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Ortega-Usobiaga J, González-López F, Peng Y, Bilbao-Calabuig R, Beltrán-Sanz J, Larrubia JR, Llovet-Osuna F. Visual outcomes of combined use of implantable collamer lens implantation and laser corneal visual correction for myopia over -18.00 diopters. J Cataract Refract Surg 2024; 50:733-738. [PMID: 38446490 DOI: 10.1097/j.jcrs.0000000000001438] [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: 01/17/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To explore visual outcomes in patients with extreme myopia receiving an implantable collamer lens (ICL) at -18.00 diopters (D), with central port, followed by bioptics by laser vision correction (laser in situ keratomileusis [LASIK] or photorefractive keratectomy [PRK]) to address residual myopia or myopic astigmatism. SETTING Clínica Baviera (Aier Eye Hospital Group), Bilbao, Spain. DESIGN Retrospective analysis of cases. METHODS The study assessed uncorrected distance visual acuity, corrected distance visual acuity (CDVA), predictability, safety, efficacy, and patient satisfaction after implantation of the ICL and bioptics. The model implanted was V4c and EVO, with a correction of -18.00 D. Bioptics were performed at least 3 months after implantation, and patients were followed up for at least 3 months after LASIK or PRK. RESULTS The analysis included 125 eyes from 90 patients. Of these, 51.2% underwent LASIK and 48.8% PRK. Mean time from implantation to bioptics was 5.9 ± 9.4 months. Patients were followed up for a mean of 40.2 ± 37.9 months after bioptics. Median manifest refractive spherical equivalent was -2.89 D before bioptics and -0.49 D after. Median CDVA was 0.18 logMAR before bioptics and 0.17 after. The mean safety and efficacy indices were 2.22 ± 1.88 and 2.06 ± 1.85, respectively. CONCLUSIONS Visual outcomes and safety indices after ICL implantation and subsequent LASIK or PRK in patients with extreme myopia are excellent.
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Affiliation(s)
- Julio Ortega-Usobiaga
- From the Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Bilbao, Spain (Ortega-Usobiaga); Department of Cataract and Refractive Surgery, Miranza IOA, Madrid, Spain (González-López); Department of Ophthalmology, Chongqing Aier-Mega Eye Hospital (Aier Eye Hospital Group), Chongqing, China (Peng); Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Madrid, Spain (Bilbao-Calabuig, Llovet-Osuna); Department of Research and Development, Clínica Baviera (Aier Eye Hospital Group), Valencia, Spain (Beltrán-Sanz); Health Sciences Research Unit, Guadalajara University Hospital, University of Alcalá, Alcalá de Henares, Spain (Larrubia)
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Han T, Chen X, Xu Y, Niu L, Wang X, Zhou X. Refractive outcomes of implantable collamer lens implantation in 1212 eyes with suboptimal corrected distance vision acuity. Curr Eye Res 2022; 47:1419-1423. [PMID: 35757851 DOI: 10.1080/02713683.2022.2094418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: To analyze the factors related to corrected distance vision acuity (CDVA) after implantable collamer lens (ICL) implantation in patients with preoperative suboptimal CDVA.Methods: This retrospective study included patients with suboptimal preoperative CDVA (CDVA ≤20/25) who underwent ICL implantation (V4 or V4c). Preoperative and postoperative clinical evaluations included CDVA, uncorrected distance visual acuity (UDVA), and refraction.Results: A total of 1,212 eyes from 731 patients were identified. CDVA increased in 90.8% of the eyes after surgery. Among them, 57.5% of the eyes (697 eyes) gained more than one line. The preoperative LogMAR CDVA was 0.32 ± 0.23, which significantly improved to 0.13 ± 0.17 postoperatively (p < 0.001). There was no significant difference between ICL V4c and ICL V4 in the LogMAR UDVA, sphere, cylinder, SE, LogMAR CDVA, efficacy index, and safety index after surgery (p > 0.05). For eyes with full correction, the postoperative LogMAR CDVA =0.575 * preoperative LogMAR CDVA -0.061 (p < 0.001, R2 = 0.53). For eyes with partial correction, the postoperative LogMAR CDVA =0.536 * preoperative LogMAR CDVA - 0.007 * SE - 0.196 (P < 0.001, R2 = 0.55).Conclusion: ICL implantation can improve CDVA in eyes with suboptimal CDVA. This study provides the postoperative outcomes of eyes with different preoperative CDVA, which makes it convenient for surgeons to communicate with such patients before surgery.
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Affiliation(s)
- Tian Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Ye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
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Liu X, Schallhorn SC, Hannan SJ, Teenan D, Schallhorn JM. Three-Month Outcomes of Laser Vision Correction for Myopia and Hyperopia in Adults With Amblyopia. J Refract Surg 2020; 36:511-519. [PMID: 32785724 DOI: 10.3928/1081597x-20200612-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 06/12/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the visual outcomes of laser vision correction in adults with myopic and hyperopic amblyopia. METHODS The medical records of patients diagnosed as having amblyopia who underwent laser refractive surgery between February 2013 and October 2017 were retrospectively reviewed. Eyes with amblyopia were analyzed, and the nonamblyopic fellow eyes of the patients who underwent laser vision correction were used as controls. The uncorrected distance visual acuity (UDVA), subjective manifest refraction, and corrected distance visual acuity (CDVA) were analyzed at the 3-month postoperative time point. RESULTS This study included 323 eyes of 164 patients. All patients underwent laser in situ keratomileusis (90.1%, 291 eyes) or photorefractive keratectomy (9.9%, 32 eyes). Three months postoperatively, the manifest spherical equivalent was -0.07 ± 0.55 diopters (D) (range: -1.75 to +1.30 D) and -0.10 ± 0.54 D (range: -2.13 to +1.30 D) in the amblyopia group and fellow eye group, respectively. The percentage of eyes achieving UDVA of 20/20 or better was 16.9% (15 eyes) in the amblyopia group and 61.9% (52 eyes) in the fellow eye group. The percentage of eyes that gained two or more lines of CDVA was 27.9% (24 eyes) in the amblyopia group and 6.2% (5 eyes) in the fellow eye group (P < .01). In the amblyopia group, there was no statistically significant difference in the mean manifest spherical equivalent between the myopic eyes and hyper-opic eyes at any follow-up visit (P = .87, 1 month postoperatively; P = .68, 3 months postoperatively). CONCLUSIONS Laser vision correction was found to be effective and safe in adult patients with amblyopia. [J Refract Surg. 2020;36(8):511-519.].
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Visual outcomes after refractive laser corneal surgery and phakic IOL in amblyopic eyes. Int Ophthalmol 2020; 40:2827-2834. [PMID: 32601965 DOI: 10.1007/s10792-020-01466-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the outcomes of laser corneal surgery and phakic IOL surgery in adult amblyopic eyes. METHODS Retrospective assessment was done in 688 amblyopic eyes 640 patients who underwent LASIK or phakic IOLs. Ophthalmological evaluation included measurement of uncorrected (UDVA) and corrected (CDVA) distance visual acuities. Analysis of modulation transfer function (MTF) was also done post-operatively as a measure of contrast sensitivity. Patients completed follow-up examinations at 1 day, 3 day, 3 months and 12 months after surgery. RESULTS The mean patient age was 24.30 ± 3.04 years with 59% females. The CDVA of amblyopic eyes improved significantly from the mean preoperative level of 0.48 ± 0.18 to 0.59 ± 0.18 at 12 months. There was improvement in the contrast sensitivity at all spatial frequencies. Refractive errors were corrected in both LASIK and phakic IOL group, but there was no clinically significant difference in visual outcomes between each group. CONCLUSION Laser vision correction and phakic IOL surgery for amblyopic eyes are promising alternative methods for improving visual outcomes in adult refractive amblyopia patients who have failed with conventional approaches.
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Doroodgar F, Niazi F, Sanginabadi A, Niazi S, Baradaran-Rafii A, Alinia C, Azargashb E, Ghoreishi M. Comparative analysis of the visual performance after implantation of the toric implantable collamer lens in stable keratoconus: a 4-year follow-up after sequential procedure (CXL+TICL implantation). BMJ Open Ophthalmol 2017; 2:e000090. [PMID: 29354720 PMCID: PMC5721648 DOI: 10.1136/bmjophth-2017-000090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/28/2017] [Accepted: 08/24/2017] [Indexed: 11/23/2022] Open
Abstract
Aims To report on 4-year postoperative visual performance with the toric implantable collamer lens (TICL) for stable keratoconus after sequential procedure (corneal collagen crosslinking plus TICL implantation). Methods Forty eyes of 24 patients with stable keratoconus with myopia between 0.00 and −18.00 dioptres (D) and astigmatism between 1.25 and 8.00 D were evaluated in this prospective interventional study (https://clinicaltrials.gov/ct2/show/NCT02833649). We evaluated refraction, visual outcomes, astigmatic changes analysed by Alpins vector, contrast sensitivity, aberrometry, modulation transfer functions (MTFs), defocus curve, and operative and postoperative complications. Results At 4-year follow-up, 45% had 20/20 vision or better and 100% had 20/40 or better uncorrected visual acuity (UCVA). Vector analysis of refractive astigmatism shows that the surgically induced astigmatism (SIA) (3.20±1.46 D) was not significantly different from the target induced astigmatism (TIA) (3.14±1.42 D) (p=0.620). At 4 years postoperatively, none of the eyes showed a decrease in UCVA, in contrast to 24 eyes in which UCVA was increased by ≥1 lines, with contrast sensitivity and improvement in total aberrations and MTF value at 5 per degree (*p=0.004) after TICL implantation. The cumulative 4-year corneal endothelial cell loss was ≤5%. No patients reported dissatisfaction. At the end of follow-up, the vault was 658±54.33m (range, 500–711) and the intraocular pressure was 11.7±2.08 mm Hg. Occurrences of glare and night-driving troubles diminished after TICL surgery. Conclusion The results from this standardised clinical investigation support TICL implantation from clinical and optical viewpoints in patients with stable keratoconus. Trial registration number NCT02833649, Pre-results
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Affiliation(s)
- Farideh Doroodgar
- Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Feazollah Niazi
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Thran, Tehran, Iran
| | - Azad Sanginabadi
- Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Sana Niazi
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Alireza Baradaran-Rafii
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Cyrus Alinia
- Department of Public Health, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran
| | - Eznollah Azargashb
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Mohammad Ghoreishi
- Ophthalmology Department, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran
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Ruiz-Rizaldos AI, Baviera-Sabater J, Ortega-Usobiaga J. Implantable collamer lens for correction of ametropia in eyes with corneal scarring. ACTA ACUST UNITED AC 2016; 92:233-236. [PMID: 27939806 DOI: 10.1016/j.oftal.2016.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 10/30/2016] [Accepted: 11/03/2016] [Indexed: 11/28/2022]
Abstract
CASES Two cases are reported in which implantation of a collagen copolymer phakic intraocular lens (implantable collamer lens) corrected refractive errors in eyes with corneal scarring. A previous accident, in both cases, resulted in a central linear scar on the surface of the cornea of one eye. In the first patient, a corneal scar was visible in the left eye. The distance corrected visual acuity was 0.3 (-7.75 -4×160°). An uncorrected distance visual acuity of 0.25 was obtained by implanting an implantable collamer lens. In the second patient an oblique corneal scar was visible in the right eye. The distance corrected visual acuity was 0.25 (-8.75 -1.25×8°), and after implantation of the implantable collamer lens, uncorrected distance visual acuity was 0.25. DISCUSSION The indications of the implantable collamer lens should be reviewed and possibly expanded.
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