylinder at 160 degrees in the right eye underwent an uneventful Implantable Collamer Lens surgery (ICL) with a V4c model, which uses a central Aquaport. This ICL does not require preoperative laser iridotomy or surgical iridectomy, as the centraflow opening is designed to prevent pupillary block. At postoperative day 1, her visual acuity in the right eye was 20/400, with diffuse microcystic corneal edema with fixed, dilated pupil and high intraocular pressure. Following intravenous mannitol, the corneal edema resolved. It was then noted that the ICL was anteriorly displaced, creating acute pupillary block, presumably due to obstruction of the central Aquaport with viscoelastic and inflammatory debris. She underwent AC wash the same day that helped in IOP control; however, the pupil remained permanently dilated and fixed because of extensive sphincter atrophy as a result of acute pupillary block. By 1 month, the visual acuity was 20/30 with an IOP of 14 mm Hg, which was maintained at 1-year follow-up. We report the first case of pupillary block glaucoma with this particular ICL design, suggesting the need for careful attention to complete removal of viscoelastic in the anterior chamber and behind the ICL, to prevent such complications and their cosmetically unacceptable sequelae.
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Gonzalez-Lopez F, Bilbao-Calabuig R, Alen R, Mompean B. Pupillary block glaucoma secondary to central port occlusion following insertion of a phakic implantable copolymer lens. J Cataract Refract Surg 2017; 43:1468-1470. [DOI: 10.1016/j.jcrs.2017.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 09/13/2017] [Indexed: 11/28/2022]
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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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Tian Y, Jiang HB, Jiang J, Wen D, Xia XB, Song WT. Comparison of Implantable Collamer Lens Visian ICL V4 and ICL V4c for high myopia: A cohort study. Medicine (Baltimore) 2017; 96:e7294. [PMID: 28640145 PMCID: PMC5484253 DOI: 10.1097/md.0000000000007294] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to investigate the visual quality of the 2 kinds of intraocular lens: Visian implantable collamer lens (ICL) V4 and Visian ICL V4c implantations for high myopia.Twenty cases (20 eyes) with high myopia who received Visian ICL V4 implantation and 18 cases (18 eyes) with high myopia who received Visian ICL V4c implantation in our hospital from April 1, 2014 to November 31, 2016 were enrolled. In 1-month follow-up, near vision, best corrected distant visual acuity (BCVA), uncorrected distant visual acuity (UDVA), and wavefront aberrations were measured, and compensation factor was calculated.Near vision, UDVA, and BCVA showed no significant difference between ICL V4 implantation and ICL V4c implantation (P >.05). However, high-order aberrations and spherical aberrations were higher in ICL V4c implantation than in ICL V4 implantation (P <.05). Low-order aberrations (defocus and astigmatism), coma, and subjective visual quality had no significant difference between ICL V4 implantation and ICL V4c implantation (P >.05).The 2 kinds of ICL Visian ICL V4 and Visian ICL V4c had similar efficacy of visual quality for high myopia. The presence of the central hole of Visian ICL V4c has no significant effect on visual quality.
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Eom Y, Kim DW, Ryu D, Kim JH, Yang SK, Song JS, Kim SW, Kim HM. Ring-shaped dysphotopsia associated with posterior chamber phakic implantable collamer lenses with a central hole. Acta Ophthalmol 2017; 95:e170-e178. [PMID: 27678470 DOI: 10.1111/aos.13248] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 07/25/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the incidence of central hole-induced ring-shaped dysphotopsia after posterior chamber phakic implantable collamer lens (ICL) with central hole (hole ICL) implantation and to investigate the causes of central hole-induced dysphotopsia. METHODS The clinical study enrolled 29 eyes of 15 consecutive myopic patients implanted with hole ICL. The incidence of ring-shaped dysphotopsia after hole ICL implantation was evaluated. In the experimental simulation study, non-sequential ray tracing was used to construct myopic human eye models with hole ICL and ICL without a central hole (conventional ICL). Simulated retinal images measured in log-scale irradiance were compared between the two ICLs for an extended Lambertian light-emitting disc object 20 cm in diameter placed 2 m from the corneal vertex. To investigate the causes of hole-induced dysphotopsia, a series of retinal images were simulated using point sources at infinity with well-defined field angles (0 to -20°) and multiple ICL models. RESULTS Of 29 eyes, 15 experienced ring-shaped dysphotopsia after hole ICL implantation. The simulation study using an extended Lambertian source showed that hole ICL-evoked ring-shaped dysphotopsia was formed at a retinal field angle of ±40°. Component-level analysis using a well-defined off-axis point source from infinity revealed that ring-shaped dysphotopsia was generated by stray light refraction from the inner wall of the hole and the posterior ICL surface. CONCLUSION Hole ICL-evoked ring-shaped dysphotopsia was related to light refraction at the central hole structure. Surgeons are advised to explain to patients the possibility of ring-shaped dysphotopsia after hole ICL implantation.
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Affiliation(s)
- Youngsub Eom
- Department of Ophthalmology; Korea University College of Medicine; Seoul South Korea
| | - Dae Wook Kim
- College of Optical Sciences; University of Arizona; Tucson Arizona USA
| | - Dongok Ryu
- Space Optics Laboratory; Department of Astronomy; Yonsei University; Seoul South Korea
- Center for Galaxy Evolution Research; Yonsei University; Seoul South Korea
- Yonsei University Observatory; Yonsei University; Seoul South Korea
| | | | - Seul Ki Yang
- Space Optics Laboratory; Department of Astronomy; Yonsei University; Seoul South Korea
- Center for Galaxy Evolution Research; Yonsei University; Seoul South Korea
- Yonsei University Observatory; Yonsei University; Seoul South Korea
| | - Jong Suk Song
- Department of Ophthalmology; Korea University College of Medicine; Seoul South Korea
| | - Sug-Whan Kim
- Space Optics Laboratory; Department of Astronomy; Yonsei University; Seoul South Korea
- Center for Galaxy Evolution Research; Yonsei University; Seoul South Korea
- Yonsei University Observatory; Yonsei University; Seoul South Korea
| | - Hyo Myung Kim
- Department of Ophthalmology; Korea University College of Medicine; Seoul South Korea
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