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Fard AM, Patel SP, Nader ND. The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis. Int Ophthalmol 2023; 43:4383-4393. [PMID: 37470861 DOI: 10.1007/s10792-023-02813-z] [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: 07/31/2022] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE To compare the efficacy of phakic intra-ocular lenses in isolation or in combination with corneal crosslinking (CXL) and/or intra-stromal corneal ring segments (ICRS) in keratoconus. METHODS Data extracted from the publications meeting the selection. The outcome parameters included mean pre- and post-operative uncorrected distance visual acuity, corrected distance visual acuity (CDVA), sphere and cylinder of refraction and complications. Available data analyzed with Cochrane Review Manager. RESULTS A total of 23 studies including 464 eyes were included. All the parameters showed significant improvement in all subgroups other than CDVA in ACPIOL + CXL subgroup and cylinder in PIOL + CXL subgroups. There was not a significant difference between PCPIOL and ACPIOL in the outcomes, exception was more improvement of CDVA in "ACPIOL only" than" PCPIOL only" subgroup. CONCLUSION Both PCPIOLs and ACPIOLs are comparably safe and efficient options in management of KCN and their efficacy significantly improves when combined with CXL/ICRS.
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Affiliation(s)
- Ali Mahdavi Fard
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Ophthalmology, Doheny Eye Center of UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Sangita P Patel
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
- Research and Ophthalmology Services, Veterans Administration of Western New York Healthcare System, Buffalo, NY, USA
| | - Nader D Nader
- Department of Anesthesiology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
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Wang Q, Fan L, Zhou Q. The best choice for low and moderate myopia patients incapable for corneal refractive surgery: implantation of a posterior chamber phakic intraocular lens. Int Ophthalmol 2023; 43:575-581. [PMID: 35984557 PMCID: PMC9971141 DOI: 10.1007/s10792-022-02459-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aims to evaluate the early clinical outcomes of central hole phakic posterior chamber intraocular lens(ICLV4c) implantation for low and moderate myopia correction. METHODS This retrospective clinical study included 27 patients(47 eyes)who underwent ICLV4c implantation to correct myopia with spherical equivalent (SE) between - 1.75D and -6.0D. The uncorrected visual acuity (UCVA), intraocular pressure(IOP), central anterior chamber depth (ACD), vault, and endothelial cell density (ECD) were evaluated after surgery. RESULTS At one year follow-up, the postoperative UCVA of patients was higher than the preoperative CDVA and showed a stable trend. There was no significant difference in ECD (p > 0.05) one month after the surgery, the vault was 0.77 ± 0.32 mm, which decreased to 0.63 ± 0.26 mm after one year of surgery. Similarly, ACD was 3.24 ± 0.25 mm in the preoperative, which decreased significantly to 2.05 ± 0.39 mm at one month, while rose to 2.2 ± 0.39 mm at one year after surgery. There was no significant correlation between IOP and ACD and vault at one month and one year after surgery. The correlation coefficient between ACD and vault was found to be - 0.72 at one month after surgery, while the same -0.71 after one year. One patient developed visual fatigue, one with glare, and while no other complications were observed with the rest of the patients. CONCLUSION The ICL implantation is a safe, effective and stable method to correct low and moderate myopia, and may be a good alternative for patients with low and moderate myopia who cannot undergo corneal refractive surgery.
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Affiliation(s)
- Qin Wang
- Chongqing Aier Eye Hospital, Chongqing, 400020 China
| | - Lina Fan
- Chongqing Aier Eye Hospital, Chongqing, 400020 China
| | - Qizhi Zhou
- Aier Chongqing Optometry Eye hospital, No. 77, Daping Changjiang Second Road, Yuzhong, Chongqing, 400040, China.
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Nassar GA, Abbas EN, Khalil MMAA, Tharwat E, Mohammed AR. Evaluation of Higher Order Aberrations and Anterior Segment Parameters Changes After Implantable Collamer Lens Implantation for High Myopia. Clin Ophthalmol 2023; 17:1097-1107. [PMID: 37064961 PMCID: PMC10103779 DOI: 10.2147/opth.s405182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/17/2023] [Indexed: 04/18/2023] Open
Abstract
Purpose To evaluate changes in higher order aberrations (HOAs) induced by implantable collamer lens (ICL) implantation in correction of high myopia and to compare the anterior segment parameters before and after surgery. Also, to correlate these parameters with HOAs, the best corrected visual acuity (BCVA) and intraocular pressure (IOP). Methods This prospective interventional cohort case series study included 40 eyes with high myopia that underwent ICL V4c implantation. They were evaluated pre-operatively and post-operatively at 1st and 3rd month HOAs using Scheimpflug Sirius Camera. The anterior segment parameters were evaluated by optical biometry. Correlations between HOAs, BCVA and anterior segment parameters were evaluated. Results The mean pre-operative BCVA was 0.67 ± 0.17, while post-operative BCVA was 0.74 ± 0.16 (p-value < 0.001). The spherical equivalent was -13.66 ± 2.23 pre-operatively, while post-operatively it was -0.77 ± 0.65 (p-value < 0.001). The mean pre-operative root mean square (RMS) of HOAs was 0.62 ± 0.11 µm, while mean post-operative RMS in the 1st month was 0.82 ± 0.29 µm (p-value < 0.001). At 3rd month, it was 0.63 ± 0.17 µm (p-value = 0.685). The mean pre-operative anterior chamber depth (ACD) was 3.66 ± 0.26 mm. It decreased in the post-operative 1st month to 3.46 ± 0.30 mm, while in 3rd month 3.45 ± 0.24 mm (p-value < 0.001, < 0.001) respectively. The mean pre-operative anterior chamber angle (ACA) 45.98 ± 8.39 o while, the mean ACA was 31.65 ± 4.14, 31.03 ± 3.74 post-operatively (p-value < 0.001, < 0.001) respectively. There was significant increase in IOP (p-value < 0.001). Conclusion ICL implantation is safe and effective in correction of high myopia, as HOAs increase at first month post-operatively then, return to the pre-operative level by 3rd month. However, anterior segment parameters show significant changes which may need longer follow up.
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Affiliation(s)
- Ghada A Nassar
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Correspondence: Ghada A Nassar, 10 Said Street, Heliopolis, Cairo, 11757, Egypt, Tel +2 01222397300, Fax +20223636504, Email
| | - Ezzat N Abbas
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Ehab Tharwat
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed R Mohammed
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Ye Y, Yang F, Ding L, Xia F, Niu L, Wang X, Zhao J, Zhou X. Comparison of Icare HOME and non-contact tonometer in intraocular pressure measurement in the early stage after ICL V4c implantation. Eur J Ophthalmol 2022; 32:3303-3311. [PMID: 35422146 DOI: 10.1177/11206721221093990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To investigate the characteristics of intraocular pressure (IOP) measurements using the Icare HOME rebound tonometer (RBT) and non-contact tonometer (NCT) during the early stage after implantable collamer lens (ICL) V4c implantation, and to assess the agreement between the two methods. Methods This prospective case series study included 104 eyes of 53 patients (mean age 28.77 ± 5.34 years), who underwent ICL V4c implantation. IOP was measured preoperatively, and at 0.5, 1, 2, 4, and 24 h postoperatively by Icare HOME and NCT, respectively. Results All surgeries were uneventful. IOP measurements by Icare and NCT preoperatively were 14.03 ± 2.90 mmHg and 14.09 ± 2.87 mmHg, respectively.The corresponding values were 12.56 ± 8.09 mmHg and 14.12 ± 6.52 mmHg (P > 0.05) at postoperative 0.5 h, 19.21 ± 8.74 mmHg and 19.60 ± 7.66 mmHg at postoperative 1 h (P > 0.05), 21.21 ± 8.10 mmHg and 20.31 ± 6.93 mmHg at postoperative 2 h (P > 0.05), 16.11 ± 5.89 mmHg and 17.04 ± 4.84 mmHg at postoperative 4 h (P > 0.05), and 14.04 ± 3.88 mmHg and 14.78 ± 2.80 mmHg at postoperative 24 h, respectively (P > 0.05). There was good agreement based on intraclass correlation coefficients (ICCs) between NCT and Icare HOME (all ICCs > 0.6 at different time points [range, 0.6986–0.956]). The Bland-Altman plot showed a mean percentage of over 95.81% of the points falling within the limits of agreement. There was a significant difference in the low IOP measurements (<10 mmHg) between Icare HOME and NCT (7.28 ± 2.55 vs. 10.65 ± 2.48, P < 0.001). Conclusion Icare HOME can be used for IOP measurement after ICL V4c implantation and demonstrated good agreement with NCT, except in cases with low intraocular pressure (<10 mmHg).
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Affiliation(s)
- Yuhao Ye
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fangwen Yang
- The second affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Lan Ding
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fei Xia
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Xu W, Song Z, Huang Y, Tao Y, Wang J, Wang L, Li Z. Long-Term Outcomes of Retinal Detachment in Phakic Eyes After Implantation of Implantable Collamer Lens V4c for High Myopia Correction. Front Med (Lausanne) 2020; 7:582633. [PMID: 33425935 PMCID: PMC7793859 DOI: 10.3389/fmed.2020.582633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022] Open
Abstract
Aim: To estimate whether implantable collamer lens (V4c ICL) implantation increases the risk of retinal detachment in high myopia comparing with myopes with Rigid Gas-Permeable (RGP) correction. Methods: This prospective study was comprised of an ICL group (704 eyes) and an RGP group (628 eyes). Patients were enrolled according to the inclusion criteria and exclusion criteria, then divided into the ICL group and RGP group. Patients in the ICL and RGP groups received V4c ICL implantation and RGP fitting respectively. Retinal details, spherical equivalent refraction (SE), uncorrected distance visual acuity (UDVA), corrected distance vision acutivity (CDVA), axis length (AL), anterior chamber depth (ACD) and other relevant parameters were recorded at different time points. Rhegmatogenous retinal detachment (RRD) morbidity and incidence, RRD morphology and relevant parameters were analyzed. Results: All enrolled patients were followed for 3–6 years. Patients characteristics before the refractive procedure did not show a statistical difference. At the end of the follow up, all the RD cases were RRD. The RRD morbidity of the ICL group and RGP group was 1.99% (14 eyes) and 0.96% (6 eyes) respectively, which did not show statistical difference (P = 0.12). During the first year after refractive procedure, the RRD incidence of the ICL group was 0.85% (6/704), while this number of the RGP group was 0.16% (1/628). It did not show statistical difference (P = 0.08). Conclusion: Compared with RGP fitting, V4c ICL implantation for high myopia correction does not add RRD risk in the long term. V4c ICL implantation is a safe method for high myopia correction.
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Affiliation(s)
- Weiwei Xu
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhou Song
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yifei Huang
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ye Tao
- Department of Ophthalmology, Henan Provincial People's Hosptial, Zhengzhou, China
| | - Junqing Wang
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Liqiang Wang
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhaohui Li
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing, China
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