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Martínez-Plaza E, López-de la Rosa A, Ossa-Calderon C, Blázquez-Arauzo F, López-Miguel A, Maldonado MJ. Assessment of the iridocorneal angle pigmentation and structures after the implantation of EVO+ Visian Implantable Collamer Lens. Int Ophthalmol 2023; 43:4711-4718. [PMID: 37697080 DOI: 10.1007/s10792-023-02871-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To evaluate the effect of EVO+ Visian Implantable Collamer Lens (ICL) implantation on the iridocorneal angle pigmentation and structures. METHODS Myopic refractive surgery candidates who underwent posterior chamber EVO+ ICL implantation were evaluated preoperatively and 3 and 6 months postoperatively. High-resolution images of the iridocorneal angle (nasal, superior, temporal and inferior quadrants) were acquired during gonioscopy. A masked observer, blinded to study visits and patients' information, evaluated the angle width, apparent iris root insertion, iris configuration, and trabecular meshwork pigmentation according to the Spaeth scale in two different occasions. The intra-rater reliability was estimated using the weighted Gwet's Agreement Coefficient (AC2). Differences between visits were analyzed using the Cochran Q test or the Friedman test. RESULTS Twenty-one patients (13 females and 8 males) aging 31.3 ± 6.3 years old were recruited. The intra-rater reliability of gonioscopy assessment was excellent for every parameter assessed (AC2 ≥ 0.97). No significant differences were found among the study visits for any quadrant in the angle width (p ≥ 0.74), apparent iris root insertion (p ≥ 0.22), iris configuration (p ≥ 0.21) and trabecular meshwork pigmentation (p ≥ 0.24). Mean pigmentation of trabecular meshwork for the four quadrants did not vary either among visits (p = 0.25). CONCLUSIONS The EVO+ ICL implantation after uneventful procedures appears not to clinically affect the iridocorneal angle pigmentation and/or structures during a short-medium follow-up using gonioscopy assessment. The intra-rater reliability of glaucoma specialists assessing iridocorneal angle structures using gonioscopy images is very high.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain
| | - Carolina Ossa-Calderon
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Francisco Blázquez-Arauzo
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain.
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Naujokaitis T, Auffarth GU, Łabuz G, Kessler LJ, Khoramnia R. Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses. Diagnostics (Basel) 2023; 13:2503. [PMID: 37568866 PMCID: PMC10417808 DOI: 10.3390/diagnostics13152503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell loss rate and the endothelial reserve in accordance with the patient's age when deciding whether to explant a pIOL. The anterior chamber morphometrics, including the anterior chamber depth and the distance between the pIOL and the endothelium, measured using Scheimpflug tomography and anterior segment optical coherence tomography (AS-OCT), can help to assess the risk of the endothelial cell loss. In patients undergoing posterior chamber pIOL implantation, accurate prediction of the vault and its postoperative measurements using AS-OCT or Scheimpflug tomography are important when assessing the risk of anterior subcapsular cataract and secondary glaucoma. Novel approaches based on ultrasound biomicroscopy and AS-OCT have been proposed to increase the vault prediction accuracy and to identify eyes in which prediction errors are more likely. Careful patient selection and regular postoperative follow-up visits can reduce the complication risk and enable early intervention if a complication occurs.
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Affiliation(s)
| | | | | | | | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
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Caixia L, Yawen B, Yuxin F, Xiaoxia L, Yuhan W, Ke Y, Liya Q. Clinical outcomes of implantation of posterior chamber phakic intraocular lens for pathologic and non-pathologic myopia. BMC Ophthalmol 2023; 23:172. [PMID: 37085809 PMCID: PMC10120149 DOI: 10.1186/s12886-023-02890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 03/30/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND To compare the clinical outcomes of posterior chamber phakic intraocular lens (pIOL) implantation for non-pathological myopia and pathological myopia. METHODS This retrospective case series study which were conducted in Beijing Tongren Eye Center between July 2017 and Oct 2021 comprised 192 eyes of 100 consecutive patients undergoing pIOL implantation. Eyes were divided into two groups based on having pathological myopia or not. Predictability, efficacy, safety, and adverse events were compared at 6 months after pIOL implantation. RESULTS Our study included 86 non-pathological myopes (171 eyes, group1) and 14 pathological myopes (21eyes, group2) to analysis. The average ages were 25.5 and 33.0, respectively, and the spherical equivalent (SE) were -9.31D and -17.50D pre-operation. Six months after pIOL implantation, the SE were 0.00 and -0.50, respectively, and the refraction changes were statistically significant (P ≤ 0.05). Six months after surgery, 76.92% and 80.41% were within ± 0.50 D of the target and 92.31% and 95.88% were within ± 1.00 D. All eyes had unchanged BCVA or gained 1 or more lines in both groups and mean BCVA both improved a line 6m after operation. The efficacy index in the two groups were 0.95 and 0.88 and the safety index were 1.20, 1.33, respectively which was significantly different (P ≤ 0.05). Over the 6-month follow-up, no cataract, pigment dispersion glaucoma, pupillary block, or other vision-threatening complications happened, either. CONCLUSIONS The pIOL performed well for the correction of both non-pathological and pathological myopia throughout the 6-month observation period. The clinical outcomes of pIOL implantation for non-pathological myopia are essentially equivalent to those for pathological myopia.
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Affiliation(s)
- Lin Caixia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Bai Yawen
- Ophthalmology Department, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Fang Yuxin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Li Xiaoxia
- Ophthalmology Department, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Wang Yuhan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Yang Ke
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Qiao Liya
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, People's Republic of China.
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Zhang Z, Niu L, Liu T, Shen Y, Shang J, Zhao J, Wei R, Zhou X, Yao P. Primary observations of EVO ICL implantation for high myopia with concave iris. EYE AND VISION (LONDON, ENGLAND) 2023; 10:18. [PMID: 37005642 PMCID: PMC10068169 DOI: 10.1186/s40662-023-00335-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/07/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To investigate the morphological changes of concave iris in myopic patients after EVO implantable collamer lens (ICL) implantation. METHODS EVO ICL candidates with posterior bowing iris were observed using ultrasound biometric microscopy (UBM) in this prospective nonrandomized observational study. Forty patients were enrolled, with 20 patients in the concave iris group and the other 20 patients in the control group. None of the patients underwent laser peripheral iridotomy. All patients received preoperative and postoperative examinations, which included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), subjective manifest refraction and intraocular pressure. UBM was used to observe iris curvature (IC), irido-corneal angle (ICA), posterior chamber angle (PCA), iris-lens contact distance (ILCD), iris-zonule distance (IZD) and ciliary process length (CPL). Anterior chamber angle pigment was observed by gonioscopy. The preoperative and postoperative data were analyzed using SPSS. RESULTS The average follow-up period was 13.3 ± 5.3 months. The mean efficacy indices were 1.10 ± 0.13 and 1.07 ± 0.11 (P = 0.58), and the safety indices were 1.19 ± 0.09 and 1.18 ± 0.17 in the control group and the concave iris group (P = 0.93), respectively. The IOP postoperatively were 14.13 ± 2.02 mmHg and 14.69 ± 1.59 mmHg in control and concave iris groups (P = 0.37). Preoperatively, the concave iris group was presented with greater IC (P < 0.0001), longer ILCD (P < 0.0001), wider ICA (P = 0.004), narrower PCA (P = 0.01), and shorter IZD (P = 0.03) than the control group. In the concave iris group, IC, ILCD and ICA were significantly decreased after ICL implantation (P < 0.0001), while PCA and IZD were significantly increased (P = 0.03 and P = 0.04, respectively). Postoperative IC, ILCD, ICA, PCA and IZD were not statistically different between groups (P > 0.05). There was no significant difference in pigment deposition grades between the two groups (P = 0.37). CONCLUSION After EVO ICL implantation, the morphology of concave iris was significantly improved, which may reduce the risk of intraocular pigment dissemination caused by iris concavity. The concave iris has no impact on the safety of EVO ICL surgery during the follow-up.
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Affiliation(s)
- Zhe Zhang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Tingting Liu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jianmin Shang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ruoyan Wei
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
| | - Peijun Yao
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
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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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Li K, Wang Z, Wang MX. Implantable collamer lens implantation (ICL) versus small incision lenticule extraction (SMILE) in low to moderate myopia: study protocol for a randomized, non-inferiority trial. Trials 2022; 23:910. [PMID: 36307873 PMCID: PMC9617386 DOI: 10.1186/s13063-022-06851-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implantable collamer lens implantation (ICL) is a form of 'foldable' posterior chamber phakic intraocular lens refractive surgery that generally does not impair cornea and natural accommodation. The potential advantages of the ICL over keratorefractive laser procedures include less induction of higher-order aberrations (HOAs) and enhanced retinal image magnification. On the other hand, small incision lenticule extraction (SMILE), currently, one of the most popular refractive surgery procedures, also offers excellent visual outcomes, particularly for eyes with low to moderate amounts of myopia. The aim of this study is to evaluate whether ICL/TICL (toric ICL) is comparable to SMILE for low to moderate myopia in terms of refractive outcomes at 3 and 18 months post-operatively. METHODS/DESIGN This is a prospective randomized study. A total of 300 participants will be randomized into two groups, the ICL/TICL group and SMILE group. Eligible participants with spherical equivalent (SE) less than - 6.0 diopter (D) will be recruited. Following randomization, participants will be followed at 1, 3, 6, 12, and 18 months. The primary outcome is the refractive predictability at every postoperative point after surgery, which is the proportion of the number of eyes achieving a postoperative SE within ± 0.5 D and ± 1.0 D of the intended target. Secondary outcome parameters include visual acuity, refraction, adverse events, and quality of vision measurements. DISCUSSION This trial will provide information on whether ICL has comparable, if not superior, refractive outcomes compared to the established SMILE for low to moderate myopia, thus providing evidence for translation into clinical practice. TRIAL REGISTRATION Chinese clinical trial registry (ChiCTR) 2200055372. Registered on 08 January 2022.
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Affiliation(s)
- Kangjun Li
- The AIER School of Ophthalmology of Central, South University, Hunan Province, Changsha, China. .,The AIER Eye and Refractive Institute of Central, South University, Hunan Province, Changsha, China. .,Xi'an AIER Eye Hospital, Shaan'xi Province, Xi'an, 710000, China.
| | - Zheng Wang
- The AIER School of Ophthalmology of Central, South University, Hunan Province, Changsha, China.,The AIER Eye and Refractive Institute of Central, South University, Hunan Province, Changsha, China
| | - Ming X Wang
- Wang Vision Institute and Aier-USA, 1801 West End Ave, Ste 1150, Nashville, TN, USA
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Li XJ, Duan JL, Ma JX, Shang QL. Macular hole following phakic intraocular lens implantation: A case report. World J Clin Cases 2022; 10:7178-7183. [PMID: 36051152 PMCID: PMC9297414 DOI: 10.12998/wjcc.v10.i20.7178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/27/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Phakic intraocular lens (pIOL) implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia. However, it is associated with multiple complications.
CASE SUMMARY This report describes a case of full-thickness macular hole (MH) in a patient with a history of bilateral pIOL implantation for the correction of myopia of –12.00 diopters in both eyes 7 mo ago. The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.
CONCLUSION In rare cases, MH can occur following pIOL. In this present case report, we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.
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Affiliation(s)
- Xue-Jing Li
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Jia-Liang Duan
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Jing-Xue Ma
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Qing-Li Shang
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Niu L, Zhang Z, Miao H, Zhao J, Li M, He JC, Yao P, Zhou X. Effects of tilt and decentration of Visian Implantable Collamer Lens (ICL V4c) on visual quality: an observational study. BMC Ophthalmol 2022; 22:294. [PMID: 35790941 PMCID: PMC9254425 DOI: 10.1186/s12886-022-02499-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/17/2022] [Indexed: 01/19/2023] Open
Abstract
Background The central hole of the Visian Implantable Collamer Lens (ICL V4c) provides a reference to observe its tilt or decentration. This study aimed to investigate the tilt and decentration effects of ICL V4c on visual quality after implantation. Methods A total of 135 eyes from 69 patients who underwent ICL V4c implantation were included in this study. Evaluation of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and aberrations were performed 6-months postoperatively. The anterior segment parameters were collected using CASIA2 anterior segment-optical coherence tomography, tilt and decentration of ICL V4c were analyzed using MATLAB software. All patients received questionnaires to investigate the visual quality postoperatively. Results The safety and effectiveness were 1.18 ± 0.17 and 1.11 ± 0.18, respectively. No significant changes were observed regarding higher-order and spherical aberrations after the operation; however, coma and trefoil significantly increased compared to preoperative values. The average total decentration and tilt was 0.21 ± 0.12 mm and 2.54 ± 1.00°, respectively. Horizontal, vertical, and total values of tilt and decentration were not significantly associated with postoperative CDVA, UDVA, and aberrations. The most common visual symptom was halo, and 97.04% of patients had a satisfaction score ≥ 8. The total or horizontal tilt was significantly positively correlated with the frequency, severity, and bothersome scores from the questionnaires. Conclusions ICL V4c implantation can obtain high visual quality and patient satisfaction. Although the degree of tilt and decentration after ICL V4c implantation was small, a positive effect on subjective visual quality was observed. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02499-4.
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Yang Z, Meng L, Zhao X, Chen Y, Luo Y. Clinical Prediction of Inadequate Vault in Eyes With Thick Lens After Implantable Collamer Lens Implantation Using Iris Morphology. Front Med (Lausanne) 2022; 9:906433. [PMID: 35755051 PMCID: PMC9218336 DOI: 10.3389/fmed.2022.906433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Obtaining an ideal vault is crucial in the implantable collamer lens (ICL) surgery. Prediction of the vault value is difficult since it requires the integration of multiple factors. The purpose of this study was to investigate the association between the iris shape and vault value in eyes with thick lens. Methods The study was conducted in Peking Union Medical College Hospital. Patients who received ICL V4c between 2017 and 2021 were screened. Eyes with thick lens (>4.0 mm) and abnormal iris shape (concave or convex) were included. The preoperative biometric parameters and postoperative vault value were compared between eyes with concave shape group and convex shape group. The relationship between various factors and vault was assessed by spearman rank analysis and multiple linear regression analysis. Representative cases our strategies to deal with the abnormal vault were demonstrated. Results Twenty eight eyes of 14 patients with thick lens and concave or convex shape iris were eventually included, with 14 eyes of 7 patients in group 1 (concave shape iris) and the other 14 eyes of 7 patients in group 2 (convex shape iris). The mean vault of group 1 was (0.16 ± 0.07) mm, which was significantly lower than (0.88 ± 0.13) mm in group 2. Multiple linear regression analysis showed iris shape (P < 0.001) was only the explanatory variables associated with the postoperative vault. In group1, 4 eyes showed extremely large ACA, requiring a secondary surgical intervention. So all of them underwent ICL exchange for a larger ICL. In group2, the ICL was implanted in a vertical or oblique position to avoid or rescue an extremely large vault. Conclusion Concave shape iris had a higher risk of low vault and convex shape iris were more likely to demonstrate high vault in eyes with thick lens. Exchanging ICL for the larger size and adjusting ICL to the vertical or oblique orientation are good option to rescue the low or high vault, respectively.
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Affiliation(s)
- Zhikun Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lihui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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11
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Zhang S, Huang C, Miao H, Wu J, Xing C, Dai Z, Sun J. Assessment of biosafety and implantation feasibility of novel phakic refractive lens. Int Ophthalmol 2022; 42:3459-3468. [PMID: 35556204 PMCID: PMC9587979 DOI: 10.1007/s10792-022-02345-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/18/2022] [Indexed: 11/25/2022]
Abstract
Purpose We investigated the biosafety and implantation feasibility of a new phakic refractive lens (PRL) in rabbit eyes. Methods Short PRLs (S-PRLs), large PRLs (L-PRLs), and large-grooved PRLs (LG-PRLs), were prepared by molding medical-grade liquid silicon. The cytotoxicity and cellular adhesion of the PRLs was assessed in vitro. To assess implantation feasibility, the S-PRL, L-PRL, and LG-PRL were implanted in the posterior chamber of rabbit eyes and the relative position was assessed by optical coherence tomography. The intraocular pressures (IOP) were compared between the S-PRL, L-PRL, LG-PRL, and control groups to evaluate the PRL biosafety after implantation. Results The in vitro assays showed that cell viability and cellular adhesion in the S-PRL, L-PRL and LG-PRL groups was not significantly different to those in the control group throughout the study. After implantation into the posterior chamber of rabbit eyes, there were no obvious signs of inflammation or increases in IOP at each time point relative to the control group, demonstrating good biosafety of the PRL. The relative positions of the L-PRLs and LG-PRLs in the posterior chamber were appropriate and the retention frequencies were high. Conclusions The newly developed LG-PRL showed good biosafety with negligible in vitro cytotoxicity, ocular inflammation, or fluctuations in IOP. The LG-PRL provided the best implantation feasibility. The grooves on the LG-PRL provided channels for aqueous humor circulation. The LG-PRL is a promising type of PRL with an appropriate size and surface structure for effective correction of refractive errors in rabbit eyes.
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Affiliation(s)
- Shaohua Zhang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Chang Huang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Huamao Miao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Junyao Wu
- Hangzhou Aijinglun Technology Co., Ltd., Zhejiang, 311100, China
| | - Chao Xing
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Zhaoxing Dai
- Shanghai Haohai Biological Technology Co. Ltd., Shanghai, 200052, China.
| | - Jianguo Sun
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
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12
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Teplovodskaya VV, Sobolev NP, Morina NA, Zhuravlev AS, Sudakova EP. [Correction of ametropia with posterior chamber phakic intraocular lens]. Vestn Oftalmol 2022; 138:64-70. [PMID: 35234423 DOI: 10.17116/oftalma202213801164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Posterior chamber phakic intraocular lens (PIOL) implantation is a widely accepted and performed refractive surgery for correction of moderate and high myopia used when corneal laser ablation procedures are not suitable. This paper analyzes literature data to reveal the advantages and limitations of the technology.
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Affiliation(s)
- V V Teplovodskaya
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N P Sobolev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N A Morina
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A S Zhuravlev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - E P Sudakova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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13
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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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14
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Zhang Z, Niu L, Zhao J, Miao H, Chen Z, Shen Y, Chen X, Ye Y, Wang X, Zhou X. Safety of EVO ICL Implantation With an Ophthalmic Viscosurgical Device-Free Technique in the Early 24 h After Surgery. Front Med (Lausanne) 2021; 8:764653. [PMID: 34869472 PMCID: PMC8635781 DOI: 10.3389/fmed.2021.764653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/21/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: To compare the safety of the non-ophthalmic viscosurgical device (OVD) technique with that of the minimum OVD technique in EVO Implantable Collamer Lens (EVO-ICL) implantation. Methods: A total of 180 eyes of 90 consecutive patients were enrolled in the study, of which 100 eyes of 50 patients were treated with non-OVD technique, with a 55% success rate. The remaining 80 eyes of 40 patients were treated with min-OVD technique, so they were classified into the min-OVD group. Preoperative and postoperative intraocular pressure (IOP) measurements were collected and analyzed at 1, 2, 3, and 24 h. Visual acuity, corneal endothelial cell density (ECD), and corneal densitometry 24 h postoperatively were evaluated. Results: No significant difference was found in visual outcomes (P = 0.54) or ECD (P = 0.78) between the two groups. The operation time was significantly shorter in the non-OVD group (P < 0.0001). The IOP was significantly higher at 1 h (P < 0.0001), 2 h (P < 0.0001) and 3 h (P = 0.0045) postoperatively in the min-OVD group. The non-OVD group had significantly lower IOP than the min-OVD group at 1 h (P = 0.01) and 2 h (P = 0.013) postoperatively. The temporal corneal densitometry in the non-OVD group were significantly lower than those in the minimum group (P = 0.0063) 1 day after surgery. Conclusion: The non-OVD technique is safe and efficient for ICL implantation. It can be a safer method of ICL implantation in that it completely eliminates ophthalmic viscoelastic devices related complications without causing additional complications in short term.
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Affiliation(s)
- Zhe Zhang
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Huamao Miao
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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15
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Kim BK, Chung YT. Long-term Clinical Outcomes of Implantable Collamer Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.8.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the long-term clinical outcomes of implantable collamer lens (ICL) implantation in myopic patients.Methods: This retrospective study included 129 eyes of 68 patients who underwent ICL implantation for correction of myopia with a 10-year follow-up.Results: Ten years after ICL implantation, the mean uncorrected and corrected distance visual acuities (LogMAR) were 0.03 ± 0.13 and -0.07 ± 0.06, respectively. Ten years postoperatively, 52.7% and 84.5% of the eyes were within ± 0.5 and ± 1.0 diopters, respectively. The mean efficacy and safety indices were 0.91 ± 0.22 and 1.07 ± 0.19, respectively. There was no significant difference between mean preoperative (13.52 ± 2.88 mmHg) and postoperative (13.59 ± 3.55 mmHg) intraocular pressures. The endothelial cell density decreased from before surgery to 10 years after surgery (3,074 ± 365 cells/mm2, 2,812 ± 406 cells/mm2, respectively; mean decrease: 8.5 ± 10.8%; p = 0.011). Eight eyes (6.2%) developed cataract during follow-up, which was symptomatic in three eyes (2.3%) and treated with ICL explantation and phacoemulsification. Rhegmatogenous retinal detachment occurred in one eye (0.8%) and was treated with vitrectomy.Conclusions: ICL implantation for the correction of myopia had good efficacy and safety outcomes during long-term follow-up of 10 years. However, patients should be closely monitored for complications such as cataract formation, endothelial cell loss, and retinal detachment.
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Ye Y, Zhao J, Niu L, Shi W, Wang X, Zhou X. Long-term evaluation of anterior lens density after implantable collamer lens V4c implantation in patients with myopia over 40 years old. Br J Ophthalmol 2021; 106:1508-1513. [PMID: 34183326 PMCID: PMC9606511 DOI: 10.1136/bjophthalmol-2021-319205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
Purpose To investigate the long-term safety and efficacy of implantable collamer lens (ICL) V4c implantation and changes in the anterior lens density (ALD) in patients with myopia ≥40 years of age. Methods This prospective study included 104 eyes of 52 patients >40 years of age before ICL V4c implantation. Spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, endothelial cell density, anterior chamber depth, anterior chamber volume and anterior chamber angle preoperatively, at 1 and 3 months, and at 3 years postoperatively were recorded. Pentacam HR was used to analyse ALD changes at a depth of 0.5, 1.0 and 1.5 mm within a 3 mm diameter range around the pupil’s centre. Results The overall follow-up was uneventful at 42±7.1 months; the safety index at last follow-up was 1.26±0.35 and the efficacy index was 0.91±0.41. No eye lost the Snellen line of CDVA, 76% of the eyes had an increase in CDVA for ≥1 line and 62% had an SE within ±0.50 dioptre. The increase in ALD at 0.5, 1 and 1.5 mm was 16.52%±10.46%, 16.72%±9.85% and 17.28%±11.93%, respectively. Preoperative, 1-month and 3-month postoperative ALDs showed correlations with SE and age, and ALD at last follow-up was correlated only with age. There was no correlation between ALD and any other parameters. Conclusion ICL V4c shows long-term safety and efficacy in people ≥40 years of age. ALD increased in such patients, which may be related to age and SE.
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Affiliation(s)
- Yuhao Ye
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, 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, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Wanru Shi
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, 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, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, 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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Sucu ME, Agca A, Tulu B. One-year follow-up of a new posterior chamber toric phakic intraocular lens implantation for moderate-to-high myopic astigmatism. Int Ophthalmol 2021; 41:2941-2949. [PMID: 33880683 DOI: 10.1007/s10792-021-01853-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate refractive and visual outcomes as well as rotational stability following implantation of Eyecryl phakic toric intraocular lens (pIOL) for moderate-to-high myopic astigmatism. METHODS The efficacy, safety, predictability, stability, and adverse events of Eyecryl toric pIOL were evaluated in patients with spherical refraction from - 4.50 to - 18.50 diopters (D) and cylindrical refraction from - 0.50 to - 5.50 D. RESULTS This study included 60 eyes of 31 patients. The mean manifest refraction spherical equivalent (MRSE) dropped from - 10.45 ± 2.74 D preoperatively to - 0.34 ± 0.51 D and - 0.40 ± 0.56 D at 6 and 12 months postoperatively, respectively. There was an 81% decrease in astigmatism after surgery. The safety and efficacy of indices were 1.36 ± 0.43 and 1.20 ± 0 .32. At the final follow-up, the rate of eyes within ± 1.00 D and ± 0.50 D of the desired MRSE were 85% and 68.33%, respectively. Vision-threatening complications were not observed during the follow-up. CONCLUSIONS The implantation of pIOL was effective, safe, and predictable in patients with moderate-to-high myopic astigmatism during 1-year follow-up.
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Affiliation(s)
- M E Sucu
- Department of Ophthalmology, Idil State Hospital, 73300, Şırnak, Turkey.
| | - A Agca
- Ataköy Dünya Göz Hospital, Istanbul, Turkey
| | - B Tulu
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
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18
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Posterior chamber phakic intraocular lens for the correction of presbyopia in highly myopic patients. J Cataract Refract Surg 2021; 46:40-44. [PMID: 32050231 DOI: 10.1097/j.jcrs.0000000000000033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the initial experience with a new presbyopic phakic intraocular lens (pIOL) in the correction of high myopia and presbyopia. SETTING Gemini Eye Clinic, Zlin, Czech Republic. DESIGN Prospective cohort study. METHODS Presbyopic eyes with moderate to high myopia were implanted with a presbyopic posterior chamber pIOL (IPCL). The visual acuities at near and distance, endothelial cell density, and ocular condition were examined 1 week, 3 months, 1 year and 2 years postoperatively. RESULTS The mean uncorrected distance visual acuity improved significantly from 1.25 logarithm of the minimum angle of resolution (logMAR) (1.15 to 1.35 95% confidence interval [CI]) to 0.11 logMAR (95% CI, 0.03 to 0.17) (P < .0001). No eye lost 1 or more lines of corrected distance visual acuity. The mean distance refraction improved significantly from -6.9 diopters (D) (range -8.6 to -5.3 D) preoperatively to -0.35 D (range -0.55 to -0.15 D, P < .0001) with less than -0.5 D residual refraction in 11 of 17 eyes. Fifteen of 17 eyes had improved uncorrected near visual acuity to J1 (Jaeger chart) at the 2-year follow-up. The near addition at the 2-year follow-up decreased from preoperatively +1.26 D (range 0.19 to 2.34 D) to +0.39 D (range 0.18 to 0.60 D). The mean endothelial cell density was reduced from 2552 cells/mm (range 2421 to 2682 cells/mm) to 2299 cells/mm (range 2108 to 2490 cells/mm) after 2 years. All patients were subjectively satisfied with the outcomes. CONCLUSIONS The new pIOL provided good visual outcomes in near and far distances in an initial case series of patients.
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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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Nakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y, Tanaka Y, Ichikawa K. Long-term In Vivo Stability of Posterior Chamber Phakic Intraocular Lens: Properties and Light Transmission Characteristics of Explants. Am J Ophthalmol 2020; 219:295-302. [PMID: 32622670 DOI: 10.1016/j.ajo.2020.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the in vivo durability of the surface and optical properties of the implantable Collamer lens (ICL). DESIGN Retrospective case series. METHODS We included patients who developed cataracts after having undergone ICL implantation from March 2003 to May 2014 and underwent ICL explantation followed by cataract surgery from March 2017 to December 2019 at the Nagoya Eye Clinic. ICL explants were submitted to Chukyo Medical Co, Ltd (Nagoya City, Japan) for laboratory analysis using ultraviolet-visible light spectroscopy, light microscopy (LM), and scanning electron microscopy. Patients' demographic and clinical data were collected and reviewed. RESULTS Thirteen eyes from 10 patients were studied. The average age at ICL explantation was 50.5 ± 8.5 years (range, 34.5-66.3 years). The average length of ICL stay in the eye (from implantation to explantation) was 10.5 ± 2.7 years (range, 4.4-13.7 years). No opacification or coloring of the ICL explants was observed by LM. The ICL explants showed almost the same light transmittance as that of unused ICLs. Scanning electron microscopy revealed no irregularities at the surface of the center and periphery of the optic and haptic footplate. The positioning holes did not show any deposition. CONCLUSION The ICLs remained in-eye for >10 years without any deterioration in the surface and optical properties of the ICL, despite their contact with the ciliary body and iris tissues and the continuous interaction with the aqueous humor components. The present study shows long-term in vivo stability of the ICL.
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Ghoreishi M, Kashfi A, Peyman M, Mohammadinia M. Comparison of Toric Implantable Collamer Lens and Toric Artiflex Phakic IOLs in Terms of Visual Outcome: a Paired Contralateral Eye Study. Am J Ophthalmol 2020; 219:186-194. [PMID: 32621900 DOI: 10.1016/j.ajo.2020.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study sought to compare the postoperative visual outcomes of toric implantable collamer lens (T-ICL) with toric Artiflex (T-Artiflex) lenses. DESIGN Alternating treatment, contralateral eye matched clinical study. METHODS This study compared 82 eyes of 41 patients with T-ICL lenses in one eye and toric Artiflex implantation in the contralateral eye to correct myopic astigmatism. Safety, efficacy, predictability, astigmatic vector changes, contrast sensitivity, endothelial cell count, and possible adverse events were assessed at least 12 months postoperatively. RESULTS After a mean follow-up of 12 months, the safety index was mean 1.40 ± 0.70 in the T-ICL group and 1.20 ± 0.21 in the T-Artiflex group. Furthermore, their mean efficacy indexes were 1.24 ± 0.42 and 1.08 ± 0.23, respectively (P = .029). A total of 39 eyes (95%) in the T-ICL group and 41 eyes (100%) in the T-Artiflex group were within ±1.00 diopter (D) of emmetropia and 33 eyes (80%) and 34 eyes (83%) were within ±0.5 D of emmetropia, respectively. Vector analysis revealed mean index of success as large as 0.25 ± 0.22 in the T-ICL group and 0.24 ± 0.15 in the T-Artiflex group. Postoperative contrast sensitivities were equal in both groups under mesopic conditions for any given spatial frequency. There was an endothelial loss of 2.18% and 1.95% in the T-ICL and T-Artiflex groups, respectively. There were no significant complications in any of the groups. CONCLUSIONS Both lenses showed promising results in terms of safety, efficacy, and predictability for correction of myopic astigmatism. As shown in this paired-eye study, most outcomes were almost identical, and neither of these lenses were clinically superior to the other.
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He X, Niu L, Miao H, Zhao F, Zhou X. Relative position of the central hole after EVO-ICL implantation for moderate to high myopia. BMC Ophthalmol 2020; 20:305. [PMID: 32723334 PMCID: PMC7385873 DOI: 10.1186/s12886-020-01569-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to evaluate the relative position of the central hole (CH) of EVO Implantable Collamer Lens (EVO-ICL), the pupil center (CP), and the corneal center (CC) after implantation of EVO-ICLs for moderate to high myopia. Methods Eighty-nine eyes of forty-seven patients with moderate to high myopia were evaluated. The mean preoperative spherical equivalent (SE) was − 12.58 ± 4.13D. A routine postoperative follow-up was performed within 1 ~ 12 months. Positions of the CH of EVO-ICLs, the CP and the CC were recorded using a slit lamp anterior segment photography system, and their relative distances were calculated with the Visio image analysis software. Results All surgeries were performed safely, and no complications were observed in follow-ups 4.3 ± 4.82 months after surgery. At the last follow-up, the safety index (postoperative CDVA/preoperative CDVA) was 1.23 ± 0.48, and the efficacy index (postoperative UDVA/preoperative CDVA) was 1.08 ± 0.31. The CH in 85 eyes (95.51%) was superior to the CC, with 47.19% (42/89) on the temporal side and 48.31% (43/89) on the nasal side. The CH in 84 eyes (94.38%) was located on the temporal side of the CP, with 56.18% (50/89) superior and 38.2% (34/89) inferior to the CP. The CP of 85 eyes (95.51%) was superior on the nasal side of the CC. On the defined x-axis, the average distance from the CH to CC was significantly shorter than the average distance from the CP to CC (p < 0.001). Conclusions An imperfect match between the central hole of EVO-ICLs and the pupil center does not necessarily indicate ICL dislocation. Compared to the pupil center, the position of the central hole of EVO-ICL is closer to the corneal center.
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Affiliation(s)
- Xiaojian He
- Department of Ophthalmology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Niu
- 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
| | - Huamao Miao
- 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
| | - Feng 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.,Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, 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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24
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Chen D, Cui G, Wang X, Li Y, Luo Y. Safety of the Minimum Ophthalmic Viscosurgical Device Technique in Phakic Implantable Collamer Lens Implantation. J Refract Surg 2020; 36:42-48. [PMID: 31917850 DOI: 10.3928/1081597x-20191119-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/18/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the safety of the minimum ophthalmic viscosurgical device (OVD) technique with the standard procedure in phakic Visian Implantable Collamer Lens (ICL) (STAAR Surgical AG, Nidau, Switzerland) implantation. METHODS This retrospective cohort study evaluated a total of 147 eyes of 74 patients who underwent ICL implantation with the minimum OVD technique (minimum OVD group) and 154 eyes of 77 patients with the standard procedure (standard OVD group). Intraoperative and postoperative complications were recorded. Preoperative and postoperative visual acuity, intraocular pressure (IOP), aqueous depth (AQD), and central corneal endothelial cell density (ECD) were collected and analyzed over the 12-month follow-up. Lens vault and occurrence of paracentesis after surgery were also recorded. RESULTS No intraocular complications were observed. No difference was found in visual outcomes, lens vault, and AQD at all time points between the two groups (P > .05). The minimum OVD group had significantly lower IOP than the standard OVD group at 2 hours (17.04 ± 4.21 vs 19.40 ± 6.78 mm Hg, P < .001) and 3 hours (15.12 ± 3.38 vs 17.15 ± 5.09 mm Hg, P < .001) postoperatively. The IOP gradually returned to the preoperative level after 24 hours postoperatively. The occurrence rate of paracentesis was significantly less in the minimum OVD group compared with the standard group (0.68% [1 of 147] vs 3.2% [5 of 154], P < .001). ECD was not significantly different between groups at all time points (P > .05). CONCLUSIONS The minimum OVD technique could achieve visual and structural outcomes comparable to the standard procedure without additional damage to the corneal endothelial cells, while reducing the IOP fluctuations after surgery. [J Refract Surg. 2020;36(1):42-48.].
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26
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Repplinger B, Kohnen T. [Intraocular pressure after implantation of an ICL with aquaport : Development of intraocular pressure after implantation of an ICL (model V4c) with aquaport without iridotomy]. Ophthalmologe 2019; 115:29-33. [PMID: 28887673 DOI: 10.1007/s00347-017-0556-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The latest version of the intraocular lens (ICL V4c) has a central hole (aquaport) that avoids a pupillary block. Due to this laser iridotomy or intraoperative surgical peripheral iridectomy are no longer required. In this study, we examined the intraocular pressure (IOP) after implantation of the ICL with aquaport, with special reference to the development of a possible pupillary block glaucoma. MATERIAL AND METHODS This retrospective non-randomized study included 87 eyes from 46 patients (consecutive case series). These patients had the ICL model V4c (without a laser iridotomy or peripheral iridectomy) implanted between January 2013 and October 2014. The preoperative IOP values were compared with the postoperative values 1-2 h, 1 day, 1 week and 1 month after implantation. RESULTS The median intraocular pressure was 14 ± 2 mm Hg before implantation of the ICL, palpatory normotensive 1-2 h after implantation, 13 ± 3 mm Hg 1 day after implantation, 15 ± 3 mm Hg 1 week after implantation and 16 ± 4 mm Hg 1 month after implantation (a slight statistically significant increase of the intraocular pressure, p < 0.05). In 2 patients there was a steroid response in both eyes with IOP reaching up to a maximum of 28 mm Hg. There were no peaks of intraocular pressure due to a pupillary block. CONCLUSION It is possible to implant the latest ICL V4c with a central hole (Aquaport) without a laser iridotomy or peripheral iridectomy or development of a pupillary block.
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Affiliation(s)
- B Repplinger
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
| | - T Kohnen
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
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Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses. Cornea 2019; 38:873-879. [PMID: 31170105 DOI: 10.1097/ico.0000000000001914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the temporal effect of toric implantable collamer lens (TICL) implantation and location on corneal endothelial cell density (ECD) over a period of 36 months after surgery. METHODS ECD [number of cells per square millimeter estimated using the Specular Microscope SP-1P (Topcon Europe Medical B.V., Netherlands)] data were collected from cases deemed suitable for the TICL (VTICMO, VTICM5; STAAR Surgical, Nidau, Switzerland). The preoperative refractive error (sphere and cylinder) ranged from -1.00 to -22.25 diopter sphere and from -0.50 to -5.50 diopter cylinder. ECD was evaluated at preoperative and all postoperative sessions. RESULTS Key findings were as follows: the mean ECD (±SD, 95% confidence interval) was 2720 cells/mm (±272, 2620-2820 cells/mm) preoperatively, which was reduced to 2372 cells/mm (±325, 2250-2490 cells/mm) at 36 months postoperatively (P < 0.001). Linear regression revealed the following significant correlations between the (1) log of the change in ECD (y1) and log of preoperative ECD (x1) at 2 years postoperatively, y1 = 2.513x1-6.2816 (n = 62, r= 0.3503, P = 0.005); (2) mean ECD (y2) and log time (in months, x2), y2= 2543.7-36.997x2-38.99x2 (r=-0.9654, n = 7, P = 0.0004); and (3) mean axial distance between the front surface of the crystalline lens and the TICL back surface (y3) and time postoperatively (in months, x3), y3 = 0.1035x3-5.2808x3 +473.18 (r = 0.8512, n = 7, P = 0.015). CONCLUSIONS Expected ECD loss after TICL implantation by 2 years postoperatively is predictable. On average, over 3 years after implantation, there is (1) an initial rapid decline in ECD, followed by a gradual fall in the rate of cell loss, and (2) a gradual fall in the distance between the TICL and the crystalline lens by 2 years postoperatively, followed by a reversal by the third year.
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Vasavada V, Srivastava S, Vasavada SA, Sudhalkar A, Vasavada AR, Vasavada VA. Safety and Efficacy of a New Phakic Posterior Chamber IOL for Correction of Myopia: 3 Years of Follow-up. J Refract Surg 2019; 34:817-823. [PMID: 30540364 DOI: 10.3928/1081597x-20181105-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/02/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the outcomes of a new posterior chamber phakic intraocular lens (IPCL; Care Group, Baroda, India) to correct myopia. METHODS This prospective, observational case series included 30 eyes undergoing implantation of the IPCL for high myopia (> -8.00 diopters [D]). Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, vault, endothelial cell loss, and adverse events were evaluated 3 years after implantation of the IPCL for high myopia. RESULTS The mean spherical equivalent decreased from -16.50 ± 5.62 D preoperatively to -0.89 ± 1.27 D at 3 years. The mean UDVA and CDVA were 0.38 ± 0.21 and 0.24 ± 0.09 logMAR. No eye lost any lines and 49% of eyes gained one line or more of CDVA. One eye (3.3%) developed anterior subcapsular cataract, but did not require cataract surgery at 3 years of follow-up. Two eyes (6.6%) developed a mild transient increase in intraocular pressure, which required topical medication only for 3 months. The percentage of endothelial cell loss at 3 years was 9.73% ± 6.72%. The IPCL vault tended to reduce with time, from a mean of 626.66 ± 188.98 μm at 1 month to 540.22 ± 210.76 μm at 3 years. No vision-threatening complications occurred. CONCLUSIONS Implantation of the new posterior chamber phakic IOL is an effective alternative to correct high myopia, showing good outcomes at 3 years. [J Refract Surg. 2018;34(12):817-823.].
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ICL versus SMILE in management of anisometropic myopic amblyopia in children. Can J Ophthalmol 2018; 53:560-567. [DOI: 10.1016/j.jcjo.2018.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 11/22/2022]
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Pjano MA, Pidro A, Biscevic A, Grisevic S, Pandzic B, Cerovic V. Refractive Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Correction of Myopia and Myopic Astigmatism. Med Arch 2018; 71:93-96. [PMID: 28790537 PMCID: PMC5511534 DOI: 10.5455/medarh.2017.71.93-96] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: The aim was to examine efficacy and safety after Implantable Collamer Lens (ICL) implantation for correction of myopia et myopic astigmatism. Methods: This prospective clinical study included 28 eyes of 16 patients which underwent implantation of ICL for correction of myopia up to -18,00 diopters (D) and myopic astigmatism up to -6,00 D in the Eye Clinic Svjetlost Sarajevo, from January 2013 to January 2016. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, six and twelve months. For statistical analysis SPSS for Windows and Microsoft Excel were used. Results: Out of 16 patients, with mean age of 28,21 ± 4,06 years, 12 of them had binocular and 4 of them had monocular procedure. After 12 months mean UDVA was 0,76 ± 0,16 compared to UDVA 0,04 ± 0,03 preoperatively. Mean SE preoperatively was -0,21 ± 0,27 D compared to -9,52 ± 3,69 D preoperatively. At 12 months one eye (3,57%) lost 2 Snellen lines. In this study 8 eyes (28,57%) gained 1 line, 5 eyes gained (17,56%) 2 lines, and 3 eyes (10,72%) gained 3 lines. EC loss was 5,50±4.71% after 12 months. There was no significant change of IOP by the end of 12 months follow up period. One haptic crack was reported as the only intraoperative complication. Three postoperative complications were: two lens rotations and one retinal detachment. Conclusion: Implantation of ICL is an effective and safe method for reducing or correcting myopia and myopic astigmatism.
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Affiliation(s)
| | - Ajla Pidro
- Eye Clinic Svjetlost, Sarajevo, Bosnia and Herzegovina
| | - Alma Biscevic
- Eye Clinic Svjetlost, Sarajevo, Bosnia and Herzegovina
| | | | | | - Vesna Cerovic
- University Eye Hospital "Svjetlost", Zagreb, Croatia
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Fernández-Vigo JI, Marcos AC, Agujetas R, Montanero JM, Sánchez-Guillén I, García-Feijóo J, Pandal-Blanco A, Fernández-Vigo JÁ, Macarro-Merino A. Computational simulation of aqueous humour dynamics in the presence of a posterior-chamber versus iris-fixed phakic intraocular lens. PLoS One 2018; 13:e0202128. [PMID: 30102728 PMCID: PMC6089426 DOI: 10.1371/journal.pone.0202128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare aqueous humour (AH) dynamics in the presence of a precrystalline (Implantable Collamer Lens®; ICL) or iris-fixed (Artiflex®) phakic intraocular lens (PIOL). Methods By computational fluid dynamics simulation, AH flow was modelled through a peripheral iridotomy (PI) or central lens hole (both 360 μm) in the presence of an Artiflex or ICL lens, respectively. The impacts of AH flow were then determined in terms of wall shear stress (WSS) produced on the endothelium or crystalline lens. Effects were also modelled for different scenarios of pupil diameter (PD 3.5 or 5.5 mm), ICL vault (100, 350, 800 μm) and number of Artiflex iridotomies (1 or 2) and location (12 or 6 o’clock). Results For a PD of 3.5 mm, AH volumes flowing from the posterior to the anterior chamber were 37.6% of total flow through the lens hole (ICL) and 84.2% through PI (Artiflex). For an enlarged PD (5.5 mm), corresponding values were 10.3% and 81.9% respectively, so PI constitutes a very efficient way of evacuating AH. Central endothelial WSS in Pa was lower for the large vault ICL and the Artiflex (1−03 and 1.1−03 respectively) compared to the PIOL-free eye (1.6−03). Crystalline lens WSS was highest for the lowest vault ICL (1−04). Conclusions AH flow varied according to the presence of a precrystalline or iris-fixed intraocular lens. Endothelial WSS was lower for an implanted ICL with large vault and Artiflex than in the PIOL-free eye, while highest crystalline WSS was recorded for the lowest vault ICL.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Departamento de Oftalmología, Hospital Universitario Clínico San Carlos, Instituto de Investigación sanitaria San Carlos, Madrid (Spain)
- Centro Internacional de Oftalmología Avanzada, Madrid (Spain)
- * E-mail:
| | - Alfonso C. Marcos
- Departamento de Expresión Gráfica, Universidad de Extremadura, Badajoz (Spain)
| | - Rafael Agujetas
- Departamento de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación científica avanzada (ICCAEx), Universidad de Extremadura, Badajoz (Spain)
| | - José María Montanero
- Departamento de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación científica avanzada (ICCAEx), Universidad de Extremadura, Badajoz (Spain)
| | | | - Julián García-Feijóo
- Departamento de Oftalmología, Hospital Universitario Clínico San Carlos, Instituto de Investigación sanitaria San Carlos, Madrid (Spain)
| | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid (Spain)
- Facultad de Medicina, Universidad de Extremadura, Badajoz (Spain)
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Mednick Z, Betsch D, Boutin T, Einan-Lifshitz A, Sorkin N, Slomovic A. Bilateral BrightOcular iris implants necessitating explantation and subsequent endothelial keratoplasty. Am J Ophthalmol Case Rep 2018; 12:1-4. [PMID: 30094397 PMCID: PMC6072912 DOI: 10.1016/j.ajoc.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To demonstrate the dangers associated with the BrightOcular iris implant, a model that had initially been touted as safer than its predecessors. Observations A 41-year-old male presented with decreased vision in both eyes, approximately two years following bilateral BrightOcular cosmetic iris implantation performed in Mexico. On initial consultation, he was found to have bilateral corneal decompensation with stromal edema and a significantly reduced endothelial cell count (ECC). On follow up 5 weeks later, his vision and corneal edema had further detriorated. In the following month, he underwent explantation of the cosmetic iris implants in both eyes. Significant corneal edema persisted in the right eye several months post-operatively, to the point of necessitating endothelial keratoplasty. Conclusions and importance Despite numerous reports in the literature of the significant ocular complications that can arise secondary to cosmetic iris implantation, individuals continue to willingly undergo this surgery. Our intention with presenting this case to the ophthalmologic community is two-fold: to highlight the ongoing clinical risk that BrightOcular devices pose, despite being marketed as safer than the older NewColourIris models, and to stress the urgency with which cosmetic iris implants should be removed from the eye.
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Affiliation(s)
- Zale Mednick
- Cornea Service, Department of Ophthalmology, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada
| | - Devin Betsch
- Dalhousie University, Faculty of Medicine, 1459 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - Tanguy Boutin
- Cornea Service, Department of Ophthalmology, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada
| | - Adi Einan-Lifshitz
- Cornea Service, Department of Ophthalmology, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada
| | - Nir Sorkin
- Cornea Service, Department of Ophthalmology, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada
| | - Allan Slomovic
- Cornea Service, Department of Ophthalmology, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada
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Nam SW, Lim DH, Hyun J, Chung ES, Chung TY. Buffering zone of implantable Collamer lens sizing in V4c. BMC Ophthalmol 2017; 17:260. [PMID: 29273016 PMCID: PMC5741871 DOI: 10.1186/s12886-017-0663-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/13/2017] [Indexed: 02/01/2023] Open
Abstract
Background The purpose of this study was to identify factors related to the unexpected vault in V4c implantable collamer lens (ICL; STAAR Surgical) implantation. Methods V4c ICLs were implanted in 43 eyes of 43 patients for the correction of myopia. The implanted V4c ICL sizes were determined individually with our previous V4 ICL sizing nomogram based on the sulcus-to-sulcus diameter (STS), and the V4 ICL sizes were then converted to V4c ICL sizes with a size-converting table. We defined the “normal-sizing group” as having a pre-converted ICL size larger than the STS, and the “under-sizing group” as having a pre-converted ICL size smaller than the STS. Refractive outcomes, safety and parameters related to postoperative vault were compared between the two groups. Results The value of “actual ICL size – STS” differed significantly between the normal-sizing and under-sizing groups (p < 0.001), but postoperative vault did not differ significantly (p = 0.442). The demographics, implanted ICL characteristics, effectiveness indexes, safety indexes, and parameters related to postoperative vault did not differ significantly between the two groups (p > 0.05). Two patients in the normal-sizing group exhibited over-vaulting; these patients had shallow anterior chambers and were implanted with high-dioptric-power ICLs. Conclusions The achievement of acceptable vault in both normal-sizing and under-sizing groups indicates the existence of a buffering zone in V4c ICL sizing. The smaller size of V4c ICLs should be considered in patients susceptible to over-vaulting, such as those with shallow anterior chambers and high-dioptric-power ICLs.
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Affiliation(s)
- Seung Wan Nam
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Preventive Medicine, Graduate School, The Catholic University of Korea, Seoul, South Korea
| | - Joo Hyun
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Saevit Eye Hospital, Goyang, South Korea
| | - Eui-Sang Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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Fernández-Vigo JI, Macarro-Merino A, Fernández-Vigo C, Fernández-Vigo JÁ, De-Pablo-Gómez-de-Liaño L, Fernández-Pérez C, García-Feijóo J. Impacts of Implantable Collamer Lens V4c Placement on Angle Measurements Made by Optical Coherence Tomography: Two-Year Follow-up. Am J Ophthalmol 2017; 181:37-45. [PMID: 28662940 DOI: 10.1016/j.ajo.2017.06.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/14/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine iridocorneal angle changes produced after 2 years of implantable collamer lens (ICL) V4c (STAAR Surgical AG, Nidau, Switzerland) placement by Fourier-domain optical coherence tomography (FD-OCT). DESIGN Prospective interventional case series. METHODS In 54 eyes of 27 myopic subjects FD-OCT iridocorneal angle measurements were made before and 1 month, 3 months, 1 year, and 2 years after ICL implant. Trabecular-iris angle (TIA), angle opening distance 500 μm from the scleral spur (AOD500), and iridotrabecular contact length (TICL) were compared among these time points and the nasal, temporal, and inferior quadrants. RESULTS Preoperative TIAs were 49.5 ± 8.7, 48.3 ± 9.6, and 49.1 ±8.6 degrees for the nasal, temporal and inferior quadrants (P < .001). Corresponding values were 29.9 ± 10.4, 28.4 ± 10.8, and 28.8 ± 9.7 degrees at 1 month and 27.3 ± 8.8, 26.8 ± 8.1, and 28.9 ± 7 degrees at 2 years of follow-up, indicating angle narrowing of 39%-45% and no further narrowing beyond 1 month in the nasal (P = .133), temporal (P = .376), and inferior (P = 1.000) quadrants. Trabecular-iris contact (TIC) was observed in 8 eyes of 8 subjects, mostly only in the temporal quadrant. Mean TICL failed to vary during follow-up (307 ± 288 μm at 3 months and 225 ± 142 μm at 2 years, P = .159). CONCLUSIONS In response to ICL V4c implant, considerable angle narrowing was detected at 1 month but this narrowing remained stable at 2 years. In the 8 cases of TIC, no progression of contact was observed beyond 3 months postimplant.
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Eissa SA, El-Deeb MW, Hendawi MS. V4B implantable collamer lens versus Intacs corneal rings to manage anisometropic myopic amblyopia in children. Can J Ophthalmol 2017; 52:409-415. [PMID: 28774525 DOI: 10.1016/j.jcjo.2017.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 12/23/2016] [Accepted: 01/06/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the safety and efficacy of phakic intraocular lens (PIOL) versus intrastromal corneal ring segments (Intacs), for correcting high myopic anisometropia in amblyopic children. DESIGN Nonrandomized prospective multi-center study. PARTICIPANTS Thirty children, aged between 4 and 12 years, with unilateral high myopic anisometropic amblyopia were included in this study. METHODS Patients who were prospectively subdivided into group A, with mean preoperative manifest refraction spherical equivalent (MRSE) of -12.96 ± 4.17 D, underwent unilateral phakic posterior chamber intraocular lens implantation. Patients with mean preoperative MRSE of -8.60 ± 1.16 D in group B were treated by Intacs corneal rings. Pre- and postoperative visual acuity, ocular examination, stereoacuity, axial biometry measurements, cycloplegic refraction, and endothelial cell counts were performed in all patients. RESULTS Group A revealed prevention of amblyopia with improvement in spectacle-corrected distance visual acuity, where 4-6 lines were achieved in 77% of children, 2-3 lines in 4%, and just 0-1 lines restricted to 19% of children. Improvement in stereoacuity was noted in 93.33% of group A cases, whereas group B showed fewer cases of successfully improved vision, with 4-6 lines in 70% of children, 2-3 lines in 3%, and just 0-1 lines restricted to 27% of children. Improvement in stereoacuity was noted in 86.66% of cases. Two cases of cataract and 1 case of glaucoma with 1 case of uveitis were noted in the implantable contact lens (ICL) group. CONCLUSIONS Posterior chamber PIOLs or Intacs may provide a safe alternative in treating anisometropic myopic patients. Intacs implantation is safer with fewer complications than ICL. However, ICL implantation is advantageous over the corneal ring segment procedure owing to the wide range of errors to correct.
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Affiliation(s)
- Sherif Ahmed Eissa
- Ophthalmology, Cairo University, and Ophthalmology and Refractive Surgery, Magrabi Hospital, Khamis Mushait, Kingdom of Saudi Arabia; Ophthalmology Department, Kasr Al Ainy, Cairo University, Egypt
| | - Mohamed Wagih El-Deeb
- Ophthalmology, Cairo University, and Ophthalmology and Refractive Surgery, New Mowasat Hospital, Salmiya, Kuwait; Ophthalmology Department, Kasr Al Ainy, Cairo University, Egypt..
| | - Mahmoud Salah Hendawi
- Ophthalmology, Cairo University, and Ophthalmology and Refractive Surgery, Al-Ourf Hospital, Jahra, Kuwait; Ophthalmology Department, Kasr Al Ainy, Cairo University, Egypt
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Garcia-De la Rosa G, Olivo-Payne A, Serna-Ojeda JC, Salazar-Ramos MS, Lichtinger A, Gomez-Bastar A, Ramirez-Miranda A, Navas A, Graue-Hernandez EO. Anterior segment optical coherence tomography angle and vault analysis after toric and non-toric implantable collamer lens V4c implantation in patients with high myopia. Br J Ophthalmol 2017; 102:544-548. [PMID: 28729370 DOI: 10.1136/bjophthalmol-2017-310518] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/12/2017] [Accepted: 06/25/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions. METHODS Longitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up. RESULTS Seventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001). CONCLUSION There is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.
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Affiliation(s)
- Guillermo Garcia-De la Rosa
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Andrew Olivo-Payne
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Juan Carlos Serna-Ojeda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Maria Sandra Salazar-Ramos
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Alejandro Lichtinger
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Arturo Gomez-Bastar
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
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Ammar H, Anbar M, Abdellah MM. Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism. Clin Ophthalmol 2017; 11:105-114. [PMID: 28096654 PMCID: PMC5207452 DOI: 10.2147/opth.s122442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism. Patients and methods This study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated. Results This study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B. Conclusion Both procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients.
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Affiliation(s)
- Hatem Ammar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Anbar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Marwa M Abdellah
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
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Chen H, Niu G, Fan Y, Ma J. Comparison of intraocular pressure andvault after implantation of implantable collamer lens with and without a central hole. BMC Ophthalmol 2016; 16:203. [PMID: 27852246 PMCID: PMC5112696 DOI: 10.1186/s12886-016-0375-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUD The Implantable Collamer Lens (ICL) has been used widely for refractive errors, We performed this prospective randomized comparative study to compare postoperative intraocular pressure (IOP) and vaults of the eyes implanted with conventional ICL and central hole ICL. METHODS This study evaluated 44 eyes of 22 patients who underwent central hole ICL implantation in one eye and conventional ICL implantation in the other eye by randomization assignment. noncontact intraocular pressure were performed on 6 h, 1 day, 3 days, 1 week, 2 weeks, 1 month, 3 months and 6 months, while ICL vaults were measured on 1 day, 1 week, 1 month and 6 months. RESULTS The IOP of both eyeswithcentral hole and conventional ICLrosetemporarily during the first month after surgeries, especially on 1 day and 2 weeks points postoperatively. The IOP ofeyes with central hole ICL was higher than that of conventionl ICL. The vaults ofeyes with central hole and conventional ICL decreased slightly with time but did not significantly affect the postoperative IOP. CONCLUSIONS Despite the sensitivity of viscoelastic agents or inflammation, this newly developed central hole ICL implantation appears to be equivalent in safty and effcacy to conventional ICL implantation for the correction of ametropia. TRIAL REGISTRATION Current Controlled Trials ChiCTR-INR-16008896 . Retrospectively registered 24 July 2016.
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Affiliation(s)
- Haiting Chen
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China.,Department of Ophthalmology, Second Hospital of Hebei Medical University, Hebei, China
| | - Guangzeng Niu
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China
| | - Yuxiang Fan
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China
| | - Jingxue Ma
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Hebei, China.
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Cao X, Wu W, Wang Y, Xie C, Tong J, Shen Y. Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia: First experience in China. Medicine (Baltimore) 2016; 95:e4641. [PMID: 27603356 PMCID: PMC5023878 DOI: 10.1097/md.0000000000004641] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this article is to evaluate the clinical outcomes of a posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens V4c) for the correction of moderate to high myopia in Chinese eyes.The article is designed as a retrospective case series.This study included the first consecutive eyes that had implantation of a new pIOL design with a central hole, at our department by the same surgeon. The safety, efficacy, predictability, stability, and adverse events of the surgery were evaluated over 6 months.The study enrolled 63 eyes (32 patients). The mean spherical equivalent decreased from -12.81 ± 3.11 diopters (D) preoperatively to -0.05 ± 0.27 D 6 months postoperatively; 96.8% of eyes were within ±0.50 D of the target and 100% of eyes were within ±1.00 D. All eyes had a decimal uncorrected distance visual acuity of 0.5 (20/40) or better at every follow-up visit. The safety and efficacy indices were 1.42 ± 0.34 and 1.11 ± 0.19, respectively. Postoperatively, the intraocular pressure (IOP) remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 505.2 ± 258.9 μm (range 120-990 μm), and the mean endothelial cell loss was 2.0%.Implantation of the pIOL was safe, effective, predictable, and stable in the correction of moderate-to-high myopia in Han Chinese patients, even without peripheral iridectomy.
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Affiliation(s)
- Xinfang Cao
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China. Department of Orthopedics, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China
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Parkhurst GD. A prospective comparison of phakic collamer lenses and wavefront-optimized laser-assisted in situ keratomileusis for correction of myopia. Clin Ophthalmol 2016; 10:1209-15. [PMID: 27418804 PMCID: PMC4935102 DOI: 10.2147/opth.s106120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate and compare night vision and low-luminance contrast sensitivity (CS) in patients undergoing implantation of phakic collamer lenses or wavefront-optimized laser-assisted in situ keratomileusis (LASIK). PATIENTS AND METHODS This is a nonrandomized, prospective study, in which 48 military personnel were recruited. Rabin Super Vision Test was used to compare the visual acuity and CS of Visian implantable collamer lens (ICL) and LASIK groups under normal and low light conditions, using a filter for simulated vision through night vision goggles. RESULTS Preoperative mean spherical equivalent was -6.10 D in the ICL group and -6.04 D in the LASIK group (P=0.863). Three months postoperatively, super vision acuity (SVa), super vision acuity with (low-luminance) goggles (SVaG), super vision contrast (SVc), and super vision contrast with (low luminance) goggles (SVcG) significantly improved in the ICL and LASIK groups (P<0.001). Mean improvement in SVaG at 3 months postoperatively was statistically significantly greater in the ICL group than in the LASIK group (mean change [logarithm of the minimum angle of resolution, LogMAR]: ICL =-0.134, LASIK =-0.085; P=0.032). Mean improvements in SVc and SVcG were also statistically significantly greater in the ICL group than in the LASIK group (SVc mean change [logarithm of the CS, LogCS]: ICL =0.356, LASIK =0.209; P=0.018 and SVcG mean change [LogCS]: ICL =0.390, LASIK =0.259; P=0.024). Mean improvement in SVa at 3 months was comparable in both groups (P=0.154). CONCLUSION Simulated night vision improved with both ICL implantation and wavefront-optimized LASIK, but improvements were significantly greater with ICLs. These differences may be important in a military setting and may also affect satisfaction with civilian vision correction.
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Affiliation(s)
- Gregory D Parkhurst
- Refractive Surgery Center, Carl R Darnall Army Medical Center, Fort Hood; Parkhurst NuVision, San Antonio, TX, USA
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Wu Y, Han F, Quan Y, Jiang W, Zhang H, Luo T. Comparison of peripheral iridectomy methods for posterior chamber phakic intraocular lens implantation in patients with brown irides. BMC Ophthalmol 2016; 16:51. [PMID: 27150380 PMCID: PMC4857290 DOI: 10.1186/s12886-016-0229-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 04/28/2016] [Indexed: 11/25/2022] Open
Abstract
Background We explore and compare the advantages and disadvantages of different operating methods for a peripheral iridectomy (PI) for phakic posterior chamber implantable contact lens (ICL) implantation in patients with dark-brown irides. Methods Forty-six patients completed this prospective comparative study. Neodymium: yttrium-aluminum-garnet (Nd:YAG) PI was performed in 15 patients (30 eyes) 2 weeks prior to surgery (YAG PI group). Surgical PI was performed in 17 patients (34 eyes) 2 weeks prior to the ICL implantation (preoperative PI group), and intraoperative PI was performed during ICL implantation in 14 patients (28 eyes) (intraoperative PI group). The postoperative recovery of visual acuity, intraoperative complications, operation duration, and patients’ visual disturbances were compared. Results Compared with the preoperative BCVA, the uncorrected visual acuity (UCVA) at 1 week was markedly restored in the preoperative PI group (P = 0.004). UCVA in the three groups of patients had all recovered well at 1 and 3 months after ICL implantation and were significantly better than the preoperative BCVA (all P < 0.01). In the YAG PI group, iris bleeding occurred in nine eyes (30.0 %) and 14 eyes (46.7 %) had pigment dispersion; these values were significantly higher than those in the preoperative PI group (5.9 and 14.7 %, respectively, both P = 0.01). In the intraoperative PI group, elevated high intraocular pressure occurred in four eyes (14.3 %), and eight eyes (28.6 %) had varying degrees of pigment dispersion after ICL implantation. Conclusions For patients with dark-brown irides, surgical PI performed 2 weeks prior to the implantation facilitated better postoperative recovery of visual acuity. Trial registration Current Controlled Trials ISRCTN35178162. Retrospectively registered March 4th, 2013.
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Affiliation(s)
- Yan Wu
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Fei Han
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Yan Quan
- Department of Health, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Wei Jiang
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China.
| | - Hengdi Zhang
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
| | - Tao Luo
- Department of Ophthalmology, ChengDu Military General Hospital, ChengDu, 610083, Sichuan Province, China
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Asymptomatic haptic migration of phakic anterior chamber intraocular lens through the peripheral iridectomy. Can J Ophthalmol 2016; 51:83-6. [PMID: 27085263 DOI: 10.1016/j.jcjo.2015.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 10/18/2015] [Accepted: 10/28/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Case series of haptic migration in patients with angle-supported phakic anterior chamber intraocular lens (PAC-IOL: Phakic6H) through the superior peripheral iridectomy (PI). METHODS Charts of 23 patients (35 eyes) with at least 6 months' postoperative follow-up were retrospectively reviewed. Evaluation included preoperative and postoperative cycloplegic and manifest refractions, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp examination, fundoscopy, corneal topography, and biometry. RESULTS Mean UCVA was 1.67 ± 0.30 (1.17-2.00) for all 35 eyes preoperatively and 0.35 ± 0.25 (0.00-1.00) postoperatively (p < 0.001; 95% CI 1.21-1.44). BCVA had a mean of 0.31 ± 0.26 for all 35 eyes preoperatively, and a mean of 0.22 ± 0.25 postoperatively (p < 0.001; 95% CI 0.04-0.14). Haptic migration into the superior PI was noted in 8 eyes (23%). The first migration was noted 2 years postoperatively and the last 8 years after implantation (mean, 5.6 ± 2 years). There was no statistically significant difference in the BCVA and UCVA before and after haptic migration. Follow-up ranged from 8 months to 8.5 years. CONCLUSIONS Angle-supported PAC-IOL implantation resulted in significant improvement in both UCVA and BCVA. However, there is a 23% incidence of haptic migration in our series with no sequelae on BCVA or harmful effect on the intraocular structures. This IOL movement may be explained by changes in aqueous dynamics at the level of the PI leading to migration of the haptic into the area of least resistance.
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Fernández-Vigo JI, Fernández-Vigo JÁ, Macarro-Merino A, Fernández-Pérez C, Martínez-de-la-Casa JM, García-Feijoó J. Determinants of anterior chamber depth in a large Caucasian population and agreement between intra-ocular lens Master and Pentacam measurements of this variable. Acta Ophthalmol 2016; 94:e150-5. [PMID: 26303627 DOI: 10.1111/aos.12824] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/08/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To establish the main determinants of anterior chamber depth (ACD) in Caucasian subjects and examine agreement between IOL Master(®) (Carl Zeiss, Meditec) and Pentacam(®) (Oculus Inc.) ACD measurements. METHODS In a cross-sectional study, 1006 right eyes of 1006 healthy subjects were subjected to a general ophthalmologic examination using the Pentacam(®) , IOLMaster(®) and OCT RTVue(®) (Optovue Inc.). The variables recorded were age, sex, intra-ocular pressure, spherical refractive error, axial length (AL), central corneal thickness, corneal diameter, iris thickness, and anterior chamber depth, volume and angle (ACA). The effects of these variables on ACD were analysed by multivariate linear regression. RESULTS Mean age was 49.1 years (range 18-84); 61% were women. In 98.3% of the eyes, ACD could be measured using the IOL Master and in 98% the Pentacam was used to give mean depths of 3.30 ± 0.42 mm and 3.35 ± 0.43 mm, respectively, for the two instruments. Agreement between these devices was high. In men, ACD was 0.13 mm on average deeper than in women (p < 0.001). ACD was correlated with ACA, AL, corneal diameter, spherical refractive error and age (p < 0.001). Five variables - age, sex, spherical error, corneal diameter and ACA - were able to explain 74.1% of the variation produced in ACD (R(2) = 0.741; p < 0.001), among which age emerged as the main determinant (partial R(2) = 0.279; p < 0.001). CONCLUSIONS Age, sex, spherical error, corneal diameter and ACA correlate highly with ACD and together serve to explain much of its variation. When used to measure ACD, the IOLMaster and Pentacam show excellent agreement.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology; Institute of Health Research; Clínico San Carlos University Hospital; Complutense University of Madrid; Madrid Spain
- International Center of advanced Ophthalmology; Madrid Spain
| | - José Ángel Fernández-Vigo
- International Center of advanced Ophthalmology; Madrid Spain
- Department of Ophthalmology; University of Extremadura; Badajoz Spain
| | - Ana Macarro-Merino
- International Center of advanced Ophthalmology; Madrid Spain
- Department of Ophthalmology; University of Extremadura; Badajoz Spain
| | - Cristina Fernández-Pérez
- Department of Preventive Medicine; Institute of Health Research; Clínico San Carlos University Hospital; Complutense University of Madrid; Madrid Spain
| | - Jose Maria Martínez-de-la-Casa
- Department of Ophthalmology; Institute of Health Research; Clínico San Carlos University Hospital; Complutense University of Madrid; Madrid Spain
| | - Julian García-Feijoó
- Department of Ophthalmology; Institute of Health Research; Clínico San Carlos University Hospital; Complutense University of Madrid; Madrid Spain
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Lee J, Kim Y, Park S, Bae J, Lee S, Park Y, Lee J, Lee JE. Long-term clinical results of posterior chamber phakic intraocular lens implantation to correct myopia. Clin Exp Ophthalmol 2016; 44:481-7. [PMID: 26661832 DOI: 10.1111/ceo.12691] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/28/2015] [Accepted: 12/05/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to determine whether implantable collamer lens (ICL) implantation to correct myopia is an effective and safe surgical option even after long-term follow up. DESIGN A retrospective observational study was carried out. PARTICIPANTS A total of 281 eyes of 145 myopic patients were included in the study. METHODS Patients underwent ICL implantation and had the follow-up period of at least 5 years (87 ± 18.9 months). MAIN OUTCOME MEASURES Outcome measures included uncorrected and corrected distance visual acuities, refraction for the evaluation of efficacy, safety, stability and predictability, ICL vault and adverse events. RESULTS The final mean logMAR uncorrected and corrected distance visual acuities were 0.02 ± 0.19 and -0.12 ± 0.13, respectively. The mean efficacy and safety indices were 1.04 ± 0.32 and 1.20 ± 0.26. The mean spherical equivalent decreased from -8.74 ± 2.27 diopter (D) to -0.58 ± 0.72 D, and there was high predictability with 69.8% and 87.2% having a postoperative refraction within 0.5 D and 1.0 D, respectively. The mean postoperative vault was changed from 2.53 ± 0.6 to 2.00 ± 0.7. Six (2.1%) eyes developed cataract, and the mean endothelial cell loss was 7.8 ± 8.3%. Increased intraocular pressure was found in two (0.7%) eyes that required the exchange of lenses with different sizes. CONCLUSIONS Implantable collamer lens implantation to correct myopia was an effective and safe surgery with high predictability and stability during long-term follow up. Slight myopic shift and cataract formation related with change in vault should be further evaluated.
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Affiliation(s)
- Jongsoo Lee
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | | | | | | | - Seunguk Lee
- The Department of Ophthalmology, School of Medicine, Kosin University, Pusan, Korea
| | - Youngmin Park
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jonghun Lee
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea
| | - Ji-Eun Lee
- The Department of Ophthalmology, School of Medicine, Pusan National University, Pusan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Effects of Implantable Collamer Lens V4c Placement on Iridocorneal Angle Measurements by Fourier-Domain Optical Coherence Tomography. Am J Ophthalmol 2016; 162:43-52.e1. [PMID: 26582312 DOI: 10.1016/j.ajo.2015.11.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess by Fourier-domain optical coherence tomography (FDOCT) changes produced in iridocorneal angle measurements in patients undergoing Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG) placement. DESIGN Prospective interventional case series. METHODS In 50 eyes of 25 myopic subjects consecutively scheduled for ICL implant, FDOCT (RTVue; Optovue Inc) iridocorneal angle measurements were made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA) and angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared among the quadrants nasal, temporal, and inferior, and correlations with ocular variables including lens vault were examined. RESULTS Preoperative TIA was 48.7 ± 8.7, 48.2 ± 8.7, and 48.7 ± 9.3 degrees for the nasal, temporal, and inferior quadrants, with no differences (P = 1.000). Following ICL implant, corresponding values fell to 31.2 ± 11.5, 30.0 ± 10.7, and 29.7 ± 8.1 degrees at 1 month postsurgery, indicating angle narrowing of 34%-42%, and to 30.6 ± 12.3, 30.1 ± 11.9, and 29.8 ± 12.3 degrees, respectively, at 3 months postsurgery. Angle measurements failed to vary between 1 month and 3 months postsurgery (P = .481). In 8 eyes, iridotrabecular contact attributable to surgery was observed. One month after surgery, vault measurements correlated with TIA (R = -.309; P = .048). Six variables were identified as predictors of TIA at 1 month postsurgery (R(2) = .907). CONCLUSIONS Although considerable angle narrowing was detected 1 month after ICL V4c implant, this narrowing remained stable at 3 months postsurgery. Factors predictive of TIA could serve to identify suitable candidates for ICL placement.
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An interesting case of implantable contact lens. Med J Armed Forces India 2015; 71:S69-72. [PMID: 26265876 DOI: 10.1016/j.mjafi.2013.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 02/26/2013] [Indexed: 11/23/2022] Open
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Lee D, Seok JY, Kyung HS, Kim JM. Risk Factors for Cataract Formation after Implantable Collamer Lens Implantation: Over a Mean 7.5-Year Follow-Up Period. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.6.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Ju Yong Seok
- Department of Ophthalmology, Korea Army Training Center District Hospital, Nonsan, Korea
| | - Hak Su Kyung
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim BK, Mun SJ, Lee DG, Chung YT. Clinical Outcomes of Beveled, Full Thickness Astigmatic Keratotomy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.8.1160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Bu Ki Kim
- Onnuri Smile Eye Clinic, Seoul, Korea
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Lee D, Lee SJ, Kyung H. Rotational Stability after Toric Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.4.477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Seung Jae Lee
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Haksu Kyung
- Department of Ophthalmology, National Medical Center, Seoul, Korea
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