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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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Chung B, Choi JY, Kang DS, Kim KY, Kim BY, Kim TI. 10-Year Clinical Outcomes of V4c Implantable Collamer Lens Implantation: Longitudinal Analysis of Visual Acuity, Endothelial Cell Density, and Vault Dynamics. Am J Ophthalmol 2024:S0002-9394(24)00360-X. [PMID: 39142448 DOI: 10.1016/j.ajo.2024.08.007] [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: 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/year for ECD and 0.056 ± 0.003/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)
| | | | | | | | - Bo Yi Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea; Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea; Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; POSTECH Biotechnology Center, Pohang University of Science and Technology, Pohang, Republic of Korea.
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Zhu J, Cheng D, Zhu XY, Li FF, Yang Y, Ye YF. Clinical prediction of insufficient vaults after implantable collamer lens implantation. Int J Ophthalmol 2024; 17:1300-1306. [PMID: 39026913 PMCID: PMC11246938 DOI: 10.18240/ijo.2024.07.15] [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: 12/11/2023] [Accepted: 03/27/2024] [Indexed: 07/20/2024] Open
Abstract
AIM To determine the factors related to preoperative ocular characters that are predictive of insufficient vault (<250 µm) after implantable collamer lens (ICL V4c; STAAR Surgical) implantation. METHODS The participants underwent ICL surgery and were divided into the low (<250 µm) and normal (250-1000 µm) vault groups based on the postoperative vault at 3mo. The preoperative biometric parameters and clinical outcomes were compared between the two groups. The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations. RESULTS Sixteen (23 eyes) and 36 patients (63 eyes) were in the low and normal vault groups, respectively. All implantation procedures were uneventful with no cataract formation in the early postoperative period. The sulcus-to-sulcus lens rise (STSL) and iris ciliary angle (ICA) were correlated with vault at 3mo after surgery. Every 0.1 mm increase in STSL was associated with 38.9 µm decrease in the postoperative 3-month vault. A rise of 1 degree in ICA is associated with a reduction of 4 µm in vault. CONCLUSION Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation, suggesting a need for adjustments to the ICL size in these patients. Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.
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Affiliation(s)
- Jun Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Dan Cheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xue-Ying Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Fen-Fen Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ye Yang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yu-Feng Ye
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, 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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González-Cruces T, Sánchez-Ventosa Á, Villarrubia A, Sánchez-González JM, Cano-Ortiz A. Management of low astigmatism in implantable collamer lens surgery: opposite clear corneal incisions vs toric implantable collamer lens. J Cataract Refract Surg 2023; 49:1249-1257. [PMID: 37651314 DOI: 10.1097/j.jcrs.0000000000001297] [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: 02/22/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE To compare 2 techniques to correct low astigmatism during implantable collamer lens (ICL) surgery: astigmatic opposite clear corneal incisions (OCCIs) and toric ICL (T-ICL). SETTING Arruzafa Ophthalmological Hospital, Cordoba, Spain. DESIGN Randomized prospective comparative study. METHODS The study comprised 152 myopic eyes undergoing ICL surgery. Patients were separated into 2 groups: Group 1 (57 patients; 76 eyes) received a spherical ICL with OCCIs and Group 2 (53 patients; 76 eyes) received a T-ICL. The inclusion criteria were refractive astigmatism up to 1.50 diopters (D), regular corneal astigmatism up to 2.00 D (Sim K, Pentacam), and agreement between the refractive and topographic corneal cylinders (discrepancies less than 30 degrees axis or 0.50 D). The outcomes were evaluated after a 1-month follow-up. RESULTS The T-ICL group achieved a mean postoperative spherical equivalent refraction and refractive astigmatism of -0.04 ± 0.17 D and -0.03 ± 0.12 D, respectively, vs -0.14 ± 0.33 D and -0.20 ± 0.36 D, in the OCCI group ( P < .001). Postoperative refractive astigmatism of less than 0.25 D was achieved in 94.74% of cases in the T-ICL group vs 73.68% in the OCCI group. Undercorrection of corneal astigmatism occurred in the OCCI group with a surgically induced astigmatism of 0.48 ± 0.24 D and correction index = 0.46. CONCLUSIONS Both the T-ICL and OCCI techniques provided excellent results in terms of safety and efficacy. T-ICL surgery was shown to be more predictable and accurate for correcting low astigmatism with a lower postoperative spherical equivalent and less residual astigmatism compared to incisional management.
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Affiliation(s)
- Timoteo González-Cruces
- From the Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, Cordoba, Spain (González-Cruces, Sánchez-Ventosa, Villarrubia, Cano-Ortiz); Department of Physics of Condensed Matter, Optics Area, University of Seville, Seville, Spain (González-Cruces, Sánchez-González)
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Alabbasi OM, Vargas J, Al Mutlak M, Fairaq R, Al Saleh A. Spherical equivalent pre- and post-implantable collamer lens implantation in patients with myopia, hyperopia, and stable keratoconus. Saudi J Ophthalmol 2023; 37:327-330. [PMID: 38155678 PMCID: PMC10752281 DOI: 10.4103/sjopt.sjopt_130_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 03/22/2023] [Accepted: 04/28/2023] [Indexed: 12/30/2023] Open
Abstract
PURPOSE Refractive errors are common in Saudi Arabia and keratorefractive surgeries are usually done to correct them. However, not all patients are fit and complications postoperatively are a concern. Implantable collamer lens (ICL) implantation can be used for patients who are not fit for keratorefractive surgeries. ICL can also be used for keratoconus. We elected to evaluate the outcomes of patients who had ICL implantation for refractive errors or keratoconus. METHODS We retrospectively reviewed patients aged between 21 and 45 years old, who attended the anterior segment clinic at King Khaled Eye Specialist Hospital and who had spherical equivalent (SE) ranging between (+16 to -23 diopters), and had ICL implantation between February 2015 and September 2017. The SE was documented before and after the surgery. Depending on the SE, patients were divided into two groups (myopia and hyperopia). Statistical analysis was done to evaluate the change in mean SE before and after surgery for patients. RESULTS We identified 169 eyes and 155 (92%) were myopic before the surgery. Before surgery, the mean SE was -8.6 and the standard deviation (SD) was 4.4. Only 14 eyes (8%) were hyperopic before the surgery with a mean SE of +5.5 and SD of 4.8. The difference in the mean of SE between after and before the surgery for myopic eyes was statistically significant (mean difference: 7.8, SD: 5, P < 0.0001). The difference in the mean of SE between post- and pre-operatively was also significant for hyperopic eyes (mean difference: -6.1, SD: 5.2, P = 0.0007). In 32 eyes with keratoconus, the mean SE before surgery was -7.9 with an SD of 4.1. For the keratoconus eyes, the mean difference of SE between after and before surgery was statistically significant as the mean difference in SE was 7.2 with an SD of 4.6 (P < 0.0001). CONCLUSION The effect of ICL implantation was significant in improving the SE for myopic, hyperopic, and keratoconus eyes.
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Affiliation(s)
- Omar M. Alabbasi
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Jose Vargas
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Mohammed Al Mutlak
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rafah Fairaq
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Ahmed Al Saleh
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Ichikawa K, Ichikawa K, Yamamoto N, Horai R. Flexural and Cell Adhesion Characteristic of Phakic Implantable Lenses. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1282. [PMID: 37512093 PMCID: PMC10385999 DOI: 10.3390/medicina59071282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: In this study, we aimed to compare the physical properties of hole-implantable collamer lenses (H-ICLs) and implantable phakic contact lenses (IPCLs) and investigate their flexural and cell adhesion characteristics. Materials and Methods: Transverse compression load to achieve lens flexion and static Young's modulus were measured in H-ICLs and IPCLs using designated equipment. Load was measured both with and without restraining the optic section of the lenses. Adhesion of iHLEC-NY2 cells to the lens surfaces was examined using phase-contrast microscopy, and cell proliferation activity was evaluated using WST-8 assay. Results: The H-ICL showed a greater tendency for transverse compression load compared to IPCL, while the IPCL showed a higher Young's modulus with respect to the force exerted on the center of the anterior surface of the optic section. The joint between the optic section and haptic support in the IPCL was found to mitigate the effects of transverse compression load. Both lens types showed minimal cell adhesion. Conclusions: Our findings indicate that H-ICLs and IPCLs exhibit distinct physical properties and adhesive characteristics. The IPCL demonstrated higher Young's modulus and unique structural features, while the H-ICL required greater transverse compression load to achieve the flexion required to tuck the haptic supports into place behind the iris to fix the lens. The observed cell non-adhesive properties for both lens types are promising in terms of reducing complications related to cell adhesion. However, further investigation and long-term observation of IPCL are warranted to assess its stability and potential impact on the iris. These findings contribute to a better understanding of the performance and potential applications of H-ICLs and IPCLs in ophthalmology.
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Affiliation(s)
| | - Kei Ichikawa
- Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan
- General Aoyama Hospital, Toyokawa 441-0103, Aichi, Japan
| | - Naoki Yamamoto
- Support Office for Bioresource Research, Translational Research Headquarters, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Rie Horai
- Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan
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Li X, Wang M, Dong W, Cai J. Anterior segment structure changes caused by different luminance light after implantable collamer lens surgery. BMC Ophthalmol 2023; 23:281. [PMID: 37328783 DOI: 10.1186/s12886-023-03014-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/03/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUNDS To investigate the changes of anterior eye segment with implantable collamer lens (ICL) under mesopic and photopic conditions. METHOD Forty-seven eyes of myopic patients who underwent ICL V4c implantation were included. Three months after surgery, the pupil diameter (PD), dynamic vault, ACD (distance from the posterior corneal surface to the anterior lens surface), ACD-ICL (distance from the posterior corneal surface to the anterior ICL surface), and anterior chamber angle parameters were measured using the anterior segment optical coherence tomography (AS-OCT, Carl Zeiss AG, Germany) under completely mesopic (0 lx) and photopic (5290 lx) lighting conditions. RESULTS Compared with mesopic conditions, a significant decreased vault was detected in photopic conditions (486.7 ± 186.1 μm versus 643.5 ± 191.2 μm, p < 0.001), while the ACD-ICL increased significantly (2.54 ± 0.24 mm versus 2.37 ± 0.23 mm, p < 0.001). The pupil was smaller in photopic condition (2.66 ± 0.23 mm versus 5.62 ± 0.55 mm, p < 0.001). ACD didn't change(3.32 ± 0.24 mm versus 3.31 ± 0.22 mm, p = 0.079). The change of the vault was positively related to the changes of the PD (r2 = 0.301, p = 0.04). There were no statistical difference between the change of vault and the change of ACD-ICL (158.0 ± 58.1 μm versus 165.9 ± 65.3 μm, p = 0.320). CONCLUSION When exposed to high intensity light after ICL surgery, the pupil constricted, vault decreased, ACA widened and ACD-ICL increased. All these changes were caused by the change of iris not the crystalline lens.
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Affiliation(s)
- Xia Li
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China.
| | - Min Wang
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Weiwen Dong
- Department of Auxiliary Examination, Shanghai Aier Eye Hospital, Shanghai, China
| | - Jinfeng Cai
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China.
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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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Qian T, Du J, Ren R, Zhou H, Li H, Zhang Z, Xu X. Vault-Correlated Efficacy and Safety of Implantable Collamer Lens V4c Implantation for Myopia in Patients with Shallow Anterior Chamber Depth. Ophthalmic Res 2023; 66:445-456. [PMID: 36596292 DOI: 10.1159/000528616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD). METHODS This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively. RESULTS All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739). CONCLUSIONS ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Jingxiao Du
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Ruixia Ren
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyan Li
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
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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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Teplovodskaya VV, Sobolev NP, Morina NA, Zhuravlev AS, Sudakova EP. [Correction of ametropia with posterior chamber phakic intraocular lens]. Vestn Oftalmol 2022; 138:64-70. [PMID: 35234423 DOI: 10.17116/oftalma202213801164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Posterior chamber phakic intraocular lens (PIOL) implantation is a widely accepted and performed refractive surgery for correction of moderate and high myopia used when corneal laser ablation procedures are not suitable. This paper analyzes literature data to reveal the advantages and limitations of the technology.
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Affiliation(s)
- V V Teplovodskaya
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N P Sobolev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N A Morina
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A S Zhuravlev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - E P Sudakova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Guan N, Zhang XN, Zhang WJ. Correlation between intraoperative and postoperative vaulting of the EVO implantable Collamer lens: a retrospective study of real-time observations of vaulting using the RESCAN 700 system. BMC Ophthalmol 2022; 22:2. [PMID: 34980022 PMCID: PMC8721482 DOI: 10.1186/s12886-021-02237-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background Implantable Collamer lens (ICL) vaulting is one of the most important parameters for the safety, aqueous humor circulation, and lens transparency after ICL implantation. This study aimed to investigate the factors associated with the actual vaulting after refractive EVO-ICL surgery. Methods This retrospective study included patients who underwent EVO-ICL surgery at a tertiary eye hospital between October and December 2019. A RESCAN 700 was used for the intraoperative and CIRRUS HD-OCT was used for postoperative observation of vaulting. Subjective and objective refractions, anterior ocular segment, corneal morphology, intraocular pressure (IOP), anterior chamber volume (ACV), crystalline lens rise (CLR), white-to-white distance (WTW), anterior chamber depth (ACD), axial length, corneal endothelial cell density (ECD), and fundoscopy were examined. A multivariable analysis was performed to determine the factors independently associated with 1-month postoperative vaulting. Results Fifty-one patients (102 eyes) were included. Compared with the eyes with normal vaulting, those with high vaulting had higher preoperative diopter values (P = 0.039), lower preoperative corrected visual acuity (P = 0.006), lower preoperative IOP (P = 0.029), higher preoperative ACD (P = 0.004), lower preoperative CLR (P = 0.046), higher ICL spherical equivalent (P = 0.030), higher intraoperative vaulting (P < 0.001), and lower IOP at 1 month (P = 0.045). The multivariable analysis showed that the only factor independently associated with high vaulting at 1 month after surgery was the intraoperative vaulting value (odds ratio = 1.005, 95% confidence interval: 1.002–1.007, P < 0.001). The intraoperative and 1-month postoperative vaulting values were positively correlated (R2 = 0.562). Conclusions The RESCAN700 system can be used to perform intraoperative optical coherence tomography to predict the vaulting value of ICL at 1 month.
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Affiliation(s)
- Nian Guan
- Department of Refractive, Wuhan Bright Eye Hospital, Wuhan, 430000, Hubei, China
| | - Xiao-Nong Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China
| | - Wan-Jun Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China.
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Effect of Implantable Collamer Lens on Anterior Segment Measurement and Intraocular Lens Power Calculation Based on IOLMaster 700 and Sirius. J Ophthalmol 2022; 2021:8988479. [PMID: 34970453 PMCID: PMC8714341 DOI: 10.1155/2021/8988479] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/04/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the possible effect of an implantable collamer lens (ICL) on ocular biometrics and intraocular lens (IOL) power calculation. Methods Ocular measurements were taken preoperatively and at the two-month follow-up using IOLMaster 700 and Sirius in 85 eyes (43 patients) who had previously undergone ICL surgery. IOL power was calculated using either IOLMaster 700 (Barrett Universal II formula) or Sirius (ray-tracing). All data were compared using the paired t-test. Results The difference between preoperative and postoperative anterior chamber depth (ACD), lens thickness (LT), and keratometry on the steep axis (K2) measured by IOLMaster 700 was statistically significant (p < 0.001). In 11 of 85 eyes, IOLMaster misjudged the anterior surface of the ICL as that of the lens, leading to an error in ACD and LT. There were no significant differences between preoperative and postoperative axial length (AL) (p = 0.223), white to white (WTW) (p = 0.100), keratometry on flat axis (K1) (p = 0.117), or central corneal thickness (CCT) (p = 0.648), measured using IOLMaster. The difference in IOL power calculated using the Barrett II formula was significant (p = 0.013). Regression analysis showed that AL and K had the greatest influence on IOL calculation (p < 0.001), and ACD and LT had less influence (p = 0.002, p = 0.218, respectively). K1 and K2 were modified to exclude the influence of K2, and modified IOLs showed no difference between pre and postoperation (p = 0.372). Preoperative and postoperative ACD measured using Sirius were significantly different (p < 0.001); however, the IOL power calculated using ray-tracing technology showed no significant differences (p > 0.05). Conclusions The ocular biometric apparatus may misjudge the anterior surface of the lens, resulting in measurement errors of ACD and LT, which has little effect on the calculation of IOL power when using IOLMaster 700 (Barrett Universal II formula) and Sirius (ray-tracing).
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First Experiences with Implantation of Phakic Lenses in Correction of Myopia in R. N. Macedonia. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021; 42:37-46. [PMID: 35032378 DOI: 10.2478/prilozi-2021-0033] [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: 11/20/2022]
Abstract
Objective: Analysis of visual acuity parameters in patients with moderate to high myopia and myopic astigmatism 1 year after treatment with phakic intraocular lenses. Material and methods: This was a retrospective study on 35 patients (52 eyes) with moderate to high myopia who were implanted with the Visian V4c phakic implantable Collamer lens (Staar Surgical, Nidau, Switzerland). Examined parameters were: uncorrected distance visual acuity (UDVA) and best corrected visual acuity (CDVA), manifest and cycloplegic refraction, intraocular pressure, and endothelial cell count. The investigated parameters were measured preoperatively, 1, 3, 6 and 12 months postoperatively. Results: In 17 patients, phakic lenses were implanted binocularly and in 18 patients monocularly. Preoperatively 34.62% of patients had CDVA from 0.9 to 1.0. One year after the surgery 48.08% of patients had UDVA from 0.9 to 1.0. Preoperatively 80.77% of patients had diopter range from -6.00 Dsph to -10.00 Dsph. At 1 year postoperatively 78.85% of patients were within 0.00 Dsph to -1.00 Dsph. Preoperatively, in patients with astigmatism -4 Dcyl to -2 Dcyl dominated, as opposed to significant improvement postoperatively when 94.23% had astigmatism ranging from -1.0 Dcyl to 0 Dcyl. Conclusion: The implantation of phakic lenses demonstrated a successful postoperative outcome in the treatment of myopia and myopic astigmatism. Visual acuity and refraction show a gradual and significant improvement in visual function parameters within 1 year of lens implantation.
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Zhang J, Shao J, Zheng L, Zhao X, Sun Y. Changes in ocular parameters the crystalline lens after implantation of a collamer lens. Clin Exp Optom 2021; 105:587-592. [PMID: 34379036 DOI: 10.1080/08164622.2021.1958654] [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] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE Understanding changes in ocular anatomical parameters after intraocular lens implantation will allow a more accurate determination of dioptric power prior to surgery. BACKGROUND The crystalline lens position might change due to the implantation and removal of an implantable collamer lens (ICL) or toric implantable collamer lens (TICL). This study aimed to assess the effect of ICL implantation on position of the crystalline lens. METHODS This retrospective study was conducted on patients who underwent V4c ICL or V4c TICL implantation between March and September, 2018. Preoperative and post-operative (2 weeks, 3 months and 6 months) axial length, central corneal thickness, crystalline lens position, crystalline lens thickness and vault height were analysed. Multivariable linear regression was used to determine the variables associated with 6-month changes in lens position. RESULTS This study included 117 eyes of 117 patients. There were decreases in all vertical distance measures from the central corneal endothelium to the anterior and posterior crystalline lens capsule (all p > 0.05). The amount of reduction was related to the crystalline lens position before the operation and crystalline lens thickness after the operation (all p < 0.01). An error in anterior chamber depth and lens thickness may appear when the ICL/TICL is close to the crystalline lens. CONCLUSION Phakic intraocular lens implantation resulted in lens thickening and forward movement on day 1 post-operatively, which becomes stable within 6 months. Preoperative lens position and post-operative lens thickness were related to the amount of movement.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Jie Shao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Li Zheng
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Xia Zhao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Yi Sun
- Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
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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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Posterior chamber phakic intraocular lens for the correction of presbyopia in highly myopic patients. J Cataract Refract Surg 2021; 46:40-44. [PMID: 32050231 DOI: 10.1097/j.jcrs.0000000000000033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the initial experience with a new presbyopic phakic intraocular lens (pIOL) in the correction of high myopia and presbyopia. SETTING Gemini Eye Clinic, Zlin, Czech Republic. DESIGN Prospective cohort study. METHODS Presbyopic eyes with moderate to high myopia were implanted with a presbyopic posterior chamber pIOL (IPCL). The visual acuities at near and distance, endothelial cell density, and ocular condition were examined 1 week, 3 months, 1 year and 2 years postoperatively. RESULTS The mean uncorrected distance visual acuity improved significantly from 1.25 logarithm of the minimum angle of resolution (logMAR) (1.15 to 1.35 95% confidence interval [CI]) to 0.11 logMAR (95% CI, 0.03 to 0.17) (P < .0001). No eye lost 1 or more lines of corrected distance visual acuity. The mean distance refraction improved significantly from -6.9 diopters (D) (range -8.6 to -5.3 D) preoperatively to -0.35 D (range -0.55 to -0.15 D, P < .0001) with less than -0.5 D residual refraction in 11 of 17 eyes. Fifteen of 17 eyes had improved uncorrected near visual acuity to J1 (Jaeger chart) at the 2-year follow-up. The near addition at the 2-year follow-up decreased from preoperatively +1.26 D (range 0.19 to 2.34 D) to +0.39 D (range 0.18 to 0.60 D). The mean endothelial cell density was reduced from 2552 cells/mm (range 2421 to 2682 cells/mm) to 2299 cells/mm (range 2108 to 2490 cells/mm) after 2 years. All patients were subjectively satisfied with the outcomes. CONCLUSIONS The new pIOL provided good visual outcomes in near and far distances in an initial case series of patients.
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Clinical Effect and Rotational Stability of TICL in the Treatment of Myopic Astigmatism. J Ophthalmol 2021; 2020:3095302. [PMID: 33489326 PMCID: PMC7803223 DOI: 10.1155/2020/3095302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/28/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the clinical outcomes and possible risk factors associated with rotational stability after the implantation of a V4c toric implantable Collamer lens (TICL) for the correction of moderate to high myopic astigmatism. Methods A total of 112 eyes of 66 patients with moderate to high myopic astigmatism underwent TICL implantation. All patients were followed up for more than 1 year. The uncorrected and best-corrected visual acuity (UCVA and BCVA), astigmatism and spherical equivalent, intraocular pressure, vault, endothelial cell morphometry, and rotation of the TICL axis were assessed at l day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. Postoperative rotation was defined as the angle between the intended axis and the achieved axis. Regression analysis was used to investigate the possible risk factors for TICL rotation postoperatively. Results The mean efficacy index and safety index 12 months postoperatively were 1.03 ± 0.09 and 1.05 ± 0.10, respectively. All patients had the same or better visual acuity than preoperatively. The mean astigmatism value decreased from -1.86 ± 0.79 D preoperatively to -0.37 ± 0.35 D. The mean absolute axis deviation of the TICL at the last follow-up was 2.75 ± 2.04° (range, 0°∼11°). The mean manifest refraction spherical equivalent (MRSE) changed from -9.04 ± 2.67 D preoperatively to -0.67 ± 0.51 D postoperatively. The logistic regression demonstrated that the absolute degree of TICL rotation had a significant association with the fixation angle of the TICL and the size of the lens (P=0.003, P=0.026, resp.). Conclusion The results of our study support that TICL implantation is safe, effective, and predictable in the treatment of moderate to high myopic astigmatism, with relatively good postoperative rotational stability.
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Barnett V, Barsam A. Update on Laser Vision Correction Versus Intraocular Lens Options. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00242-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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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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Takagi Y, Nakamura T, Ichikawa K, Kojima T. Recurrent prolapse of toric implantable collamer lens after blunt ocular trauma under mesopic conditions. Clin Case Rep 2019; 7:626-629. [PMID: 30997050 PMCID: PMC6452523 DOI: 10.1002/ccr3.2055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 12/03/2022] Open
Abstract
Implantable collamer lenses (ICL) carry a risk of prolapse caused by direct ocular trauma, especially in mesopic conditions and when oversized ICLs are implanted. We recommend early surgical repositioning, as well as patient education that encourages goggle use during active sports.
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Affiliation(s)
- Yuki Takagi
- Department of OphthalmologyIida Municipal HospitalNaganoJapan
| | | | | | - Takashi Kojima
- Department of OphthalmologyKeio University School of MedicineTokyoJapan
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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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Packer M. Query regarding rate of complications with Implantable Collamer Lens. J Curr Ophthalmol 2018; 31:113. [PMID: 30899859 PMCID: PMC6407148 DOI: 10.1016/j.joco.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/02/2018] [Accepted: 10/02/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA
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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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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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Kumar A, Mehta A, Ravani RD, Kakkar P. Management of a case of myopic foveoschisis with phakic intraocular lens (pIOL) in situ: intraoperative challenges. BMJ Case Rep 2017; 2017:bcr-2016-218224. [PMID: 28432184 DOI: 10.1136/bcr-2016-218224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We describe the case of a 30-year-old man with pathological myopia with a phakic intraocular lens (IOL) (Visian ICL V4c model; STAAR, Monrovia, California, USA) in situ having complaints of metamorphopsia in the left eye with documented myopic foveoschisis on swept-source optical coherence tomography (DRI OCT Triton; Topcon, Tokyo, Japan). The patient underwent pars plana vitrectomy with internal limiting membrane peeling. This report discusses the intraoperative challenges occurring as a result of increased optical aberrations in the presence of a phakic IOL.
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Affiliation(s)
- Atul Kumar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Mehta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Raghav Dinesh Ravani
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prateek Kakkar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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30
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Kocová H, Vlková E, Michalcová L, Motyka O. Implantation of posterior chamber phakic intraocular lens for myopia and hyperopia - long-term clinical outcomes. J Fr Ophtalmol 2017; 40:215-223. [PMID: 28291554 DOI: 10.1016/j.jfo.2016.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/21/2016] [Accepted: 10/18/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate long-term refractive outcomes of implantable collamer lens (ICL) implantation and late postoperative complications. METHODS We assessed outcomes of patients who underwent ICL implantation (type ICM V4 for myopia, ICH V3 for hyperopia, TICM V4 for astigmatism) in our department between 1998 and 2013. It comprised 62 eyes (40 myopic and 22 hyperopic). The average follow-up period was 10.5 years. We evaluated: uncorrected and best-corrected visual acuity (UCVA and BCVA), spherical equivalent (SE), ICL vault, endothelial cell density and late postoperative complications. RESULTS In myopes, the average UCVA was 1.0±0.37 and BCVA 1.18±0.38, in hyperopes 0.78±0.19 and 1.14±0.18, respectively. The average SE in myopes, whose target refraction was emmetropia, was -0.6±0.83 Dsf, in hyperopes +0.73±0.93. Central ICL vault was 206.16μm±105.94, (range 10-427) in myopes, 195.5μm±109.09, (range 20-404) in hyperopes. The most common late postoperative complication was cataract formation. Three myopic eyes (7.5%) developed symptomatic anterior subcapsular opacities with loss of at least two lines of BCVA. Cataract significantly affecting visual acuity occurred in 5 myopic eyes (12.5%) and 2 hyperopic eyes (9.09%). In these eyes, ICL removal and cataract surgery was performed. CONCLUSIONS In our experience, ICL implantation in moderate and high ametropia was effective and relatively safe. The most common late complication was cataract formation. This complication can be managed effectively surgically with good refractive outcomes without loss of BCVA.
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Affiliation(s)
- H Kocová
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic.
| | - E Vlková
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - L Michalcová
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - O Motyka
- Nanotechnology Centre, VŠB - Technical University of Ostrava, 17, Listopadu 15, 70833 Ostrava, Czech Republic
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Kim B, Mun S, Choi H, Chung Y. Short-term Clinical Outcomes of Implantable Collamer Lens Implantation with Simultaneous Full Thickness Astigmatic Keratotomy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.8.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Buki Kim
- Onnuri Smile Eye Clinic, Seoul, Korea
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