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Wang H, Zhang B, Du W, Sun Z, Fan Q, Pang C. The optimization of the vault-predicting formula based on the anterior segment measurements from artemis insight 100. Sci Rep 2024; 14:13296. [PMID: 38858519 PMCID: PMC11164931 DOI: 10.1038/s41598-024-64390-0] [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: 12/14/2023] [Accepted: 06/07/2024] [Indexed: 06/12/2024] Open
Abstract
To optimize and evaluate the accuracy of the vault-predicting formula generated from a very high-frequency digital ultrasound robotic scanner (Artemis Insight 100). The relationship between the achieved lens vault (LVa) at one month after intraocular collamer lens (ICL) implantation surgery and the predicted vault (LVp) was analyzed by a retrospective study, and an optimized formula was built up. Then, the accuracy of the optimized vault-predicting formula was evaluated in a prospective study by comparing the LVa and the predicted vault from the optimized formula (LVop). The retrospective study included 77 patients (133 eyes) while the prospective study enrolled 90 patients (170 eyes). The difference between LVp and LVa at one month after surgery was statistically significant (P < 0.05), and the linear regression analysis of LVa against LVp yielded a good fit (R2 = 0.68). The optimized vault-predicting formula was LVop (μm) = 1.21 × LVp (μm) + 124.73. In the validation study, the difference between LVop and LVa was not statistically significant (P = 0.10), and a good agreement between LVop and LVa was shown by Bland-Altman analysis. The optimized vault-predicting formula could predict the actual LV after ICL implantation surgery, help to select an appropriate ICL size and reduce the need for re-operation.
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Affiliation(s)
- Hao Wang
- Department of Refractive Surgery, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, Henan Eye Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Henan University, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Bo Zhang
- Department of Refractive Surgery, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, Henan Eye Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Henan University, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Wenwen Du
- Department of Refractive Surgery, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, Henan Eye Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Henan University, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Zaohe Sun
- Department of Refractive Surgery, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, Henan Eye Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Henan University, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Qi Fan
- Department of Refractive Surgery, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, Henan Eye Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, 450003, China
- Department of Refractive Surgery, People's Hospital Affiliated to Henan University, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Chenjiu Pang
- Department of Refractive Surgery, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China.
- Department of Refractive Surgery, Henan Eye Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China.
- Department of Refractive Surgery, People's Hospital Affiliated to Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, 450003, China.
- Department of Refractive Surgery, People's Hospital Affiliated to Henan University, No. 7 Weiwu Road, Zhengzhou, 450003, China.
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Zhang GM, Zhao LJ, Xie HT, Wu MF. Anterior Segment Biometry During Accommodation After Posterior Chamber Phakic Implantable Collamer Lens Implantation. J Refract Surg 2024; 40:e164-e172. [PMID: 38466765 DOI: 10.3928/1081597x-20240212-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
PURPOSE To evaluate the dynamic changes in anterior segment parameters during accommodation following Implantable Collamer Lens (ICL) implantation with swept-source optical coherence tomography (SS-OCT). METHODS Under the accommodation of 0.00 diopters (D), 3.00 D, and maximum amplitude, SS-OCT was used to examine the anterior segment parameters, including ICL vault, ICL depth (the distance between the corneal endothelium and the posterior surface of ICL), crystalline lens thickness, anterior chamber depth, and various parameters of the anterior chamber angle, comprising angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle. RESULTS During accommodation, the ICL vault showed a significant decrease from baseline (536 ± 278 μm) to 3.00 D (522 ± 281 μm), followed by an increase from 3.00 D to maximum amplitude (548 ± 306 μm) (analysis of variance [ANOVA], P < .001). Four eyes (2.61%) exhibited a decrease in ICL vault to less than 100 μm (47 ± 32 μm) at maximum accommodation. The ICL depth decreased significantly as accommodation increased (ANOVA, P < .001). Crystalline lens thickness increased, whereas anterior chamber depth decreased during accommodation (ANOVA, P < .001). The anterior chamber angle widened during 3.00 D of accommodation but narrowed at maximum accommodation, leading to significant changes in the angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle during accommodation (ANOVA, P < .001 for all). CONCLUSIONS The anterior segment, including ICL vault and anterior chamber angle, undergo significant dynamic changes during accommodation. These accommodative changes may require careful monitoring for the surgery design of ICL implantation. [J Refract Surg. 2024;40(3):e164-e172.].
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Brar S, Wadhokar ST, Sriganesh SS, Sriganesh. Comparison of Dynamic Vault Changes Following Implantation of Two Different Models of Phakic Intraocular Lenses. J Refract Surg 2023; 39:546-554. [PMID: 37578182 DOI: 10.3928/1081597x-20230626-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE To compare the dynamic vault range (the difference in the central vault height from scotopic to photopic light condition) after implantation of the ICL/TICL (STAAR Surgical) and Eyecryl phakic/Eyecryl phakic toric intraocular lens (IOL) (Biotech Healthcare). METHODS This retrospective study included patients with myopia or myopic astigmatism eligible for phakic IOL implantation with either the ICL/TICL or Eyecryl phakic/Eyecryl phakic toric IOL. Vault changes in varying light conditions (scotopic, mesopic, and photopic) were assessed using an anterior segment optical coherence tomography-based tomographer and dynamic vault range (DVR) was compared between the two groups. RESULTS A total of 60 eyes from 36 patients (30 eyes in each group) with a mean age of 28.63 ± 6.36 years were included. The mean postoperative follow-up at the time of assessment was 9.4 ± 5.3 and 8.9 ± 5.28 months (P = .75) in the ICL and Eyecryl groups, respectively. The mean values of scotopic, mesopic, and photopic vault were 490.56 ± 238.64, 453.56 ± 224.30, and 373.96 ± 200.24 μm in the ICL group and 515.46 ± 174.34, 490.26 ± 184.04, 450.43 ± 173.92 μm in the Eyecryl group (P = .32, .24, and .05, respectively). The DVR was 116.6 ± 59.29 μm in the ICL group versus 65.03 ± 31.78 μm in the Eyecryl group (P < .001). CONCLUSIONS The Eyecryl phakic IOL showed significantly fewer light-induced changes in the central vault height (DVR) compared to the ICL, which may be attributed to the difference in the material of the two phakic IOL models. This may be clinically significant in eyes with low postoperative vaults with respect to their follow-up and risk assessment of cataractogenesis in the long term. [J Refract Surg. 2023;39(8):546-554.].
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Cakir I, Sonmez O, Pehlivanoglu S, Cakir GY, Yildiz BK, Yildirim Y, Agca A. Long-term results of a new posterior chamber phakic intraocular lens in patients with high myopia: 5-year results. J Cataract Refract Surg 2023; 49:409-415. [PMID: 36888565 DOI: 10.1097/j.jcrs.0000000000001110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/27/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change. SETTING Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN Retrospective. METHODS Eyes that were not suitable for corneal refractive surgery, had high myopia between -6.00 diopters (D) and -20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm 2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded. RESULTS 36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% ( P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye. CONCLUSIONS Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.
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Affiliation(s)
- Ihsan Cakir
- From the Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey (I. Cakir, Sonmez, Pehlivanoglu, G.Y. Cakir, Yildiz, Yildirim); Atakoy World Eye Hospital, Istanbul, Turkey (Agca)
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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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Sánchez Trancón A, Cerpa Manito S, Torrado Sierra O, Baptista AM, Serra PM. Vault differences in eyes implanted with spherical and toric implantable collamer lenses: an inter-eye analysis. BMC Ophthalmol 2022; 22:435. [PMCID: PMC9664806 DOI: 10.1186/s12886-022-02653-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose
To determine the influence of implantable collamer lenses (ICL) geometry, i.e. spherical and toric on the vault, and report the refractive and visual outcomes of patients bilaterally implanted with the two ICL geometries.
Methods
This retrospective case series analysed 41 patients implanted with a spherical ICL (sICL) in one eye and an equal sized toric ICL (tICL) in the fellow eye. The anatomical and ICL-related parameters were assessed using anterior-segment optical coherence tomography (AS-OCT Visante, Zeiss Meditec AG) and optical tomography (Pentacam, OCULUS). The influence of the anatomical and ICL-related parameters on the vault was determined using generalised estimating equations (GEE) to incorporate inter-eye correlations.
Results
Postoperative spherical equivalent was within ± 0.50D in 66% and 83% of the eyes, respectively implanted with sICL and tICL. The efficacy index in the sICL group was 1.06 and 1.14 in the tICL group. The mean inter-eye vault difference was -1.46 µm, anatomical and ICL-related parameters showed similar associations with the vault for sICL and tICL. The GEE identified the ICL size minus the anterior chamber width, the ICL spherical power and ICL central thickness as significant factors influencing the vault.
Conclusions
Spherical and toric ICL showed good efficacy for the correction of myopia and astigmatism. Patients implanted bilaterally with sICL and tICL tend to present similar vaults. The vault produced by both types of ICL was mainly regulated by the oversizing of the ICL. This suggests that the ICL geometry (spherical vs toric) is a factor with limited influence on the vault, thus the sizing method of a sICL and tICL should be similar.
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Niu L, Zhang Z, Miao H, Zhao J, Wang X, He JC, Zhou X. Effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens. EYE AND VISION (LONDON, ENGLAND) 2022; 9:42. [PMID: 36329521 PMCID: PMC9635130 DOI: 10.1186/s40662-022-00313-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Background To investigate the effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens (ICL V4c). Methods This observational study recruited 62 eyes of 31 myopia patients underwent ICL V4c implantation. Anterior segment optical coherence tomography (AS-OCT) assessed the anterior chamber depth (ACD), ACD-ICL (distance from the corneal endothelium to anterior surface of the ICL V4c), vault (distance between the posterior ICL V4c surface and anterior crystalline lens surface), and crystalline lens tilt under various lighting conditions and accommodation relative to the corneal topographic axis at one year after ICL V4c implantation. Baseline was defined as the scotopic condition, which was also the non-accommodative stimulus condition. The ICL V4c tilt was analyzed using MATLAB. The significance level was set at P < 0.05. Results The ACD-ICL values were similar under various lighting conditions (P = 0.978) but decreased during accommodation (P < 0.001). The vault was significantly smaller under mesopic and photopic conditions than the baseline (P = 0.044 and P < 0.001, respectively) but remained unchanged during accommodation (P = 0.058). The inferotemporal proportion of ICL V4c (88.7%, 55 eyes) and crystalline lens (74.2%, 46 eyes) tilts were not significantly different (P = 0.063). Crystalline lens under various lighting conditions and accommodation exhibited similar tilts. The vertical tilt of ICL V4c was significantly larger under photopic conditions than the baseline (P = 0.038). The horizontal and total tilts were significantly decreased during accommodation (P = 0.043 and 0.013, respectively). Conclusions The axial position of ICL V4c in the anterior chamber was stable under various lighting conditions. Lighting conditions and accommodation may influence vertical, horizontal and total tilts of ICL V4c. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-022-00313-2.
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Affiliation(s)
- Lingling Niu
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhe Zhang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Huamao Miao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Ji C He
- New England College of Optometry, MA, Boston, USA.
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China. .,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China. .,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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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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Zhang J, Xia Z, Han X, Liu Z, Lin H, Qiu X, Zhang M, Ruan X, Chen X, Jin G, Gu X, Tan X, Luo L, Liu Y. Accuracy of Intraocular Lens Calculation Formulas in Patients Undergoing Combined Phakic Intraocular Lens Removal and Cataract Surgery. Am J Ophthalmol 2022; 234:241-249. [PMID: 34624249 DOI: 10.1016/j.ajo.2021.09.035] [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: 07/29/2021] [Revised: 09/19/2021] [Accepted: 09/27/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the prediction accuracy of intraocular lens (IOL) calculation formulas, and the impact of anterior chamber depth (ACD) and lens thickness (LT) measurement errors on IOL power calculation in patients undergoing combined phakic IOL (PIOL) removal and cataract surgery. DESIGN Retrospective, consecutive case series study. METHODS Thirty-six PIOL implanted eyes (12 anterior chamber PIOLs and 24 posterior chamber PIOLs [PC-PIOL]) undergoing cataract surgery were included. The prediction accuracy of new formulas (Barrett universal II, Emmetropia verifying optical, Kane, and Ladas super formula) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) with or without Wang-Koch (WK) axial length (AL) adjustment was evaluated. The influence of ACD and LT measurement errors of IOLMaster 700 on refractive outcomes was also investigated. RESULTS The Kane and traditional formulas with WK AL adjustment had no significant systematic prediction error and displayed a smaller median absolute error, whereas the other formulas showed significant hyperopia shift (P < .05) and relatively lower prediction accuracy. The accuracy rate of IOLMaster 700 in measuring the ACD and LT was 100% in eyes with anterior chamber PIOL implantation, and 37.50% in the PC-PIOL subgroup. No significant difference was observed in refractive outcomes of formulas using correct and wrong parameters in the PC-PIOL subgroup (P > .05). CONCLUSIONS The Kane and traditional formulas with WK AL adjustment exhibited relatively higher prediction accuracy in patients who underwent combined PIOL removal and cataract surgery. The IOLMaster 700 displayed low accuracy in ACD and LT measurements for PC-PIOL implanted eyes, but showed negligible impact on IOL prediction accuracy.
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Affiliation(s)
- Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Zhaoxia Xia
- Department of Ophthalmology, the Sixth Affiliated Hospital of Sun Yat-sen University (Z.X.), Guangzhou, Guangdong, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Haowen Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaozhang Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Miao Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaoting Ruan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xiaoxun Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.).
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.).
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J.Z., X.H., Z.L., H.L., X.Q., M.Z., X.R., X.C., G.J., X.G., X.T., L.L. Y.L.)
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10
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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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11
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Chen X, Wang X, Xu Y, Cheng M, Han T, Wang X, Zhou X. Long-term Comparison of Vault and Complications of Implantable Collamer Lens with and without a Central Hole for High Myopia Correction: 5 Years. Curr Eye Res 2021; 47:540-546. [PMID: 34894946 DOI: 10.1080/02713683.2021.2012202] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the long-term safety, efficacy, stability, vault, and complications of implantable collamer lens with (ICL V4c) and without (ICL V4) a central hole for correcting high myopia. METHODS 78 eyes (40 patients) underwent ICL V4c implantation and 78 eyes (48 patients) underwent ICL V4 implantation were enrolled. They were followed up for 5 years of the uncorrected and corrected distance visual acuity, spherical equivalent (SE), axial length, intraocular pressure, endothelial cell density and vault. RESUITS The safety indices of the ICL V4c and V4 groups at 5 years were 1.25 ± 0.40 and 1.31 ± 0.40, respectively (P = .353). The efficacy indices were 0.90 ± 0.29 and 1.00 ± 0.44, respectively (P = .098). The preoperative, 1 month and 5 year postoperative logMAR UDVAs were respectively 1.54 ± 0.48, 0.11 ± 0.17, and 0.20 ± 0.26 in the V4c group and 1.56 ± 0.44, 0.14 ± 0.19, and 0.22 ± 0.26 in the V4 group (P = .703, 0.329, 0.585). The logMAR CDVAs were resepectively 0.13 ± 0.18, 0.02 ± 0.11, and 0.05 ± 0.16 in the V4c group and 0.18 ± 0.22, 0.05 ± 0.14, and 0.09 ± 0.21 in the V4 group (P = .128, 0.169, 0.229). The SE were resepectively -15.10 ± 4.32 D, -0.71 ± 1.31 D and -1.65 ± 1.30 D in the V4c group and -15.44 ± 3.51 D, -0.61 ± 1.12 D and -1.40 ± 1.30 D in the V4 group (P = .585, 0.637, 0.296). The mean vault reduced by 97.31 ± 136.61 μm in the V4c group and by 99.74 ± 245.83 μm in the V4 group. Three eyes (3.85%) with mid-periphery anterior subcapsular opacification in the V4c group and two (2.56%) with cataract, one (1.28%) with central anterior subcapsular opacification in the V4 group were observed. The CDVA of 20/40 was obtained in the two cataract eyes after phacoemulcification and intraocular lens implantation. CONCLUSION Long-term ICL V4c and ICL V4 implantations are safe, effective, and stable for high myopia correction. ICL V4c can potentially reduce the risk of lens opacification and may be more tolerant to low vault than ICL V4.
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Affiliation(s)
- Xun Chen
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqi Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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12
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Chen X, Wang X, Xu Y, Cheng M, Han T, Niu L, Wang X, Zhou X. Five-year outcomes of EVO implantable collamer lens implantation for the correction of high myopia and super high myopia. EYE AND VISION 2021; 8:40. [PMID: 34753516 PMCID: PMC8576084 DOI: 10.1186/s40662-021-00264-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022]
Abstract
Background To evaluate the long-term safety, efficacy, predictability, and stability of implantable collamer lens with a central hole (EVO ICL) implantation for correcting high myopia (HM) and super high myopia (SHM). Methods This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error (SE): HM group (− 12 D ≤ SE < − 6 D) and SHM group (SE < − 12 D). They were followed up for 5 years after ICL implantation; assessments of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive error, axial length, intraocular pressure, corneal endothelial cell density, and vault were conducted, and a questionnaire was administered. ResuIts At 5 years postoperatively, the safety indices of the HM and SHM groups were 1.03 ± 0.10 and 1.32 ± 0.39, and the efficacy indices were 0.83 ± 0.25 and 0.86 ± 0.32, respectively. In the HM group, 60.47% and 79.07% of the eyes were within ± 0.50 D and ± 1.00 D of the attempted correction, while it was achieved for 22.50% and 47.50% of the eyes in the SHM group, respectively. The SE of the HM group decreased from − 9.72 ± 1.41 D preoperatively to 0.04 ± 0.39 D 1 month postoperatively and − 0.67 ± 0.57 D 5 years postoperatively, while in the SHM group, it decreased from − 15.78 ± 3.06 D preoperatively to − 0.69 ± 0.97 D 1 month postoperatively and − 1.74 ± 1.19 D 5 years postoperatively. Conclusion EVO ICL implantation is safe, effective, and predictable for correcting HM and SHM. CDVA improved more after surgery for SHM, but the growth of axial length still needs attention.
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Affiliation(s)
- Xun Chen
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqi Wang
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - LingLing Niu
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China. .,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| | - Xingtao Zhou
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China. .,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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13
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Vault changes and pupillary responses to light in myopic and toric implantable collamer lens. BMC Ophthalmol 2021; 21:366. [PMID: 34656092 PMCID: PMC8520211 DOI: 10.1186/s12886-021-02119-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Achieving an appropriate vault is the main concern after the implantation of Implantable Collamer Lens (ICLs) for surgical correction of high myopia. The vault will vary with time and optical parameters, such as accommodation and pupil size. This research is to evaluate the vault change in Myopic and Toric ICLs under different lighting conditions; and to analyze the relationship between vault changes and pupillary responses to light. METHODS We enrolled and analyzed 68 eyes from 68 patients who were implanted with Myopic EVO ICLs; we also included 60 eyes from 60 patients who were implanted with Toric EVO ICLs. The anterior chamber depth, pupil size and the post-operative vault were evaluated, 1 week after the operation, using a Visante Optical Coherence Tomography (OCT) under different lighting conditions. For each eye that was assessed, we calculated the vault change, which is defined as the difference between vault under mesopic condition and photopic condition; and the rate of vault change, which is defined as the vault change divided by mesopic vault. RESULTS No significant difference was noted with the anterior chamber depth between mesopic and photopic conditions in either group. A significant decrease in vault and pupil size was detected under photopic condition in both groups. We found no difference in vault change between Myopic and Toric EVO ICLs under different lighting conditions. Moreover, the rate of vault change had a significant decrease with increased mesopic vault (baseline value). CONCLUSIONS Too low a mesopic vault has a big rate of vault change, which may cause the contact of ICL with crystalline lens in photopic state; Too high a mesopic vault would constrict the posterior movement of pupil. The findings of the study suggest that, for patients with high or low vault, we should be more careful and must perform checks in different lighting conditions.
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14
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Zhao J, Zhao J, Yang W, Li M, Hao G, Chen Z, Wang X, Yao P, Zhou X. Consecutive contralateral comparison of toric and non-toric implantable collamer lenses V4c in vault after implantation for myopia and astigmatism. Acta Ophthalmol 2021; 99:e852-e859. [PMID: 33369209 DOI: 10.1111/aos.14720] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
AIMS To compare the vault performance between implantable collamer lens (ICL) V4c and Toric ICL (TICL) V4c after implantation and to investigate the affecting factors. METHODS Sixty-eight eyes from 34 patients with myopia or myopia astigmatism who underwent implantation of TICL in one eye (group A) and identically sized ICL (group B) in the contralateral eye were included. Mean follow-up time were 7.58 ± 1.63 months (range: 6-10 months). Vault was compared between the two groups and correlations between vault and age, preoperative ocular biometric measurements were analysed. Generalized estimating equation (GEE) model of postoperative vault adjusting for within-patient intereye correlations was performed. RESULTS The safety indices were 1.27 and 1.35, and the efficacy indices were 1.20 and 1.24 for groups A and B, respectively. Vault of TICL was significantly higher than that of ICL (554.11 ± 219.36 μm vs 449.70 ± 172.47 μm, P < 0.001). The difference between ICL/TICL size and WTW (size-WTW) and STS (size-STS), anterior chamber depth and pupil diameter (PD) were positively correlated with vault. Patient age and clear lens rise measured by Pentacam were negatively correlated with vault. Results of GEE model showed preoperative PD, age, cylindrical power of TICL and size-WTW were influencing factors for postoperative vault. CONCLUSIONS Vault after TICL implantation is higher than that with ICL. PD, age, cylindrical power of TICL and size-WTW could affect postoperative vault.
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Affiliation(s)
- Jiao Zhao
- Department of Ophthalmology People’s Hospital of Leshan Leshan China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Wen Yang
- Department of Ophthalmology The Third People’s Hospital of Chengdu The Affiliated Hospital of Southwest Jiaotong University Chengdu China
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Gengsheng Hao
- Department of Ophthalmology People’s Hospital of Leshan Leshan China
| | - Zhuoyi Chen
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology Eye & ENT Hospital Fudan University Shanghai China
- NHC Key Laboratory of Myopia (Fudan University) Key Laboratory of Myopia Chinese Academy of Medical Sciences Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
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15
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Brar S, Gautam M, Sute SS, Pereira S, Ganesh S. Visual and Refractive Outcomes With the Eyecryl Phakic Toric IOL Versus the Visian Toric Implantable Collamer Lens: Results of a 2-Year Prospective Comparative Study. J Refract Surg 2021; 37:7-15. [PMID: 33432990 DOI: 10.3928/1081597x-20201013-04] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the 2-year visual and refractive outcomes with the Eyecryl Phakic Toric IOL (EP TIOL) (Biotech Vision Care Pvt Ltd) and Visian Toric ICL (TICL) (STAAR Surgical) for correction of high myopic astigmatism. METHODS This prospective, interventional, non-randomized comparison study included eligible patients who underwent toric phakic IOL surgery in one or both eyes with either the EP TIOL or TICL for myopic astigmatism. Two years postoperatively, both lenses were compared for their safety, efficacy, stability, and patient satisfaction. Vector analysis of astigmatism was performed using the Alpins method with the ASSORT software (ASSORT Party Ltd). RESULTS A total of 50 eyes were included, of which 25 eyes received EP TIOL implantation and the remaining 25 received TICL implantation. Preoperative mean ± standard deviation of spherical equivalent (SE) and cylinder was -10.15 ± 4.04 and -2.08 ± 0.86 diopters (D) in the EP TIOL group and -10.21 ± 3.97 and -2.17 ± 0.95 D in the TICL group, respectively. At 2 years of follow-up, there was no significant difference between the mean uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, and residual astigmatism between the two groups (P > .05 for all parameters). Ninety-two percent of eyes in the EP TIOL group and 88% of eyes in the TICL group were within ±0.50 D of refractive astigmatism. Vector analysis of astigmatism showed a comparable Correction Index of 0.98 in the EP TIOL group and 0.94 in the TICL group, signifying a mild undercorrection of 2% and 6%, respectively. Two eyes in the TICL group underwent exchange for high vault and one eye required realignment due to significant postoperative rotation. CONCLUSIONS At least for the first 2 years postoperatively, both toric phakic IOLs were safe and effective in managing high myopic astigmatism with comparable visual results and patient satisfaction. [J Refract Surg. 2021;37(1):7-15.].
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16
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Almorín-Fernández-Vigo I, Sánchez-Guillén I, Fernández-Vigo JI, De-Pablo-Gómez-de-Liaño L, Kudsieh B, Fernández-Vigo JÁ, Macarro-Merino A. Agreement between optical coherence and Scheimpflug tomography: Vault measurements and reproducibility after implantable collamer lens implantation. J Fr Ophtalmol 2021; 44:1370-1380. [PMID: 34330550 DOI: 10.1016/j.jfo.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the agreement between Scheimpflug tomography (Pentacam, Oculus) and anterior segment optical coherence tomography (AS-OCT, RTVue 100, Optovue) as well as the reproducibility of each technique in assessing the lens-ICL distance (vault) after implantable collamer lens (ICL) implantation. METHODS The vault was measured manually with Scheimpflug tomography and AS-OCT. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to determine the reproducibility of measurements and the agreement between them. Multivariate regression analysis was performed to identify predictors of differences in vault measurements between devices. RESULTS 80 eyes of 46 ICL patients were analyzed. Mean patient age was 33.8±7.4 years (range, 21 to 51), and 27 (59%) were women. The preoperative spherical equivalent refraction ranged from -26 to 8.5 diopters (D). The mean vault measured by AS-OCT was 558.8±240.2μm (range, 162 - 1220) vs. 430.1±215.3μm (range, 0 to 1070) by Pentacam. AS-OCT yielded vault values, on average, 128.1±64.6μm higher than the Pentacam (range, -22 to 293μm). The ICC values for consistency and absolute agreement were 0.960 and 0.928, respectively. Reproducibility of vault measurements was excellent for both devices (ICC≥0.946). Four parameters-vault, pupil diameter (PD), PD differences between devices, and preoperative spherical equivalent refraction-were significant predictors of differences in vault measurements (adjusted-R2=0.412; P<0.001). CONCLUSIONS Agreement between AS-OCT and Pentacam for vault measurement was good. Vaults were higher when measured by AS-OCT. These differences are clinically relevant, and therefore these devices cannot be used interchangeably to measure vault.
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Affiliation(s)
| | - I Sánchez-Guillén
- Centro Internacional de Oftalmología Avanzada, Badajoz, Spain; Department of ophthalmology, hospital Llerena-Zafra, Badajoz, Spain
| | - J I Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Department of ophthalmology, hospital Clínico San Carlos, Madrid, Spain
| | | | - B Kudsieh
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Department of ophthalmology, hospital Puerta de Hierro, Madrid, Spain
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Badajoz, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain; School of Medicine, Universidad de Extremadura, Badajoz, Spain
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17
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Determining vault size in implantable collamer lenses: preoperative anatomy and lens parameters. J Cataract Refract Surg 2021; 46:728-736. [PMID: 32358268 DOI: 10.1097/j.jcrs.0000000000000146] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine patient preoperative anatomical features and the parameters of implantable collamer lenses (ICLs) relevant in explaining vault variability. SETTING Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain. DESIGN Retrospective case series. METHODS This study comprised 360 eyes of 360 patients implanted with myopic or toric ICLs. Pentacam imaging was used for assessing white-to-white (WTW) diameter, central keratometry, and central corneal thickness. Anterior-segment optical coherence tomography was used to measure the horizontal anterior chamber angle distance (ATA), internal anterior chamber (ACQ), crystalline lens rise (CLR), anterior chamber angle (ACA), and vault. The sample was divided according to the implanted lens size (12.6 mm, 13.2 mm, and 13.7 mm). Vault predictors were identified from the variables above using multivariate regression analysis. RESULTS The groups showed significant statistical differences for WTW, ATA, ACQ, ACA, and vault (P < .007 for all). In general, bigger lenses were implanted in eyes with larger transverse sizes (WTW and ATA) and deeper ACQ. Also, larger ICL diameters were associated with higher vaults. Multivariate regression analysis identified the lens size (13.2 mm as reference; 12.6 mm: β [standardized coefficients] = -0.33; 13.7 mm: β = 0.42), ATA (β = -0.42), and CLR (β = -0.25), ICL spherical equivalent (β = -0.22) and patient age (β = -0.12) as predictors of the vault size (adjusted-R = 0.34 P < .001). CONCLUSIONS The multivariate model explained 34% of vault variability. The predictors indicated the presence of different mechanisms regulating the vault. These involved the difference between the transverse size of the eye and the ICL, the crystalline lens protrusion, and the ICL properties, such as power and size.
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Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Lisa C, Madrid-Costa D, Alfonso JF. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. EYE AND VISION 2021; 8:23. [PMID: 34112241 PMCID: PMC8194243 DOI: 10.1186/s40662-021-00247-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. METHODS Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. RESULTS The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was - 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.
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Affiliation(s)
| | | | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, University Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
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Zhao J, Zhao J, Yang W, Miao H, Niu L, Shang J, Wang X, Zhou X. Peripheral Anterior Chamber Depth and Angle Measurements Using Pentacam After Implantation of Toric and Non-toric Implantable Collamer Lenses. Front Med (Lausanne) 2021; 8:610590. [PMID: 33585524 PMCID: PMC7873523 DOI: 10.3389/fmed.2021.610590] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose: To evaluate the characteristics of peripheral anterior chamber measurements by Pentacam after posterior implantable collamer lenses (ICL) and toric ICL (TICL) with central hole (V4c) implantation. Methods: Prospective, non-randomized consecutive case series. Forty-six patients undergoing ICL implantation in one eye (Group A) and identically sized TICL in the contralateral eye (Group B) in the Refractive Surgery Center of Eye and ENT Hospital of Fudan University were prospectively included. According to ICL/TICL size, these eyes were further divided into four subgroups. Peripheral anterior chamber depth (PACD) and angle (ACA) in nasal and temporal sides were measured using Pentacam pre-operatively and 12-month post-operatively. Results: The safety indices were 1.34 ± 0.32 and 1.25 ± 0.16 and the efficacy indices were 1.20 ± 0.24 and 1.19 ± 0.19 for ICL and TICL groups, respectively. There was no significant difference in pre-operative PACD or ACA between the two groups. Post-operative PACD and ACA were significantly lower than pre-operative values. Variations of PACD and ACA of TICL group were significantly larger than those of ICL group. The change of ACA for 13.2 mm lenses was significantly larger than that of 12.6 mm lenses. Pre-operative CACD and vault were significantly associated with post-operative PACD, while pre-operative ACA and vault were significantly associated with post-operative ACA. Conclusions: Variations of PACD and ACA were greater in eyes after TICL (V4c) implantation compared with identically sized ICL (V4c) implantation and with larger size than smaller size lens implantation. Pre-operative anterior chamber structure and vault affect post-operative PACD and ACA.
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Affiliation(s)
- Jiao Zhao
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
| | - Wen Yang
- Department of Ophthalmology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Huamao Miao
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
| | - Jianmin Shang
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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
- Eye Institute and Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,National Health Center 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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20
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Phakic intraocular lens implantation for the correction of hyperopia. J Cataract Refract Surg 2020; 45:1503-1511. [PMID: 31564323 DOI: 10.1016/j.jcrs.2019.05.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 11/27/2022]
Abstract
The prevalence of myopia is much higher than hyperopia. Hence, there are relatively few studies investigating phakic intraocular lens (pIOL) implantation for the correction of hyperopia. This review aimed to summarize the available relevant literature on the efficacy and safety of pIOL implantation for the correction of hyperopia and hyperopic astigmatism. At present, two types of pIOLs are used to correct hyperopia and hyperopic astigmatism: anterior chamber iris-fixated pIOLs and posterior chamber implantable collamer lenses. Both have been found to be safe and effective. No serious events (eg, retinal or choroidal detachment, endophthalmitis) were reported in the reviewed articles. Implantation of pIOLs might be the optimal refractive surgery for the correction of high hyperopia.
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21
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Cerpa Manito S, Sánchez Trancón A, Torrado Sierra O, Baptista AMG, Serra PM. <p>Inter-Eye Vault Differences of Implantable Collamer Lens Measured Using Anterior Segment Optical Coherence Tomography</p>. Clin Ophthalmol 2020; 14:3563-3573. [PMID: 33154615 PMCID: PMC7605967 DOI: 10.2147/opth.s258817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/12/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | | | | | - Pedro Miguel Serra
- Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain
- Optics and Optometry Department, Instituto Superior de Educação e Ciências, Lisbon, Portugal
- Correspondence: Pedro Miguel Serra Email
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22
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Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age. J Ophthalmol 2020; 2020:7457902. [PMID: 32676203 PMCID: PMC7341401 DOI: 10.1155/2020/7457902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/09/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose To assess the efficacy, safety, and predictability of the Visian Implantable Collamer Lens (ICL) model having a central port in patients over 40 years of age. Methods This study included 33 eyes from 21 patients who underwent V4c ICL implantation for the correction of myopia and myopic astigmatism. We assessed uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events occurring over a 1-year period. Results Mean age of the patients at the time of implantation was 43.52 ± 4.49 years (range: 40 to 56 years). Efficacy and safety indexes were 1 and 1.09, respectively. Surgical outcomes for CDVA were as follows: no eye lost any lines, 19 eyes (57.58%) showed no CDVA changes, 7 eyes (21.21%) gained 1 line, 4 eyes (12.12%) gained 2 lines, and 3 eyes (9.09%) gained ≥3 lines. Mean postoperative spherical equivalent (SE) was −0.09 ± 0.47 D. A total of 29 eyes (87.8%) were within ±0.50 D and 31 eyes (93.9%) were within ±1.00 D of the desired SE. At 1-year, mean IOP was 15.27 ± 3.03 mmHg (range: 9 to 20 mmHg, p=0.12 pre vs. post) and mean ECD was 2516 ± 234 cells/mm2 (p=0.29 pre vs. post). Mean postoperative vault was 320 ± 136 μm, with 201–300 μm being the most prevalent vault range for 9 eyes (31.03%). None of the eyes showed a vault >701 μm. There were neither intraoperative nor postoperative complications; in fact, all ICL implantation procedures were uneventful. Conclusions Our study's findings support the use of this lens in patients over 40 years of age. A long follow-up period is advisable to monitor ICL position relative to the crystalline lens.
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23
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Hernández-Rodríguez CJ, Piñero DP. A systematic review about the impact of phakic intraocular lenses on accommodation. JOURNAL OF OPTOMETRY 2020; 13:139-145. [PMID: 31937486 PMCID: PMC7301210 DOI: 10.1016/j.optom.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 07/26/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
Phakic intraocular lenses (pIOL) are the main treatment for patients who have either high ametropia or contraindications for laser refractive surgery. The main feature that makes this kind of lenses suitable for its implantation in young adults searching for independence of optical prescription is the conservation of accommodation, since lens extraction is not required. A systematic review has been performed to evaluate the scientific literature on the effect of pIOL implantation on accommodation. Critical assessment of the articles included in the review was achieved using the tool Critical Appraisal Skills Programme in its Spanish form (CASPe). After revising the complete text of 10 articles pre-selected, two quasi-experimental pre-post studies evaluating the outcomes of a specific model of posterior chamber pIOL were included in the systematic review. The CASPe scoring of both studies were 5/11. According to this outcome, the evidence describing the impact of the pIOL implantation on the accommodative function can be defined poor. Some trends are reported as the decrease in the amplitude of accommodation, a decrease positive relative accommodation and improvement of accommodation. However, these results should be confirmed in future controlled studies.
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Affiliation(s)
- Carlos J Hernández-Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain.
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24
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Yu Y, Zhang C, Zhu Y. Femtosecond laser assisted cataract surgery in a cataract patient with a "0 vaulted" ICL: a case report. BMC Ophthalmol 2020; 20:179. [PMID: 32370735 PMCID: PMC7201666 DOI: 10.1186/s12886-020-01440-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Femtosecond laser assisted cataract surgery (FLACS) combined with implantable collamer lenses (ICLs) extraction has been shown to be a feasible method for patients developing cataracts after the ICL implantation. All reported cases had shallow vaults, ranging from 47 μm (μm) to 100 μm. We report for the first time, a case in which the FLACS was performed on the "0" vault eye. CASE PRESENTATION A 38-year-old man with anterior subcapsular cataracts underwent the FLACS combined with ICLs extraction 6 years after ICLs implantation in both eyes. In his left eye, the ICL touched the anterior capsule, existing "0" vault. During the capsulotomy, cavitation bubbles were trapped in the shallow space beneath the ICL, developing from small bubbles into big ones, which resulted in the incomplete capsulotomy. Comparatively, in the right eye, the ICL vault was measured 72 μm, and the capsulotomy was complete and no big cavitation bubbles formed. In both eyes, capsulotomy zones were manually assigned to the anterior capsule surface in the process of laser identification. However, the nuclear pre-fragmentations were unsuccessful in both eyes. Other steps of surgeries were performed uneventfully. Depending on the design of monovision, the uncorrected distance visual acuity (UDVA) was 20/32, and the near uncorrected visual acuity (UCVA) was 20/25 in both eyes postoperatively. CONCLUSIONS This case suggested that the surgeon should pay attention to the incomplete laser capsulotomy when using a femtosecond laser in cataractous cases with "0" vaulted ICLs, and manual adjustment was required in the process of laser identification.
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Affiliation(s)
- Yibo Yu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, China
| | - Chengshou Zhang
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, China
| | - Yanan Zhu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, China.
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25
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Comparison of intraoperative vs postoperative optical coherence tomography measurement of implantable collamer lens vaulting. J Cataract Refract Surg 2020; 46:737-741. [DOI: 10.1097/j.jcrs.0000000000000119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Choi JH, Lim DH, Nam SW, Yang CM, Chung ES, Chung TY. Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia. J Cataract Refract Surg 2019; 45:1555-1561. [DOI: 10.1016/j.jcrs.2019.06.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
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27
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Jadidi K, Mosavi SA, Nejat F, Mohammadi N, Aghamolaei H, Daryabari SH, Torabi H, Alishiri A. Use of low-vault posterior chamber collagen copolymer phakic intraocular lenses for the correction of myopia: a 3-year follow-up. Graefes Arch Clin Exp Ophthalmol 2019; 257:1555-1560. [DOI: 10.1007/s00417-019-04336-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 11/28/2022] Open
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Zhu Y, Zhang J, Zhu H, Chen J, Zhou J. The effect of mydriasis on moderate-to-high myopic eyes with implantable collamer lenses V4 and V4c. Eur J Ophthalmol 2019; 30:462-468. [PMID: 30845836 DOI: 10.1177/1120672119831218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the vault change and anterior segment movement induced by mydriasis in moderate-to-high myopic eyes with implantable collamer lenses (ICL). SETTING Shanghai, China. DESIGN A prospective consecutive observational study. METHODS A total of 45 eyes of 24 patients with ICL V4 implantation and 128 eyes of 65 patients with ICL V4c implantation were included and analyzed. Anterior chamber depth, posterior corneal endothelium-to-ICL distance, and vault before and after mydriasis were measured by Pentacam (Oculus, Wetzlar, Germany) at 1, 3, and 6 months after surgery. RESULTS Significant vault increases and anterior chamber depth increases induced by mydriasis were noted in both ICL V4 and V4c groups at 1, 3, and 6 months postoperatively. The corneal endothelium-ICL distance increased significantly in eyes with implanted ICL V4c after mydriasis at 3 and 6 months. Moreover, mydriasis-induced vault increases were greater in the ICL V4 group than in the ICL V4c group at 3 and 6 months. In eyes with implanted ICL V4c, mydriasis-induced vault increases were significantly greater at 1 month than at 3 and 6 months. CONCLUSION Mydriasis results in a general vault increase in eyes with implanted ICLs. The adjustment of the pressure equilibrium via the central hole of the ICL V4c has an important role in vault change. The mydriasis-induced vault increases tend toward stability after 3 months postoperatively. Mydriasis is relatively safe in eyes with ICL implantation.
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Affiliation(s)
- Yi Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jing Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Haobin Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jili Chen
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Ophthalmology, Shibei Hospital, Shanghai, China
| | - Jibo Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens. Cornea 2019; 38:217-220. [PMID: 30371566 PMCID: PMC6344073 DOI: 10.1097/ico.0000000000001785] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE An appropriate vault after implantation of a posterior chamber phakic intraocular lens with a central hole (ICL KS-AP) is important for successful long-term outcomes. In the present study, we used anterior segment optical coherence tomography (AS-OCT) to examine dynamic pupil and vault changes under photopic and scotopic conditions and during accommodation in eyes with ICL KS-AP. METHODS This retrospective study included patients at an outpatient ophthalmology clinic who underwent ICL KS-AP implantation >1 month before enrollment. All patients underwent dynamic AS-OCT imaging under photopic and scotopic conditions. Patients aged <40 years also underwent imaging in the accommodative and nonaccommodative states. Primary outcome measures were the pupil size and vault at the maximum and minimum pupil sizes. RESULTS This study included 91 eyes of 47 patients (35.5 ± 8.6 years, 21 men). Accommodation was examined in 51 eyes of 26 patients (28.9 ± 5.0 years, 10 men) younger than 40 years. The pupil size was significantly smaller under photopic conditions (3.64 ± 0.77 mm) than under scotopic conditions (4.91 ± 0.75 mm, P < 0.001) and during accommodation (3.88 ± 0.64 vs. 4.10 ± 0.61 mm, P < 0.001). Vault was also significantly lower under photopic conditions (476.1 ± 219.6 μm) than under scotopic conditions (521.1 ± 220.4 μm, P < 0.001) and during accommodation (454.8 ± 224.9 vs. 481.6 ± 219.1 μm, P < 0.001). CONCLUSIONS Vault can be significantly lowered by light-induced pupil constriction and accommodation in eyes with ICL KS-AP.
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Gimbel HV, LeClair BM, Jabo B, Marzouk H. Incidence of implantable Collamer lens–induced cataract. Can J Ophthalmol 2018; 53:518-522. [DOI: 10.1016/j.jcjo.2017.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/17/2017] [Accepted: 11/21/2017] [Indexed: 10/17/2022]
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31
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Jonker SM, Berendschot TT, Ronden AE, Saelens IE, Bauer NJ, Nuijts RM. Five-Year Endothelial Cell Loss After Implantation With Artiflex Myopia and Artiflex Toric Phakic Intraocular Lenses. Am J Ophthalmol 2018; 194:110-119. [PMID: 30053473 DOI: 10.1016/j.ajo.2018.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/12/2018] [Accepted: 07/15/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the long-term changes in endothelial cell density (ECD) after the implantation of 2 types of foldable iris-fixated phakic intraocular lenses (pIOLs) for the treatment of myopia and astigmatism. DESIGN Prospective clinical cohort study. METHODS Two-hundred and ninety-three and 188 eyes implanted with, respectively, the Artiflex Myopia and Artiflex Toric (Ophtec B.V., Groningen, The Netherlands) iris-fixated pIOL for the treatment of myopia or astigmatism at the University Eye Clinic Maastricht as of January 2004. One-hundred and forty-six eyes from the myopic and 64 eyes from the toric groups completed a 5-year follow-up. Main outcome measures were chronic endothelial cell (EC) loss, percentage of eyes with a ≥25% decrease in ECD, and the percentage of eyes with an ECD < 1500 cells/mm2. RESULTS Chronic EC loss showed an annual decline of 64 cells/mm2 in the myopic (P < .001, standard error 3.58) and 62 cells/mm2 in the toric (P < .001, standard error 3.77) groups. Total chronic EC loss from 6 months to 5 years postoperatively was 10.5% in the myopic and 10.2% in the toric groups. After 5 years, an ECD decrease of ≥25% occurred in 4.4% and 4.3% of eyes, and an ECD < 1500 cells/mm2 was reported in 3.0% and 0.0% of eyes, respectively. Explantation of a pIOL owing to EC loss was required in 3.1% and 0% of eyes. CONCLUSION Chronic EC loss was around 10% over a 5-year period in eyes implanted with the foldable myopic (toric) pIOL. In up to 3.1% of eyes significant EC loss resulted in subsequent pIOL explantation.
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Gonzalez-Lopez F, Mompean B, Bilbao-Calabuig R, Vila-Arteaga J, Beltran J, Baviera J. Dynamic Assessment of Light-Induced Vaulting Changes of Implantable Collamer Lens With Central Port by Swept-Source OCT: Pilot Study. Transl Vis Sci Technol 2018; 7:4. [PMID: 29736325 PMCID: PMC5931257 DOI: 10.1167/tvst.7.3.4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/24/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess dynamic variations in vault induced by changes in brightness in eyes implanted with phakic collamer intraocular lens (pIOL) with central port for correction of myopia, defining new parameters of vaulting measurement. Methods We used a noninvasive Fourier-domain swept-source anterior-segment optical coherence tomography (AS-OCT) system to dynamically evaluate the shifts between the pIOL and anterior chamber structures under changing light conditions. For each eye assessed, we measured vault interval (VI), which we define based on central vault values in maximum mydriasis and in maximum miosis after light-induced changes in pupil diameter, and vault range (VR), which we define as the absolute difference between the VI values. Results The pilot study sample comprised 39 eyes (23 patients) previously implanted (mean 107 ± 156 days) with a pIOL. A significant difference in vault value was found when maximum and minimum pupil size was assessed under changing external light conditions (P < 0.001). The mean VR from scotopic (0.5 lux) to photopic (18,500 lux) light conditions was 167 ± 70 μm. Conclusions Vault is continuously affected during movements of the pupil induced by external luminance. Translational Relevance Quantifiable dynamic parameters VR and VI obtained with this AS-OCT device describe the position of the pIOL in the posterior chamber of the eye in a more accurate and real way than static vault measurements, and may contribute to improved understanding of the behavior of the pIOL in terms of safety.
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Affiliation(s)
| | - Blas Mompean
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain.,Department of Ophthalmology, Hospital Torrevieja, Alicante, Spain
| | | | | | - Jaime Beltran
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain
| | - Julio Baviera
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain
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Zheng LY, Zhu SQ, Su YF, Zou HY, Wang QM, Yu AY. Comparison between toric and spherical phakic intraocular lenses combined with astigmatic keratotomy for high myopic astigmatism. EYE AND VISION 2017; 4:20. [PMID: 28828390 PMCID: PMC5561629 DOI: 10.1186/s40662-017-0085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 08/09/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND To compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical PIOL combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism. METHODS This study enrolled patients with high myopic astigmatism, including 30 eyes (22 patients) that received a toric PIOL implantation (TICL group), and 32 eyes (24 patients) that received combined AK and a spherical PIOL implantation (AK+ ICL group). The outcomes were compared between the two groups before surgery, and at the following time points after surgery: 1 week, 1, 3, 6 months, and 1, 2 years. RESULTS Preoperatively, the mean manifest spherical equivalent (SE) was -14.14 ± 2.12 D in the TICL group and -14.83 ± 2.79 D in the AK + ICL group (P = 0.28), and the mean manifest refractive cylinder, -2.87 ± 1.09 D and -2.58 ± 0.85 D, respectively (P = 0.28). Two years postoperatively, the mean safety index was 1.53 ± 0.55 in the TICL group and 1.60 ± 0.70 in the AK + ICL group (P = 1.00), and the mean efficacy index, 1.18 ± 0.45 and 1.38 ± 0.52, respectively (P = 0.86). The mean manifest refractive cylinder correction was 1.94 ± 1.07 D in the TICL group and 1.39 ± 0.71 D in the AK + ICL group (P = 0.02). The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0.50 D in both groups. CONCLUSIONS Both TICL implantation and AK + ICL implantation are a good alternative for correction of astigmatism in addition to high myopia. TICL implantation has better predictability in correction of high myopic astigmatism. TRIAL REGISTRATION NCT03202485.
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Affiliation(s)
- Lin-Yan Zheng
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Shuang-Qian Zhu
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Yan-Feng Su
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Hu-Yong Zou
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - Qin-Mei Wang
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
| | - A-Yong Yu
- The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325000 Zhejiang People's Republic of China
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Qi MY, Chen Q, Zeng QY. The Effect of the Crystalline Lens on Central Vault After Implantable Collamer Lens Implantation. J Refract Surg 2017; 33:519-523. [DOI: 10.3928/1081597x-20170602-02] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/16/2017] [Indexed: 11/20/2022]
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Cao X, Wu W, Wang Y, Xie C, Shen Y. Comparison Over Time of Vault in Chinese Eyes Receiving Implantable Contact Lenses With or Without a Central Hole. Am J Ophthalmol 2016; 172:111-117. [PMID: 27659350 DOI: 10.1016/j.ajo.2016.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the longitudinal vault changes after implantation of a posterior chamber phakic intraocular lens (pIOL) (Visian implantable contact lens) with (ICL V4c) and without (ICL V4) a central artificial hole for moderate to high myopia in Chinese eyes. DESIGN Retrospective case series. METHODS This study comprised 78 eyes implanted with the ICL V4c model and 82 eyes implanted with the ICL V4 model at our department by the same surgeon. The time course of the postoperative pIOL vault changes was quantitatively assessed using ultrasound biomicroscopy over 6 months. RESULTS There was a trend toward a decrease in all measures of central vault, peripheral vault, and the endothelium-anterior pIOL distance for both central hole pIOL and conventional pIOL over time, although the variance was not statistically significant (all P > .05). There were no significant between-group differences in the amount of the pIOL central vault, peripheral vault, or the endothelium-anterior pIOL distance at any time point after surgery (all P > .05). CONCLUSIONS The time course of the central hole pIOL vault changes is essentially equivalent to that of the conventional pIOL vault, suggesting that the presence of the central hole did not significantly affect the pIOL position.
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Affiliation(s)
- Xinfang Cao
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Weiliang Wu
- Department of Orthopedics, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Wang
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Xie
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ye Shen
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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In Vivo Positional Analysis of Implantable Collamer Lens Using Ultrasound Biomicroscopy. J Ophthalmol 2016; 2016:4060467. [PMID: 27672446 PMCID: PMC5031854 DOI: 10.1155/2016/4060467] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/17/2016] [Accepted: 08/23/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate the anterior segment, the anatomical position of the implantable collamer lenses (ICL), and its relationship to adjacent ocular structures using Ultrasound Biomicroscopy (UBM). Methods. In a prospective study, 142 myopic eyes of 93 patients implanted with Visian ICL were subjected to UBM examination between March 2010 and January 2015. The relative position of ICL to the adjacent structure and the overall iris configuration were evaluated. The machine calibers were used to measure the minimum central distance between the ICL and anterior lens capsule (vault) and the vertical central distance between the corneal endothelium and the ICL (E-ICL). Results. The mean ICL vault was 376 ± 105 μm. The mean E-ICL was 2826 ± 331 μm. Contact between ICL and the posterior epithelium of the iris was present in all eyes. The overall iris configuration was flat in 89 eyes. Central anterior convexity was present in 41 eyes and mild peripheral iris bombe in 12 eyes. The haptics could be imaged in the ciliary sulcus in 112 eyes and at least one haptic resting on the lens periphery and zonules in 30 eyes. Conclusion. UBM can provide valuable anatomical information that allows detailed postoperative in vivo assessment of ICL.
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Chen X, Miao H, Naidu RK, Wang X, Zhou X. Comparison of early changes in and factors affecting vault following posterior chamber phakic Implantable Collamer Lens implantation without and with a central hole (ICL V4 and ICL V4c). BMC Ophthalmol 2016; 16:161. [PMID: 27604229 PMCID: PMC5015244 DOI: 10.1186/s12886-016-0336-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/23/2016] [Indexed: 12/04/2022] Open
Abstract
Background To objectively compare the early changes in vault over time following implantation of an Implantable Collamer Lens without (ICL V4) and with (ICL V4c) a central hole and the respective factors affecting vault change in moderate to high myopia. Methods This prospective study comprised of 38 eyes of 38 patients implanted with ICL V4 and 39 eyes of 39 patients implanted with ICL V4c intraocular lenses. We quantitatively assessed the postoperative values of vault and pupil size at 1 day, 1 week, and 1 month following implantation using a rotating Scheimpflug camera (Pentacam). We compared these postoperative values within and between the two groups and identified the factors affecting vault change. Results The mean vaults at 1 day, 1 week, and 1 month following ICL V4 implantation were 303.68 ± 185.11, 517.89 ± 160.07 and 521.32 ± 155.72 μm respectively, and those following ICL V4c were 316.67 ± 186.89, 495.13 ± 180.84 and 510.77 ± 175.51 μm, respectively. There was a significant difference in vault between 1 day and 1 week postoperatively. There was a significant association between the vault change and the pupil size change in both groups from 1 day to 1 month postoperatively (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001; ICL V4c: r = 0.588, P <0.001). The vault value 1 month after implantation of ICL V4 and ICL V4c was associated with the preoperative anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus. Conclusions Pupil movement is a critical factor in vault change, with increasing vault observed postoperatively from 1 day to 1 week associated with the declining effects of pharmacological miosis and increasing pupil size. The anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus show some correlation with vault. Electronic supplementary material The online version of this article (doi:10.1186/s12886-016-0336-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xun Chen
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Huamao Miao
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | | | - Xiaoying Wang
- Key Lab of Myopia, Ministry of Health, Shanghai, China. .,EYE & ENT Hospital of Fudan University, Shanghai, China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Eye and ENT Hospital of Fudan University, No. 19 BaoQing Road, Shanghai, 200031, China.
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
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Real-time assessment of intraoperative vaulting in implantable collamer lens and correlation with postoperative vaulting. Eur J Ophthalmol 2016; 27:21-25. [PMID: 27405290 DOI: 10.5301/ejo.5000818] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the intraoperative vaulting in patients undergoing implantable collamer lens (ICL) implantation with microscope-integrated intraoperative optical coherence tomography (iOCT) and correlate it with the postoperative vaulting. METHODS Forty eyes of 22 consecutive patients undergoing ICL implantation were prospectively evaluated. Vaulting was measured intraoperatively using microscope-integrated iOCT. The ICL-lenticular relationship was dynamically assessed throughout the surgery. Postoperative vaulting was measured using anterior segment optical coherence tomography on the first postoperative day and after 1 month and compared with the intraoperative vaulting. Uncorrected and best-corrected Snellen visual acuity, intraocular pressure (IOP), and anterior and posterior segments were assessed in all cases. RESULTS The mean central vaulting noted intraoperatively was 558.4 ± 122.8 µm. Postoperative mean vaulting was 576.0 ± 131.2 µm on day 1 and 551.1 ± 122.5 µm on day 30. There was a significant correlation between the intraoperative and the postoperative day 1 vaulting (paired samples correlation: 0.969, p<0.001) and day 30 vaulting (paired samples correlation: 0.945, p<0.001). An ICL-lenticular touch was not noted at any time during the surgery. The postoperative course was uneventful and no patient developed raised IOP or lenticular changes by the last follow-up. CONCLUSIONS Intraoperative vaulting correlates well with postoperative vaulting and can aid in on-table detection of extremes of vaulting and decision-making. It enhances the safety of the surgical procedure by providing a real-time display of the intraoperative manipulations.
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Lisa C, Baamonde B, Pérez-Vives C, Montés-Micó R, Alfonso JF. Five-year functional outcomes and vault of -20 diopter myopic phakic intraocular lens implantation. J Cataract Refract Surg 2016; 41:2724-30. [PMID: 26796453 DOI: 10.1016/j.jcrs.2015.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 07/09/2015] [Accepted: 07/15/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate refractive and visual outcomes and complications associated with phakic intraocular lens (pIOL) implantation to correct high myopia. SETTINGS Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective observational case series. METHODS Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction, vault, and adverse effects were evaluated after 5 years with Visian ICMV4 pIOL. RESULTS Mean spherical equivalent (SE) dropped from -18.32 ± 2.37 diopters (D) preoperatively to -0.88 ± 0.52D 5 years postoperatively; 61% of eyes were within ±0.75 D of the target. The mean Snellen decimal CDVA and UDVA were 0.73 ± 0.23 and 0.55 ± 0.26, respectively. More than 50% of eyes achieved 20/25 or better CDVA postoperatively. Four eyes had lost 2 or 1 lines of CDVA, 10 eyes had not lost any lines from preoperatively, and 46 eyes had gained 1 or more lines of CDVA 5 years postoperatively. The safety index was 1.26 ± 0.32. Forty eyes had UDVA of 20/40 or better postoperatively. The efficacy index was 0.99 ± 0.42. At 5-year follow-up, the mean central vault was 475.28 ± 216.38 μm. No eyes showed central contact between the pIOL and crystalline lens. Nevertheless, 10 eyes showed peripheral contact with a central vault between 150 and 260 μm. Two eyes developed anterior subcapsular cataract, although only 1 eye required cataract surgery. CONCLUSIONS Predictability, safety and effective outcomes of posterior pIOL of (- were good, as well as postoperative complications over the long term. A central vault of 260 μm was enough to prevent the peripheral contact between the pIOL and crystalline lens in eyes with high myopia. FINANCIAL DISCLOSURE The authors have no proprietary interest in any of the materials mentioned in this article.
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Affiliation(s)
- Carlos Lisa
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Begoña Baamonde
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Cari Pérez-Vives
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Robert Montés-Micó
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - José F Alfonso
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
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Lee H, Kang DSY, Ha BJ, Choi M, Kim EK, Seo KY, Kim TI. Effect of Accommodation on Vaulting and Movement of Posterior Chamber Phakic Lenses in Eyes With Implantable Collamer Lenses. Am J Ophthalmol 2015; 160:710-6.e1. [PMID: 26189089 DOI: 10.1016/j.ajo.2015.07.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 07/09/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate and compare vaulting and movement changes during accommodation in eyes with the V4c and V4 implantable collamer lenses (ICL). DESIGN Comparative, observational case series. METHODS The medical records of 35 eyes (18 patients) with the V4 ICL and 51 eyes (26 patients) with the V4c ICL were retrospectively examined and included in analyses. Anterior chamber depth (ACD), posterior corneal surface-to-ICL distance (endo-ICL distance), pupil size, and postoperative vaulting were evaluated using the Visante anterior chamber optical coherence tomography system. Images were taken during the nonaccommodative and accommodative states 3 months after ICL implantation. Refractive error, keratometry values, axial length, intraocular pressure, and central corneal thickness were evaluated at 3 months postoperatively. RESULTS ICL vaulting did not significantly change during accommodation in eyes with either the V4 or V4c ICL (P = .532 for V4 ICL and P = .415 for V4c ICL). However, significant reductions in ACD, endo-ICL distance, and pupil size were observed during accommodation in both groups. In eyes with a V4 ICL, the change in [Δ] ACD was 0.2 ± 0.1 mm (P < .001), Δendo-ICL distance was 0.2 ± 0.1 mm (P < .001), and Δpupil size was 0.5 ± 0.9 mm (P = .021). For eyes with the V4c ICL, ΔACD was 0.2 ± 0.2 mm (P < .001), Δendo-ICL distance was 0.2 ± 0.2 mm (P < .001), and Δpupil size was 0.8 ± 1.2 mm (P < .001). The mean reductions of each parameter were not statistically different between eyes with the V4 ICL and the V4c ICL. CONCLUSIONS Contrary to the light stimulation response, accommodation does not significantly affect ICL vaulting differently in eyes with either the V4 or V4C ICLs.
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Alfonso JF, Lisa C, Fernández-Vega L, Almanzar D, Pérez-Vives C, Montés-Micó R. Prevalence of cataract after collagen copolymer phakic intraocular lens implantation for myopia, hyperopia, and astigmatism. J Cataract Refract Surg 2015; 41:800-5. [PMID: 25840304 DOI: 10.1016/j.jcrs.2014.07.039] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the prevalence of cataract after Implantable Collamer Lens phakic intraocular lens (pIOL) implantation with different models at different ages and for different refractive powers. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective nonrandomized clinical study. METHODS The pIOL (models V4, V4b, or V4c) was implanted in all cases. RESULTS The study included 3420 eyes (1898 patients). The mean patient age at surgery was 31.2 years ± 6.4 (SD) (range 18 to 50 years) and the mean spherical refractive error, -7.27 ± 5.24 diopters (D) (range -26.5 to 12.5 D). Twenty-one eyes (0.61%) of 15 patients had pIOL explantation (all model V4) because cataract developed. The mean age of the patients who had explantation was 39.43 ± 4.57 years; 7 were younger than 40 years, and 8 were 40 years or older. The mean spherical equivalent was -10.1 ± 5.41 D; 3 eyes had a pIOL power less than -10.50 D, 4 eyes between -10.50 D and -13.50 D, and 14 higher than -13.50 D. The mean time between pIOL implantation and cataract surgery was 4.2 ± 1.8 years. No eye with implantation of the latest models (V4b and V4c) developed cataract. The mean vault distance in eyes that developed cataracts was 103 ± 69 μm. CONCLUSIONS The incidence of cataract was low after pIOL implantation at the 6-year follow-up. The rate of cataract was higher in older patients and in those with high refractive errors. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- José F Alfonso
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain.
| | - Carlos Lisa
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Luis Fernández-Vega
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Dagoberto Almanzar
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Cari Pérez-Vives
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- From the Fernández-Vega Ophthalmological Institute (Alfonso, Fernández-Vega) and the Surgery Department (Alfonso, Lisa, Fernández-Vega, Almanzar), School of Medicine, University of Oviedo, Oviedo, and the Optics Department (Pérez-Vives, Montés-Micó), Optometry Research Group, Faculty of Physics, University of Valencia, Valencia, Spain
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Zeng QY, Xie XL, Chen Q. Prevention and management of collagen copolymer phakic intraocular lens exchange: causes and surgical techniques. J Cataract Refract Surg 2015; 41:576-84. [PMID: 25804582 DOI: 10.1016/j.jcrs.2014.06.036] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/14/2014] [Accepted: 06/20/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze causes leading to explantation and exchange of Implantable Collamer Lens phakic intraocular lenses (pIOLs) and examine the surgical techniques of pIOL exchange. SETTING Wuhan Aier Eye Hospital, Wuhan, China. DESIGN Retrospective analysis of prospectively collected data. METHODS Different techniques were used to explant the pIOLs based on the amount of vaulting. Preoperative and postoperative data were collected to evaluate possible causes leading to pIOL exchange and the safety of pIOL exchange. RESULTS Of 616 myopic eyes with previous pIOL implantation, 16 eyes of 15 patients having pIOL exchange were reviewed. Eight surgeries (50%) were performed because of low vaulting (≤100 μm) and another 8 (50%) because of too high vaulting (≥1000 μm). The causes leading to low vaulting included increased crystalline lens thickness (≥4.0 mm), low anterior chamber depth (ACD) (<3.1 mm), and a too-small pIOL (<12.0 mm). The high vaulting was primarily the result of oversized white-to-white (WTW) measurements with Scheimpflug pachymetry (Pentacam) or the use of a digital caliper by an unskilled examiner and of ciliary body cysts. Six months after pIOL exchange, the vaulting ranged from 162 to 715 μm. No anterior subcapsular cataracts or other complications occurred during the observation period. CONCLUSIONS The main causes of abnormal vaulting and subsequent pIOL exchange included a thick crystalline lens, low ACD, too-small pIOL, WTW measurement error, and ciliary body cysts. Phakic IOL explantations were individually designed based on the vaulting to achieve proper safety and efficacy. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Qing-Yan Zeng
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China.
| | - Xiu-Li Xie
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China
| | - Qian Chen
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China
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Karimian F, Baradaran-Rafii A, Hashemian SJ, Hashemloo A, Jafari ME, Yaseri M, Ghahari E, Akbarian S. Comparison of three phakic intraocular lenses for correction of myopia. J Ophthalmic Vis Res 2015; 9:427-33. [PMID: 25709766 PMCID: PMC4329701 DOI: 10.4103/2008-322x.150805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 11/11/2022] Open
Abstract
Purpose: To compare the visual outcomes and complications of three different types of phakic intraocular lenses (PIOLs), for correction of moderate to high myopia. Methods: We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer lens (ICL, 36 eyes). Best corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared. Results: Mean follow-up period was 30 ± 11 months. Preoperatively, spherical equivalent (SE) refractive error was −11.6 ± 3.7, −9.59 ± 1.97, and −12.3 ± 4.8 D in the Artisan, Artiflex and ICL groups, respectively. SE was comparable among the study groups at final follow-up (P = 0.237). Mean astigmatic reduction was 0.31 ± 0.72, 0.45 ± 0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P = 0.007). Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P = 0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P = 0.158); pachymetric changes were minimal with no difference among the three groups (P = 0.754), and mean CEC loss was 10 ± 9%, 9 ± 6% and 9 ± 10% in the Artisan, Artiflex and ICL groups, respectively (P = 0.694). HOAs (P = 0.039), vertical trefoil (P = 0.032) and spherical aberration (P = 0.001) were higher with Artisan group as compared to ICL. Total aberrations (P = 0.028) and spherical aberration (P = 0.001) was also higher with Artisan group as compared to Artiflex. Conclusion: Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.
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Affiliation(s)
- Farid Karimian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Seyed Javad Hashemian
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Hashemloo
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Jafari
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ghahari
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shadi Akbarian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee H, Kang SY, Seo KY, Chung B, Choi JY, Kim KS, Kim TI. Dynamic vaulting changes in V4c versus V4 posterior chamber phakic lenses under differing lighting conditions. Am J Ophthalmol 2014; 158:1199-1204.e1. [PMID: 25149911 DOI: 10.1016/j.ajo.2014.08.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare vaulting changes in eyes implanted with V4c and V4 implantable collamer lenses (ICLs) under differing lighting conditions. DESIGN Noninterventional, cross-sectional comparative observational case series. METHODS Fifty-six eyes of 38 patients implanted with V4c ICLs, and 54 eyes of 28 patients implanted with V4 ICLs were enrolled and analyzed. Anterior chamber depth, pupil size and postoperative vaulting were evaluated using a Visante optical coherence tomography system under photopic and mesopic conditions 1 month postoperatively. Refractive errors, keratometry values, axial lengths, intraocular pressures, anterior chamber volumes, and central corneal thicknesses were also recorded. RESULTS No significant differences were noted in anterior chamber depth between photopic and mesopic conditions in either group. Significant decreases in vaulting and pupil size were detected under photopic conditions in both groups. Moreover, vaulting changes in eyes implanted with V4c ICLs were significantly larger than those in eyes implanted with V4 ICLs. CONCLUSIONS V4c ICL vaulting decreased more prominently under photopic conditions than did V4 ICL vaulting. Therefore, postoperative vaulting under mesopic and photopic conditions should be considered when interpreting the vaulting of eyes implanted with V4c ICLs.
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Affiliation(s)
- Hun Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Kyoung Yul Seo
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byunghoon Chung
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Kyu Seo Kim
- Emory University School of Medicine, Atlanta, GA, USA
| | - Tae-Im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
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Price MO, Price FW. Evaluation of the toric implantable collamer lens for simultaneous treatment of myopia and astigmatism. Expert Rev Med Devices 2014; 12:25-39. [PMID: 25418502 DOI: 10.1586/17434440.2015.984685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Myopic astigmatism is a prevalent condition that can be treated with spectacles, contact lenses, or laser refractive surgery. However, these treatment options have functional limitations at higher levels of refractive error. The toric implantable collamer lens is designed to treat a broad range of refractive error, generally up to -18 diopters with +1 to +6 diopters of astigmatism. Approval for a more limited treatment range of up to 15 diopters of myopia with +1 to +4 diopters of astigmatism is being sought in the US, where this device has not yet received marketing approval. Surgical correction of high-myopic astigmatism can be life-altering and allow people to participate in activities that were not previously feasible because of visual limitations. The toric implantable collamer lens is implanted behind the iris and in front of the natural crystalline lens. With earlier lens designs, it was necessary to create an iridectomy or iridotomy to prevent pupillary block. The newest toric implantable collamer lens model has a small central hole that is not visually noticeable. This eliminates the need to create a hole in the iris, thereby enhancing the safety of the procedure.
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Affiliation(s)
- Marianne O Price
- Cornea Research Foundation of America, 9002 N. Meridian St, Suite 212, Indianapolis, IN 46260, USA
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Hurmeric V, Yoo SH, Mutlu FM. Optical coherence tomography in cornea and refractive surgery. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.28] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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47
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Higueras-Esteban A, Ortiz-Gomariz A, Gutiérrez-Ortega R, Villa-Collar C, Abad-Montes JP, Fernandes P, González-Méijome JM. Intraocular pressure after implantation of the Visian Implantable Collamer Lens With CentraFLOW without iridotomy. Am J Ophthalmol 2013; 156:800-5. [PMID: 23876870 DOI: 10.1016/j.ajo.2013.05.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 02/05/2023]
Abstract
PURPOSE To compare the intraocular pressure (IOP) values during a 3-month period after implantation of the new Visian Implantable Collamer Lens (ICL; STAAR Surgical Company, Nidau, Switzerland) V4c design with CentraFLOW technology without iridotomy using a standard procedure followed by implantation of the conventional ICL V4b model. DESIGN Retrospective cohort study. METHODS This study included 17 eyes implanted with the ICL V4b model and 18 eyes implanted with the ICL V4c model. The mean preoperative spherical equivalent refractions were -7.48 ± 5.00 diopters and -8.66 ± 4.2 diopters, respectively. We compared the best-corrected distance visual acuity before surgery with the uncorrected distance visual acuity after surgery. The intraocular pressure (IOP) was measured 1 week, 1 month, and 3 months after surgery. The central vault at 3 months was measured using optical coherence tomography. RESULTS Three months after surgery, the mean uncorrected distance visual acuities were -0.09 ± 0.12 logarithm of the minimal angle of resolution units with the V4b and -0.07 ± 0.11 logarithm of the minimal angle of resolution units with the V4c. The mean distances between the ICL and the anterior crystalline lens surface were 557 ± 224 μm and 528 ± 268 μm for the V4b and V4c, respectively (P = .73). After 1 week and 1 month, the mean IOPs were 13.7 and 13.3 mm Hg and 14.7 and 15.1 mm Hg, respectively. There were no significant differences in IOP within or between groups during the follow-up period (P > .05, for all comparisons). CONCLUSIONS The new ICL with the CentraFLOW design seems to provide similar results as its predecessors for the correction of moderate to high myopia and maintenance of safe IOP levels without iridotomy.
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Dynamic Positional Change and Defocus Curve of a Phakic Foldable Anterior-Chamber Angle-Supported Intraocular Lens during Accommodation. Ophthalmology 2013; 120:1373-9. [DOI: 10.1016/j.ophtha.2012.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 12/04/2012] [Accepted: 12/07/2012] [Indexed: 11/18/2022] Open
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Lindland A, Heger H, Kugelberg M, Zetterström C. Changes in vaulting of myopic and toric implantable collamer lenses in different lighting conditions. Acta Ophthalmol 2012; 90:788-91. [PMID: 21834924 DOI: 10.1111/j.1755-3768.2011.02224.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the changes in vaulting of myopic and toric Implantable Collamer Lenses (ICLs) in different lighting conditions. METHODS Thirty-seven eyes of 37 patients implanted with a myopic ICL and 26 eyes of 26 patients implanted with a toric ICL were examined using Visante optical coherence tomography (OCT) in photopic (257 lux) and mesopic (2 lux) conditions. Pupil diameter and distance changes between the ICL and adjacent intraocular structures were measured. RESULTS The mean horizontal pupillary diameters in mesopic conditions were 5.3 ± 0.9 (SD) mm. In photopic conditions, a mean decrease of -1.8 ± 0.6 mm [95% confidence interval (95% CI) -2.0 to -1.7; p < 0.0001] was observed. The mean distances between the ICL and the crystalline lens in mesopic conditions were 0.33 ± 0.17 mm. In photopic conditions, a mean decrease of -0.04 ± 0.06 mm (95% CI -0.05 to -0.02; p < 0.0001) in the ICL-crystalline lens distance was found. There was a -0.02 ± 0.04 mm (95% CI -0.03 to -0.01; p = 0.0022) decrease in the anterior chamber depth and a 0.02 ± 0.06 mm (95% CI 0.002 to 0.032; p = 0.0275) increase in the distance between the cornea and the ICL. We found no difference in the change in vaulting between the two ICLs in different lighting conditions. CONCLUSION There is a decrease in the central vaulting of myopic and toric ICLs in photopic conditions. This is due to both posterior movement of the ICL and anterior protrusion of the crystalline lens.
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Affiliation(s)
- Are Lindland
- Department of Ophthalmology, University of Oslo, Oslo, Norway.
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50
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Malyugin BE, Shpak AA, Pokrovskiy DF. Accommodative changes in anterior chamber depth in patients with high myopia. J Cataract Refract Surg 2012; 38:1403-7. [PMID: 22814046 DOI: 10.1016/j.jcrs.2012.04.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 02/26/2012] [Accepted: 04/02/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE To study the accommodative changes in the central anterior chamber depth (ACD) in patients with high myopia using anterior segment optical coherence tomography (AS-OCT). SETTING Cataract Surgery Department and Clinical & Functional Diagnostics Department, S. Fyodorov Eye Microsurgery Complex-Federal State Institution, Moscow, Russian Federation. DESIGN Prospective case-control study. METHODS The ACD measurements were obtained in the nonaccommodative state (baseline) and during accommodation using the Visante AS-OCT device. RESULTS Thirty-six myopic eyes (36 patients; mean age 27 years; mean spherical equivalent (SE) -12.52 diopters [D]) and 31 emmetropic eyes (31 subjects; mean age 26 years; mean SE -0.39 D) were examined. At baseline, the mean ACD in both groups was similar. During accommodation, the mean maximum changes in the ACD were significantly less pronounced in the myopia group (-0.14 mm ± 0.07 [SD]; range -0.03 to -0.29 mm) than in the emmetropia group (-0.22 ± 0.08 mm; range -0.04 to -0.35 mm) (P<.0001). Ten patients in the myopia group had a critically shallow anterior chamber (ACD <2.8 mm) in the state of accommodation. CONCLUSIONS Accommodative changes in the ACD were significantly less pronounced in eyes with high myopia than in emmetropic eyes. Still, the anterior chamber might become critically shallow during accommodation in some myopic eyes, and this should be taken into account when planning phakic intraocular lens implantation to correct high myopia. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Boris E Malyugin
- Cataract Surgery Department, S. Fyodorov Eye Microsurgery Complex-Federal State Institution, Moscow, Russian Federation
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