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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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Randleman JB, Asroui L, Tarib I, Scarcelli G. The Most Cited Articles and Authors in Refractive Surgery. J Refract Surg 2023; 39:78-88. [PMID: 36779469 DOI: 10.3928/1081597x-20221213-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To provide a comprehensive analysis of the most highly cited articles and authors in refractive surgery. METHODS The Scopus database was searched for articles pertaining to refractive surgery using multiple search terms to identify the top 100 most cited articles in refractive surgery. A publicly available database of more than 100,000 scientists that provides standardized information on multiple variables resulting in a composite indicator (C score) was searched to identify refractive surgery authors. A refractive surgery-specific composite score was created using only the authors' publications that were directly related to refractive surgery. RESULTS The 100 most cited articles and 40 refractive surgery authors with the highest ranked C score were identified. The article with the most citations by Trokel et al has garnered nearly 800 citations to date. All articles included in the top 100 had 200 or more citations. The peak publication years were 1998 to 2001. Laser in situ keratomileusis (22), photorefractive keratectomy (18), and postoperative corneal ectasia and/or corneal biomechanics (16) were the most represented topics. Emory University generated the most articles (7) and the majority of publications (48%) originated in the United States. Steven E. Wilson, MD, had the highest refractive C score and Jorge L. Alió, MD, PhD, had the most refractive surgery articles and citations. Among all authors listed, the average number of refractive surgery publications was 97, with 35% of the group having more than 100 refractive surgery articles published. All authors on the list had more than 2,000 citations for their refractive surgery articles, whereas 38% had 4,000 or more citations. CONCLUSIONS This list provides a comprehensive assessment of the most cited articles and authors in refractive surgery and demonstrates key focuses and trends in the field over time. [J Refract Surg. 2023;39(2):78-88.].
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Namkung S, Boyle AB, Li Y, Gokul A, McGhee C, Ziaei M. Repeatability and Agreement of Horizontal Corneal Diameter Measurements Between Scanning-Slit Topography, Dual Rotating Scheimpflug Camera With Placido Disc Tomography, Placido Disc Topography, and Optical Coherence Tomography. Cornea 2022; 41:1392-1397. [PMID: 34935660 DOI: 10.1097/ico.0000000000002964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to assess the repeatability and agreement of horizontal white-to-white (WTW) measurements using 4 different imaging modalities including a slit-scanning elevation topographer, dual rotating Scheimpflug camera and Placido Disc tomographer, Placido Disc topographer, and anterior segment optical coherence (OCT) tomographer. METHODS In this prospective study, 33 eyes of 33 healthy subjects were scanned 3 times using each of the Orbscan IIz, Sirius, Nidek OPD III, and DRI OCT Triton devices and WTW measurements were recorded. Repeatability was assessed using the intraclass correlation coefficient (ICC), and agreement was analyzed using Bland-Altman plots. RESULTS Mean WTW values obtained from the Orbscan IIz, Sirius, Nidek, and DRI OCT Triton devices were 11.76 ± 0.41, 12.10 ± 0.45, 12.14 ± 0.41, and 12.40 ± 0.48 mm, respectively. Overall, there was high repeatability, with the ICC >0.86 for all devices. The Sirius showed the highest repeatability (ICC = 0.993), and the Nidek the lowest (ICC = 0.870). All pairwise comparison showed significant differences in the mean WTW measurements ( P < 0.01) except between Sirius and Nidek ( P = 0.27). Mean differences showed that the DRI OCT Triton had the highest WTW values, followed by Nidek, Sirius, and finally by Orbscan, which provided the lowest measurements. All pairwise comparisons had wide limits of agreements (between 0.60 and 0.80 mm). CONCLUSIONS In healthy subjects the 4 devices demonstrated high repeatability in WTW measurement. However, a poor agreement between the devices suggests that they should not be used interchangeably for WTW measurements in clinical practice.
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Affiliation(s)
- Soobin Namkung
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
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Five Years Follow-Up of Acrysof Cachet® Angle-Supported Phakic Intraocular Lens Implantation for Myopia Correction. J Ophthalmol 2022; 2022:5362020. [PMID: 35378887 PMCID: PMC8976641 DOI: 10.1155/2022/5362020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/04/2021] [Accepted: 12/13/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The Acrysof Cachet® angle-supported phakic intraocular lens (pIOL) (Alcon Laboratories, Inc., Fort Worth, TX) is designed to correct high refractive errors in human eyes. The aim of this study was to evaluate the outcome of AcrySof Cachet® angle-supported pIOL implantation with particular regard to efficacy and safety of the implant over a 60-month follow-up period. Design Retrospective consecutive clinical case study. Methods Prior to pIOL implantation, patients had a complete ophthalmologic examination including objective and subjective refraction, uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA), endothelial cells density (ECD), slit lamp photography, optical coherence tomography (OCT), Scheimpflug digital videokeratoscopy, optical biometry, slit lamp examination, intraocular pressure (IOP) measurement, and pupillometry. Postoperatively, patients received yearly a complete eye examination. Results Thirty-one eyes of 16 patients were included in this study. The mean age was 36.2 ± 8.1 years. UCVA (logMAR) improved from 1.33 ± 0.20 before surgery to 0.08 ± 0.14 one year after surgery and was 0.20 ± 0.20 five years after surgery. CDVA (logMAR) improved from 0.10 ± 0.10 before surgery to 0.05 ± 0.13 one year after surgery and was 0.04 ± 0.14 five years postoperatively. The mean percentage of endothelial cells loss (ECL) was 11.51% over the first year and 15.95% five years after surgery. There were no intraoperative complications in any of the eyes. Conclusions Our results up to five years after implantation of the AcrySof Cachet® angle-supported pIOL demonstrated very good outcomes in all above shown measurements, including CDVA, UCVA, and ECD. However, since major endothelial cell loss may occur in some patients with this type of pIOL, regular follow-up visits are required.
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Choe GS, Kim KY. Comparison of Anterior Segment Measurements between Scheimpflug-Placido Camera and New Swept-source Optical Coherence Tomography. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.10] [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: We compared anterior segment measurements obtained using a Scheimpflug-Placido topographer (SIRIUS®, Costruzione Strumenti Oftalmici, Florence, Italy) and a new anterior module for a swept-source optical coherence tomography system (ANTERION®, Heidelberg Engineering Inc., Heidelberg, Germany).Methods: Anterior segment measurements were evaluated in 74 eyes of 101 patients with the two devices. Central corneal thickness (CCT), anterior chamber depth (ACD), corneal refractive power (K), J0 (Jackson cross-cylinder with axes at 180° and 90°), J45 vector (Jackson cross-cylinder with axes at 45° and 135°), and white-to-white corneal diameter (WTW) measurements obtained using the SIRIUS® system and the new anterior segment module of ANTERION® were compared.Results: The mean CCTs measured by SIRIUS® and ANTERION® were 558.69 ± 44.65 and 540.26 ± 36.57 μm, respectively. The difference was statistically significant (p < 0.005), and there were high correlations between the two methods (r = 0.915, p < 0.001). The mean ACD measurements were 3.34 ± 0.53 and 3.34 ± 0.51 mm (p = 0.856), respectively, for SIRIUS® and ANTERION®. The measurements were strongly correlated (r = 0.966, p < 0.001). The measurements of WTW, total mean K, and J0 obtained with the two systems differed significantly (p < 0.005, p = 0.017, and p < 0.005, respectively), with high correlations between the two systems (r = 0.875, r = 0.967, and r = 0.933, respectively; all p < 0.001).Conclusions: There were significant differences in measurements of K, CCT, WTW, and J0 between the two devices. Agreement analysis suggests that SIRIUS® and ANTERION® should not be used interchangeably.
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Sun Y, Hammer M, Yildirim TM, Khoramnia R, Auffarth GU. Pupil dynamics after in-the-bag versus anterior and retropupillary iris-fixated intraocular lens implantation. Sci Rep 2021; 11:21436. [PMID: 34728749 PMCID: PMC8564516 DOI: 10.1038/s41598-021-01051-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022] Open
Abstract
An Intraocular Lens (IOL) fixated on the iris either anteriorly, as a phakic IOL, or posteriorly, as an aphakic IOL, can influence pupil motility. In this interventional case series study, we evaluated pupil size under different levels of illumination (scotopic = 0.04 lx, low-mesopic = 0.4 lx and high-mesopic = 4 lx) for anterior iris-claw IOL fixation for correcting myopia or hyperopia (IFPH), retropupillary iris-claw IOL fixation to correct aphakia or as treatment for late in-the-bag IOL dislocation/subluxation (IFRP), and capsular-fixation IOL in-the-bag implantation (IB). Pupil size was measured preoperatively for the IFPH- and IB-group as well as 6 months after surgery for all groups. We analyzed a total of 70 eyes: 22 eyes of 11 patients with phakic IOLs, 22 eyes of 20 patients in the IFRP group and 26 eyes of 13 patients in the IB group. Both IFPH and IB showed a smaller postoperative scotopic pupil size, compared with the preoperative values. When compared to postoperative values of IB and IFPH, IFRP showed a significantly smaller postoperative scotopic pupil size (IFPH: 5.89 ± 0.83 mm, IFRP: 4.37 ± 0.83 mm, IB: 5.34 ± 0.98 mm, p < 0.001) while no differences were seen at high-mesopic lighting. Neither of the surgical techniques seems to impair the constriction of the pupil.
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Affiliation(s)
- Yanxiu Sun
- Department of Ophthalmology, Peking University Third Hospital, Northgarden Road 49, Haidian District, Beijing, 100191, China.,International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, Ruprecht-Karls University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Maximilian Hammer
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, Ruprecht-Karls University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Timur M Yildirim
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, Ruprecht-Karls University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, Ruprecht-Karls University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, Ruprecht-Karls University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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Yildirim TM, Khoramnia R, Son HS, Mayer CS, Łabuz G, Munro DJ, Auffarth GU. Reasons for explantation of phakic intraocular lenses and associated perioperative complications: cross-sectional explant registry analysis. BMC Ophthalmol 2021; 21:80. [PMID: 33579238 PMCID: PMC7879667 DOI: 10.1186/s12886-021-01847-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background We discuss the safety, since their introduction, of phakic intraocular lenses (pIOLs) to correct refractive errors in healthy eyes. We investigated the reasons for pIOL explantation and the associated perioperative complications. Methods This retrospective, cross-sectional study included 69 pIOLs, explanted at a single tertiary center between July 2005 and March 2020: 34 angle-supported (G1), 28 iris-fixated (G2) and seven posterior chamber (G3) pIOLs. Case data including the reason for explantation was taken from the patient records. Intra- and postoperative complications were evaluated for an association with the pIOL. Results The mean duration in the eye was 10.4 (0.2–28) years. Cataractogenesis and subsequent surgery that required pIOL explantation was the reason in 42% of all cases. In 22%, cataract in combination with endothelial damage prompted explantation, with 26, 18 and 14% for G1, G2 and G3 respectively. The second most common reasons were corneal damage alone in the angle-supported group (26%), IOL subluxation in the iris-fixated group (18%), and photopic disturbance in the posterior chamber group (29%). In 68% of all explantations, the surgical course was unremarkable, while in the remaining cases perioperative complications were associated with the lens in 45.7%. Conclusion Overall, the need for cataract surgery was the most common reason for pIOL explantation. Corneal complications were more frequent in the angle-supported pIOLs and their removal was associated with higher rates of complication compared to the other groups.
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Affiliation(s)
- Timur M Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christian S Mayer
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Grzegorz Łabuz
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Donald J Munro
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gerd U Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Duignan ES, Quigley C, Treacy MP, Aldouri A, O'Keefe M. Iris-fixated phakic intraocular lens explantation. Eur J Ophthalmol 2020; 31:988-993. [PMID: 32544989 DOI: 10.1177/1120672120934985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIMS To evaluate the visual outcomes and indication for surgery in a series of patients who underwent explantation of a phakic intraocular lens (PIOL). METHODS A retrospective case series of patients who underwent PIOL explantation in our institution was performed. The indication for explantation and visual and refractive outcomes were examined. The method of explantation is described. RESULTS Twenty-two eyes of 16 patients underwent PIOL explantation with a mean time to explantation of 7 ± 3 years (range 3-11.4). The mean age at explantation was 50.3 ± 9.3 years. Sixteen Artisan PIOLs and six Artiflex PIOLs were explanted. The indications for explanation were cataract development (17/22), endothelial cell loss (4/22) and synechiae formation (1/22). All patients with cataract underwent a combined procedure with explantation and phacoemulsification and the placement of a posterior chamber IOL. Mean corrected vision after explantation was 0.22 ± 0.10 logMAR (range 0.1-0.3 logMAR). One patient with endothelial cell loss required a Descemet's Stripping Endothelial Keratoplasty (DSEK). CONCLUSION Removal of PIOLs was necessitated most frequently by cataract followed by endothelial cell loss. Both explantation alone and explantation with concurrent phacoemulsification are safe procedures with good visual outcomes and will become more frequent in the future as more patients with PIOLs reach cataractous age.
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Choi JH, Lim DH, Nam SW, Yang CM, Chung ES, Chung TY. Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia. J Cataract Refract Surg 2019; 45:1555-1561. [DOI: 10.1016/j.jcrs.2019.06.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
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Gharaibeh AM, Liehneova I, Mojzis P, Ziak P, Alió JL. Iris and ciliary body cysts and phakic intraocular lenses. Eur J Ophthalmol 2019; 30:974-977. [PMID: 31544491 DOI: 10.1177/1120672119876532] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Phakic intraocular lenses are used to correct refractive errors. The procedure is predictable and potentially reversible. The procedure is not free of complications though. The occurrence of iris cyst after implantation of a phakic intraocular lens was not described previously in the literature. We describe two cases of iris cysts in the presence of a phakic intraocular lens; the first case describes a cyst which was not present prior to the anterior chamber phakic intraocular lens implantation. The second case describes a hidden iris cyst that affected the posterior chamber phakic intraocular lens position and lead to glaucoma.
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Affiliation(s)
- A M Gharaibeh
- Vissum Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | | | - P Mojzis
- Premium Clinic, Teplice, Czech Republic
| | - P Ziak
- Eye Clinic, Jessenius Faculty of Medicine, Martin, Slovakia
| | - Jorge L Alió
- Vissum Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain
- Division of ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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Al-Qahtani S, Al-Afraj K, Al-Jindan M, Al-Beshri AS, Khandekar R. Short and long-term outcomes of angle supported phakic intraocular lens implantation in high myopic eyes. Int J Ophthalmol 2018; 11:888-890. [PMID: 29862192 PMCID: PMC5957045 DOI: 10.18240/ijo.2018.05.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 03/01/2018] [Indexed: 11/23/2022] Open
Abstract
This cohort study included 36 eyes of 21 patients with high myopia treated with angle supported phakic intraocular lens (pIOL). Endothelial cell density (ECD) at baseline, 6mo and 3y were 3017±296, 2775±265 and 2558±299 cells/mm2 respectively. ECD loss at 6mo was 7.2% and annual ECD loss was 3% over 36mo. Corrected distance visual acuity at 36mo was 0.4 logMAR or better in 32 (88.9%) eyes. Intraocular pressure did not change (P=0.9). No eyes developed cataract, retinal detachment or pupillary distortion. Angle supported pIOL gives good visual outcome. Endothelial cell loss should be monitored.
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Affiliation(s)
- Saeed Al-Qahtani
- Department of Surgery, Faculty of Medicine, Najran University, Najran 61441, Saudi Arabia
| | - Khalid Al-Afraj
- Department of Ophthalmology, Dammam University, Dammam 34464, Saudi Arabia
| | - Mohanna Al-Jindan
- Department of Ophthalmology, Dammam University, Dammam 34464, Saudi Arabia
| | - Ali S Al-Beshri
- Research Department, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia
| | - Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia
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Schultz T, Schwarzenbacher L, Dick HB. Comparing Femtosecond Laser-Assisted Cataract Surgery Before and After Phakic Intraocular Lens Removal. J Refract Surg 2018; 34:343-346. [PMID: 29738591 DOI: 10.3928/1081597x-20180301-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/21/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate two approaches for femtosecond laser-assisted cataract surgery (FLACS) in patients with phakic intraocular lenses (IOLs). METHODS Anterior capsulotomy and lens fragmentation were performed with an image-guided femtosecond laser. Laser treatment was performed under sterile conditions prior to (technique 1, 5 cases) or after (technique 2, 5 cases) phakic IOL explantation. RESULTS In technique 1, gas accumulated between the phakic IOL and the anterior capsule. In 2 (40%) of these cases, an anterior capsule tear occurred during phacoemulsification. In both cases, no anterior vitrectomy was necessary and the IOL was implanted into the capsular bag. In technique 2, no anterior capsule tears or other complications occurred. CONCLUSIONS Laser treatment prior to phakic IOL explantation has a risk for anterior capsule tears. Potentially, the laser beam is deflected by the optic of the phakic IOL and gas between the anterior capsule and the phakic IOL induces radial forces. [J Refract Surg. 2018;34(5):343-346.].
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Ghoreishi M, Abdi-Shahshahani M, Peyman A, Pourazizi M. A model for predicting sulcus-to-sulcus diameter in posterior chamber phakic intraocular lens candidates: correlation between ocular biometric parameters. Int Ophthalmol 2018; 39:661-666. [PMID: 29468555 DOI: 10.1007/s10792-018-0859-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/03/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to determine the correlation between ocular biometric parameters and sulcus-to-sulcus (STS) diameter. METHODS This was a cross-sectional study of preoperative ocular biometry data of patients who were candidates for phakic intraocular lens (IOL) surgery. Subjects underwent ocular biometry analysis, including refraction error evaluation using an autorefractor and Orbscan topography for white-to-white (WTW) corneal diameter and measurement. Pentacam was used to perform WTW corneal diameter and measurements of minimum and maximum keratometry (K). Measurements of STS and angle-to-angle (ATA) were obtained using a 50-MHz B-mode ultrasound device. Anterior optical coherence tomography was performed for anterior chamber depth measurement. Pearson's correlation test and stepwise linear regression analysis were used to find a model to predict STS. RESULTS Fifty-eight eyes of 58 patients were enrolled. Mean age ± standard deviation of sample was 28.95 ± 6.04 years. The Pearson's correlation coefficient between STS with WTW, ATA, mean K was 0.383, 0.492, and - 0.353, respectively, which was statistically significant (all P < 0.001). Using stepwise linear regression analysis, there is a statistically significant association between STS with WTW (P = 0.011) and mean K (P = 0.025). The standardized coefficient was 0.323 and - 0.284 for WTW and mean K, respectively. The stepwise linear regression analysis equation was: (STS = 9.549 + 0.518 WTW - 0.083 mean K). CONCLUSION Based on our result, given the correlation of STS with WTW and mean K and potential of direct and essay measurement of WTW and mean K, it seems that current IOL sizing protocols could be estimating with WTW and mean K.
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Affiliation(s)
- Mohammad Ghoreishi
- Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.,Parsian Vision Science Research Institute, Isfahan, Iran
| | - Mehdi Abdi-Shahshahani
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Ophthalmology, Feiz Hospital, Modares St., Isfahan, Iran.
| | - Alireza Peyman
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Pourazizi
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Jirásková N, Rozsíval P, Kohout A. A Survey of Intraocular Lens Explantation: A Retrospective Analysis of 23 IOLs Explanted during 2005. Eur J Ophthalmol 2018; 17:579-87. [PMID: 17671934 DOI: 10.1177/112067210701700416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To evaluate the indications, lens styles, perioperative findings, and results of intraocular lens (IOL) explantation or exchange performed in the authors department in 2005. Methods The retrospective analysis comprised 22 patients (23 eyes). Twenty-one eyes had previous phacoemulsification and IOL implantation, one eye secondary aphakic IOL, and one eye phakic IOL implantation. The indications for IOL explantation/exchange and perioperative complications were evaluated. The best-corrected visual acuity (BCVA) before and after surgery was compared. Results Time from initial surgery to explantation/exchange varied from 1 to 121 months, median value was 46 months. The IOLs were explanted using local anesthesia and in 21 eyes replaced with new lens. Indications for IOL removal were opacification of the IOL in 12 eyes, malposition of the IOL in 5 eyes, postoperative refractive error in 2 eyes, recurrent toxic anterior segment syndrome in 1 eye, pseudophakic dysphotopsia in 1 eye, endothelial cell loss in phakic anterior chamber IOL in 1 eye, and visual discomfort with intraocular telescopic lens in 1 eye. The mean BCVA (decimal scale) before and after IOL explantation/exchange was 0.562±0.279 and 0.627±0.276, respectively. There was no significant difference in visual acuity before and after IOL exchange (Wilcoxon test). Conclusions The most frequent indications for IOL explantation/exchange were opacification of the IOL and IOL malposition. Surgeries were uneventful in most cases. Final visual results have been largely good. Long-term follow-up of patients with various types of IOLs should be maintained.
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Affiliation(s)
- N Jirásková
- Department of Ophthalmology, Faculty of Medicine and University Hospital, Charles University, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
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Abstract
PURPOSE To assess efficacy and safety of the combination of angle-supported phakic intraocular lenses (IOLs) and photorefractive keratectomy (PRK) for the correction of myopia and astigmatism. METHODS Prospective, non-randomized single-surgeon study on 48 patients (76 eyes) undergoing angle-supported phakic IOL implantation with surgical peripheral iridectomy, followed 2 to 3 months later by PRK to correct residual refractive error. Twenty-three patients (33 eyes) achieved good uncorrected visual acuity with IOL implantation alone and did not undergo PRK. Thus, the study was completed by 25 patients (43 eyes) with preoperative mean defocus equivalent (DEQ) of 15.73 D (SD 4.67 D) and mean astigmatism of -2.87 D (SD 1.39 D). RESULTS Eight months after PRK, mean spherical equivalent was -0.08. Mean DEQ was 0.47 D (SD 0.37); 42/43 eyes (98%) were within +/-1 D of DEQ, and 33/43 eyes (77%) within +/-0.5 D. Mean uncorrected visual acuity was 0.7 (SD 1.9). Safety index was 1.25; efficacy index 1.11. Best-corrected visual acuity improvement (0.16) was statistically significant (95% CI: 1.1 to 2). Halos were moderate in 6/25 patients (24%); severe in 1/25 patients (4%). Endothelial cell density decreased by -6.6%. Pain after PRK was severe in 3/25 patients (12%) and moderate in 13/25 patients (52%). Complications were recurrent iridocyclitis in one eye, transient ocular hypertension in two eyes, and incomplete iridectomy in one eye. CONCLUSIONS Angle-supported phakic IOLs followed by adjustment by PRK offer good efficacy, predictability, and safety to manage large refractive myopic errors.
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Lee JH, Ryu GW, Park BG. Changes in Ocular Biometrics Measured after Implantation of a Phakic Intraocular Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.3.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jung Hoo Lee
- Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | | | - Byung Gun Park
- Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Kim JM, Kang MS, Jin KH. Comparison of Anterior Segment Measurements between Scheimpflug Camera and New Module of Optical Coherence Tomography. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.7.613] [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)
- Jae Min Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Min Seok Kang
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyung Hyun Jin
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
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Refractive Errors & Refractive Surgery Preferred Practice Pattern®. Ophthalmology 2018; 125:P1-P104. [DOI: 10.1016/j.ophtha.2017.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022] Open
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Kohnen T, LaFontaine L, Andrew R. Long-term safety follow-up of an anterior chamber angle-supported phakic intraocular lens. J Cataract Refract Surg 2017; 43:1163-1170. [DOI: 10.1016/j.jcrs.2017.06.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 05/11/2017] [Accepted: 06/10/2017] [Indexed: 11/15/2022]
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Hengerer FH, Conrad-Hengerer I. Phake Intraokularlinsen. AUGENHEILKUNDE UP2DATE 2017. [DOI: 10.1055/s-0042-122806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungDie Implantation von phaken Intraokularlinsen stellt eine etablierte Therapieform zur Korrektur von höhergradigen Ametropien bei Myopie und Hyperopie sowie kombinierten Refraktionszuständen mit Astigmatismen dar. Bei der Anwendung sind gewisse anatomische und refraktive Voraussetzungen zu beachten. Der Artikel beschreibt die aktuell gängigen Verfahren und Intraokularlinsensysteme unter besonderer Berücksichtigung der Möglichkeiten und Grenzen.
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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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Aerts AAS, Jonker SMR, Wielders LHP, Berendschot TTJM, Doors M, De Brabander J, Nuijts RMMA. Phakic intraocular lens: Two-year results and comparison of endothelial cell loss with iris-fixated intraocular lenses. J Cataract Refract Surg 2016; 41:2258-65. [PMID: 26703303 DOI: 10.1016/j.jcrs.2015.10.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/05/2014] [Accepted: 01/12/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the efficacy, safety, and stability of a foldable angle-supported Acrysof Cachet phakic intraocular lens (pIOL) to correct moderate to high myopia and compare endothelial cell loss after iris-fixated Artisan and Artiflex pIOL implantation. SETTING University Eye Clinic Maastricht, the Netherlands. DESIGN Retrospective observational study. METHODS Foldable angle-supported pIOL implantation for myopia ranging from -6.0 to -16.5 diopters (D) was done. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, spherical equivalent (SE), and adverse events were documented preoperatively and 6 months and 1 and 2 years postoperatively. Endothelial cell loss after implantation of the foldable angle-supported pIOL and iris-fixated pIOLs was compared 6 months and 1 and 2 years postoperatively. RESULTS There were 158 eyes. The UDVA was equal to or more than 20/25 in 95% of eyes at 1 and 2 years postoperatively. The mean SE was -0.17 D ± 0.43 (SD) 2 years postoperatively. One patient developed pupil ovalization, resulting in explantation of the pIOL from both eyes. Acute endothelial cell loss in the foldable angle-supported pIOL group was -3.2% ± 0.7%, significantly higher than after iris-fixated pIOL implantation. Chronic endothelial cell loss from 6 to 24 months after surgery was -3.8% ± 0.7%. At the 2-year follow-up, the chronic endothelial cell loss in the foldable angle-supported pIOL group was not different than with iris-fixated pIOLs (P > .05). CONCLUSIONS The foldable angle-supported pIOL effectively corrected moderate to high myopia. However, acute surgical endothelial cell loss was significantly higher than with iris-fixated pIOLs. FINANCIAL DISCLOSURE Dr. Nuijts is a consultant to Alcon Laboratories, Inc., Théa Pharma GmbH, and ASICO LLC; he has received study grants from Acufocus, Inc., Alcon Laboratories, Inc., Carl Zeiss Meditec AG, Ophtec BV, and Physiol S.A. No other author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Andreas A S Aerts
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Soraya M R Jonker
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Laura H P Wielders
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Muriël Doors
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - John De Brabander
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rudy M M A Nuijts
- From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
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Alió JL, Plaza-Puche AB, Cavas F, Yébana Rubio P, Sala E. An angle-supported foldable phakic intraocular lens for correction of myopia: A five-year follow-up. ACTA ACUST UNITED AC 2016; 92:4-11. [PMID: 27453580 DOI: 10.1016/j.oftal.2016.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/27/2016] [Accepted: 05/30/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of an angle-supported foldable phakic intraocular lens (pIOL) for the correction of moderate to high myopia after 5 years follow-up. METHODS Prospective and retrospective, observational, longitudinal, non-randomised consecutive series of cases conducted on a total of 100 eyes of 67 patients with moderate to high myopia implanted with an Acrysof Cachet pIOL (Alcon Laboratories Inc.) with the aim of minimising the refractive error. The ages ranged between 18 to 60years. Uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity (CDVA), endothelial cells density, pIOL position, intraocular pressure, and complications were recorded preoperatively and during the 5 year follow-up. RESULTS Five years after implantation, the mean manifest spherical equivalent refraction reduced significantly from -11.62±3.35 dioptres (D) to -0.33±0.85D. UDVA was 20/20 or better in 5 of 25 cases (20%), and 20/40 or better in 22 cases (88%). CDVA was 20/20 or better in 17 cases (68%), and 20/32 or better in 23 cases (92%) of eyes. The residual refractive error was within ±0.50D of emmetropia in 12 cases (48%), and within ±1.00D in 19 cases (76%). Mean endothelial cell loss at 5 years was 11.8% central, and 13.7% peripheral. Mean endothelium-pIOL distance was 2.11±0.18mm, and mean pIOL-crystalline distance was 0.88±0.20mm. CONCLUSIONS This angle supported pIOL provided a favourable refractive correction and predictability, as well as acceptable safety in patients with moderate to high myopia. Although endothelial cell density decreased over 5years, the results are within the range reported in previous studies with other pIOLs.
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Affiliation(s)
- J L Alió
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España; División de Oftalmología, Departamento de Patología y Cirugía, Universidad Miguel Hernández, Alicante, España.
| | - A B Plaza-Puche
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España
| | - F Cavas
- Departamento de Expresión Gráfica, Universidad Politécnica de Cartagena, Cartagena, Murcia, España
| | - P Yébana Rubio
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España
| | - E Sala
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España
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Prakash G, Philip R, Bacero R, Srivastava D. Multivariate Analysis to Predict the Horizontal Anterior Chamber Diameter from Other Anterior Chamber Parameters Using Scheimpflug Imaging: Is There a Better Method Than Adding a Fixed Constant? Curr Eye Res 2016; 42:58-64. [PMID: 27266440 DOI: 10.3109/02713683.2016.1151529] [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: 11/13/2022]
Abstract
PURPOSE To evaluate the predictive association between the horizontal anterior chamber diameter (HACD) and other measurements using Scheimpflug imaging, and to assess whether a method superior to using fixed constants can be proposed. METHODS This hospital-based study was performed in the Cornea and Refractive Surgery Services, New Medical Center (NMC) specialty hospital, Abu Dhabi. Initially, 100 candidates were included serially in the model building group (group1). All candidates underwent detailed evaluation and Scheimpflug imaging (CSO, Sirus, Italy). Subsequently, another 100 candidates were included serially in the validation group (group 2). Candidates in both groups underwent the same tests. RESULTS In group 1, the mean HACD was 12.25 ± 0.48 mm. This measurement correlated significantly with the horizontal visible iris diameter (HVID), anterior chamber depth, angle (ACA), and volume (ACV) (r = 0.2-0.7). The overall regression equation was HACD = 5.62 + 0.01 × ACV + 0.45 × HVID - 0.013 × ACA (adjusted R2 = 0.66, p < 0.001). Situation-based equations derived from the outcomes of group 1 were tested in group 2. Equation A included all factors found significant during model-building, Equation B included only non-volumetric significant factors, and situation C only included the HVID. Equations D through F used direct substitution by HVID plus a constant to predict HACD (the constant was 0.0, 0.5, and 1.0 for Equations D, E, and F, respectively). The predicted HACD (pHACD) was within ±0.5 mm of the actual HACD (aHACD) in 93%, 88%, 87%, 83%, 69%, and 16% case for Equations A, B, C, D, E, and F, respectively. The mean prediction error was -0.14 ± 0.27 mm (p = 0.08), -0.15 ± 0.28 mm (p = 0.03), -0.18 ± 0.30 mm (p = 0.001), -0.18 ± 0.32 mm (p < 0.001), 0.33 ± 0.35 mm (p < 0.001), and 0.83 ± 0.35 mm (p < 0.001) for Equations A, B, C, D, E, and F, respectively. CONCLUSION Regression equations using Scheimpflug-derived anterior chamber parameters may predict HACD to varying degrees, depending on the input parameters. Adding 0.5 or 1.0 mm to the corneal diameter (CD) to estimate the HACD is not recommended.
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Affiliation(s)
- Gaurav Prakash
- a Cornea and Refractive Surgery Services, NMC Eye Care , New Medical Center Specialty Hospital , Abu Dhabi , United Arab Emirates
| | - Reena Philip
- a Cornea and Refractive Surgery Services, NMC Eye Care , New Medical Center Specialty Hospital , Abu Dhabi , United Arab Emirates
| | - Ruthchel Bacero
- a Cornea and Refractive Surgery Services, NMC Eye Care , New Medical Center Specialty Hospital , Abu Dhabi , United Arab Emirates
| | - Dhruv Srivastava
- a Cornea and Refractive Surgery Services, NMC Eye Care , New Medical Center Specialty Hospital , Abu Dhabi , United Arab Emirates
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Long-Term Observation of Triplex Surgery for Cataract after Phakic 6H Implantation for Super High Myopia. J Ophthalmol 2016; 2016:9569868. [PMID: 27190642 PMCID: PMC4848451 DOI: 10.1155/2016/9569868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/09/2016] [Accepted: 02/24/2016] [Indexed: 12/31/2022] Open
Abstract
Purpose. To analyze the safety, effectiveness, and stability of triplex surgery for phakic 6H anterior chamber phakic intraocular lens explantation and phacoemulsification with in-the-bag IOL implantation for super high myopia in long-term observations. Methods. This retrospective case series evaluated 16 eyes of 10 patients who underwent triplex surgery. Best corrected visual acuity (BCVA), endothelial cell density (ECD), and associated adverse events were evaluated. Results. The mean follow-up time after the triplex surgery was 46 ± 14 months. The mean logMAR BCVA was significantly improved after triplex surgery (P = 0.047). One eye developed endophthalmitis five days postoperatively and underwent pars plana vitrectomy (PPV). Five eyes with preoperative severe endothelial cell loss developed corneal decompensation and underwent keratoplasty at a mean time of 9.4 ± 2.6 months after the triplex surgery. One eye had graft failure and underwent a second keratoplasty. The eye developed rhegmatogenous retinal detachment and underwent PPV with silicone oil 18 months later. ECD before the triplex surgery was not significantly different compared with that at last follow-up (P = 0.495) apart from these five eyes. Three eyes (18.8%) developed posterior capsule opacification. Conclusions. Triplex surgery was safe and effective for phakic 6H related complicated cataracts. Early extraction before severe ECD loss is recommended.
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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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Kohnen T, Maxwell WA, Holland S. Correction of Moderate to High Myopia with a Foldable, Angle-Supported Phakic Intraocular Lens: Results from a 5-Year Open-Label Trial. Ophthalmology 2016; 123:1027-35. [PMID: 26875005 DOI: 10.1016/j.ophtha.2015.12.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/14/2015] [Accepted: 12/17/2015] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the 5-year efficacy of a foldable, hydrophobic, angle-supported phakic intraocular lens (pIOL) when used to correct moderate to high myopia. DESIGN Prospective, nonrandomized, multicenter, open-label cohort study conducted in the United States, the European Union, and Canada (3 separate protocols). PARTICIPANTS This was a pooled analysis of 515 eyes from 360 patients 18 to 49 years of age with moderate to high myopia (preoperative corrected distance visual acuity [CDVA] ≤0.34 logarithm of the minimum angle of resolution [logMAR]) and with variance in the manifest refraction spherical equivalent within ±0.5 diopter (D) for a minimum of 12 months. INTERVENTION Implantation of the AcrySof Cachet angle-supported anterior chamber pIOL (Alcon Laboratories, Inc., Fort Worth, TX). MAIN OUTCOME MEASURES Uncorrected distance visual acuity (UDVA), CDVA, predictability and stability of manifest refraction spherical equivalent (MRSE), serious adverse events, endothelial cell density, and patient satisfaction. RESULTS Of 360 patients who received implantation in at least 1 eye (515 eyes), 326 (90.6%) completed the study (5-year best-corrected visual acuity data available for 415 eyes). At 5 years, a decrease in CDVA of 2 lines or more was observed in 0.5% of eyes (n = 2/415) compared with preoperative baseline. At 5 years, all 415 eyes achieved a CDVA of 0.34 logMAR or less; 91.3% (n = 379/415) had a CDVA of 0.04 logMAR or less. Mean UDVA ± standard deviation (SD) was 0.01±0.18 logMAR; 94.7% (n = 393/415) and 66.3% (n = 275/415) of eyes had a UDVA of 0.34 logMAR or less or 0.04 logMAR or less, respectively, at 5 years. Mean MRSE ± SD was -0.34±0.57 D (range,-2.50 to 1.63 D). Most eyes (89.8%; n = 371/413) had an MRSE within ±1.00 D of their target refractive error at 5 years and 67.3% (n = 278/413) were within ±0.50 D. Mean annualized central endothelial cell loss was 1.46% (90% confidence interval [CI], -1.6% to -1.3%) from 6 months to 5 years. The most common pIOL-related serious adverse event was adhesion between the cornea and the iris (synechia; n = 24). Most patients (98.1%) indicated that they would have the same pIOL implanted again. CONCLUSIONS In patients with moderate to high myopia, the AcrySof Cachet angle-supported pIOL provided excellent refractive correction for up to 5 years after implantation, with a low rate of mean central endothelial cell loss. Careful patient selection is necessary to achieve optimal postsurgical outcomes.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany.
| | | | - Simon Holland
- Department of Ophthalmology, University of British Columbia, Vancouver, Canada, and Pacific Laser Eye Centre, Vancouver, Canada
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Bouheraoua N, Bonnet C, Labbé A, Sandali O, Lecuen N, Ameline B, Borderie V, Laroche L. Iris-fixated phakic intraocular lens implantation to correct myopia and a predictive model of endothelial cell loss. J Cataract Refract Surg 2015; 41:2450-7. [PMID: 26703496 DOI: 10.1016/j.jcrs.2015.05.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/12/2015] [Accepted: 05/18/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE To report long-term results of Artisan phakic intraocular lens (pIOL) to correct myopia and to propose a model predicting endothelial cell loss after pIOL implantation. SETTING Quinze-Vingts National Ophthalmology Hospital, Paris, France. DESIGN Retrospective, interventional case series. METHODS Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and central endothelial cell count (ECC) were determined before and at yearly intervals up to 5 years after pIOL implantation. Linear model analysis was performed to present a model that describes endothelial cell loss as a linear decrease and an additional decrease depending on postoperative loss. RESULTS A total of 49 patients (68 eyes) implanted with pIOLs from January 2000 to January 2009 were evaluated. The mean preoperative and final spherical equivalent (SE) were -13 ± 4.10 and -0.75 ± 0.74 diopters (D), respectively. The mean preoperative and final central ECC were 2629 ± 366 and 2250 ± 454 cells/mm(2), respectively. There were no intraoperative complications for any of the eyes. One eye required surgery for repositioning the pIOL, and 1 eye required pIOL exchange for postoperative refractive error. The model predicted that for patients with preoperative ECC of 3000, 2500, and 2000 cells/mm(2), a critical ECC of 1500 cells/mm(2) will be reached at 39, 28, and 15 years after implantation, respectively. CONCLUSIONS Implantation of the pIOL was an effective and stable procedure after 5 years of follow-up. The presented model predicted EC loss after pIOL implantation, which can assist ophthalmologists in patient selection and follow-up. FINANCIAL DISCLOSURE The authors report no conflict of interest.
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Affiliation(s)
- Nacim Bouheraoua
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France.
| | - Clemence Bonnet
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Antoine Labbé
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Otman Sandali
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Nicolas Lecuen
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Barbara Ameline
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Vincent Borderie
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Laurent Laroche
- From the Quinze-Vingts National Ophthalmology Hospital (Bouheraoua, Bonnet, Sandali, Lecuen, Ameline, Borderie, Laroche), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; INSERM UMR S 968 (Bouheraoua, Labbé, Borderie, Laroche), Institut de la Vision, Paris, France; Sorbonne Universités (Bouheraoua, Labbé, Borderie, Laroche), UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS (Bouheraoua, Labbé, Borderie, Laroche), UMR 7210, Paris, France; Quinze-Vingts National Ophthalmology Hospital (Labbé), and Ambroise Paré Hospital (AP-HP), Versailles Saint Quentin en Yvelines University, Versailles, France
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Gimbel HV, Norton NR, Amritanand A. Angle-supported phakic intraocular lenses for the correction of myopia: Three-year follow-up. J Cataract Refract Surg 2015; 41:2179-89. [PMID: 26703294 DOI: 10.1016/j.jcrs.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/26/2015] [Accepted: 04/09/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate patient safety and refractive outcomes in eyes with an angle-supported phakic intraocular lens (pIOL), and to assess the correlation between rotation and corneal endothelial cell damage. SETTING Gimbel Eye Centres, Calgary and Edmonton, Alberta, Canada. DESIGN Retrospective cohort study. METHODS This study included patients with moderate to high myopia (range -6.50 to -19.50 diopters [D]) who received the Acrysof Cachet pIOL. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity, manifest refraction spherical equivalent (MRSE), endothelial cell density (ECD), and IOL rotation. RESULTS This study evaluated 119 eyes of 61 patients. The mean ECD decrease from preoperative measurements was 3.11% (n = 46), with a mean IOL rotation of 10.6 degrees (n = 35) at the 3-year postoperative visit. Of the 49 eyes at the 3-year visit measured for UDVA, 98.0% were 20/40 or better and 77.6% were 20/20 or better. The MRSE improved from a preoperative mean of -9.26 diopters (D) ± 2.43 (SD) (range -19.50 to -5.63 D) to -0.33 ± 0.61 D (range -3.12 to +0.71 D) at the 3-year visit. The residual refractive error was within ±0.50 D of the target refraction for 78.4% and within ±1.00 D for 92.2% of the 51 eyes. The study included one bilateral pIOL removal due to endothelial cell loss, one case of synechia, and one case of subtle pupil ovalization. CONCLUSIONS No correlation between IOL rotation and ECD decrease was found (R(2) = 0.0143); the pIOL provided promising refractive outcomes and acceptable safety in patients with moderate to high myopia. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Howard V Gimbel
- From the Gimbel Eye Centre (Gimbel, Amritanand), Calgary, Alberta, Canada; Loma Linda University (Gimbel, Norton), Loma Linda, California, USA.
| | - Nicholas R Norton
- From the Gimbel Eye Centre (Gimbel, Amritanand), Calgary, Alberta, Canada; Loma Linda University (Gimbel, Norton), Loma Linda, California, USA
| | - Anika Amritanand
- From the Gimbel Eye Centre (Gimbel, Amritanand), Calgary, Alberta, Canada; Loma Linda University (Gimbel, Norton), Loma Linda, California, USA
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Olivo-Payne A, Gomez-Bastar A, Lichtinger A, Ramirez-Miranda A, Graue-Hernandez EO, Navas A. More Than a Decade of Experience With Implantable Collamer Lens. J Refract Surg 2015; 31:854. [PMID: 26653733 DOI: 10.3928/1081597x-20151118-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Moya T, Javaloy J, Montés-Micó R, Beltrán J, Muñoz G, Montalbán R. Implantable Collamer Lens for Myopia: Assessment 12 Years After Implantation. J Refract Surg 2015; 31:548-56. [PMID: 26248348 DOI: 10.3928/1081597x-20150727-05] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 06/17/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the long-term refractive and visual stability and the risks related to the implantation of Implantable Collamer Lens (ICL; STAAR Surgical, Monrovia, CA) phakic intraocular lens (PIOL) for myopia. METHODS This retrospective, consecutive, cumulative clinical study was performed in a group of 144 eyes implanted with ICL PIOL for myopia. Only the cases with clinical data available 12 years after the implantation were included in the series. Corrected distance visual acuity (CDVA), uncorrected distance visual acuity, spherical equivalent, refractive astigmatism, endothelial cell density, ICL vaulting, and postoperative complications were analyzed. RESULTS Mean spherical equivalent refraction was -16.90±4.26 diopters (D) preoperatively and -1.77±1.93 D 12 years postoperatively. Mean CDVA at the first and last visit were 0.31±0.19 logMAR and 0.22±0.22 logMAR, respectively (Mann-Whitney U test, P<.001). Twelve years postoperatively, 8.9% of eyes had lost more than two lines of CDVA. The incidence of clinically relevant cataracts (13.88%) was significantly linked to the use of the V3 model ICL (chi-square test, P=.007). During the follow-up period, a significant reduction in PIOL vaulting was observed (Kruskal-Wallis test, P<.05), and the mean endothelial cell density decreased by 19.75%. CONCLUSIONS The ICL PIOL provided good refractive outcomes and stability in the long term. The incidence of cataracts is low when the latest models of this PIOL are used.
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Fan S, Sun Y, Yang X, Dai C, Ren Q, Zheng H, Zhou C. Whole eye segment imaging and measurement with dual-channel spectral-domain OCT. Ophthalmic Surg Lasers Imaging Retina 2015; 46:186-94. [PMID: 25707043 DOI: 10.3928/23258160-20150213-25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 11/06/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES To image and measure whole eye segments using dual-channel spectral-domain optical coherence tomography (SD-OCT) and to compare the results with those from the IOLMaster (Carl Zeiss Meditec, Dublin, CA). PATIENTS AND METHODS Twenty eyes of 20 volunteers were recruited. Ocular dimensions, including cornea thickness, anterior chamber depth (ACD), lens thickness, anterior lens surface curvature, and axial length (AL), were calculated. The reproducibility of SD-OCT measurements, statistical significance of inter-instrument difference, correlation, and agreement were evaluated. RESULTS No significant differences were found between independent SD-OCT measurements (P > .05). The ACD and AL measured with IOLMaster were significantly shorter than those from SD-OCT (P < .001). There were high correlations and agreements in ACD (r = 0.994; 95% limits of agreement [LOA], 0.131-0.223 mm) and AL (r = 0.998; 95% LOA, 0.678-0.853 mm) between the two methods. CONCLUSION Dual-channel SD-OCT was demonstrated to have good repeatability in imaging and measuring whole eye segments. The results had high correlations and agreements with those from the IOLMaster.
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Kim MK, Lee H, Lee HK, Seo KY, Kim EK, Kim TI. Incidence of Retinal Lesions before and after Refractive Surgery and Preoperative Prophylactic Laser Treatment. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.11.1671] [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)
- Min Kyo Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
- Siloam Eye Hospital, Seoul, Korea
| | - Hoon Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Keun Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Yul Seo
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Kweon Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Akil H, Dhubhghaill SN, Tassignon MJ. Iris atrophy and erosion caused by an anterior-chamber angle-supported phakic intraocular lens. J Cataract Refract Surg 2014; 41:226-9. [PMID: 25532647 DOI: 10.1016/j.jcrs.2014.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED We report a case in which an angle-supported phakic IOL was implanted to correct high myopia. Subsequently, the patient experienced photophobia, glare, halo, and loss of visual acuity and became concerned about the cosmetically deforming aspect of her eye. Findings included endothelial cell loss, cataract, pupil ovalization, and severe iris atrophy. The pIOL was removed and cataract surgery was performed, followed by implantation of a bag-in-the-lens IOL, but successful surgical repair of the iris was not possible because of severe iris atrophy. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Handan Akil
- From the Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium.
| | | | - Marie-José Tassignon
- From the Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
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Alió JL, Toffaha BT, Peña-Garcia P, Sádaba LM, Barraquer RI. Phakic intraocular lens explantation: causes in 240 cases. J Refract Surg 2014; 31:30-5. [PMID: 25486676 DOI: 10.3928/1081597x-20141202-01] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/14/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE To describe the main causes of explantation of phakic intraocular lenses (PIOLs) according to the anatomical site of implantation (angle supported, iris fixated, or posterior chamber). METHODS This multicentric, retrospective, and consecutive study sponsored by the Spanish Ministry of Health comprised a total of 240 eyes (226 patients) explanted due to PIOL complications. Clinical data of 144 angle-supported lenses, 24 iris-fixated lenses, and 72 posterior chamber lenses explanted were recorded preoperatively and postoperatively. RESULTS Mean age of the patients at explantation was 46.30 ± 11.84 years (range: 25 to 80 years). The mean time between implantation and explantation was 381.14 ± 293.55 weeks (range: 0.00 to 1,551.17 weeks). It was 422.33 ± 287.81 weeks for the angle-supported group, 488.03 ± 351.95 weeks for the iris-fixated group, and 234.11 ± 4,221.60 weeks for the posterior chamber group. It was 8.10 ± 5.52 years for the angle-supported group, 9.36 ± 6.75 years for the iris-fixated group, and 4.49 ± 4.25 years for the posterior chamber group. This period of time was significantly shorter in the posterior chamber group (P < .001). Overall, the main causes of explantation were cataract formation (132 eyes, 55%), endothelial cell loss (26 eyes, 10.83%), corneal decompensation (22 eyes, 9.17%), PIOL dislocation/decentration (16 eyes, 6.67%), inadequate PIOL size or power (12 eyes, 5%), and pupil ovalization (10 cases, 4.17%). Cataract development was the cause of explantation in 51.39% of angle-supported cases, 45.83% of iris-fixated cases, and 65.28% of posterior chamber cases. Endothelial cell loss was the cause of explantation in 15.97% of angle-supported PIOLs, 8.33% of iris-fixated PIOLs, and 1.39% of posterior chamber PIOLs. CONCLUSIONS Cataract is the main cause of PIOL explantation, especially in posterior chamber PIOLs. In the angle-supported group, endothelial cell loss was the second cause of explantation.
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Baumeister M. [Scheimpflug photography for the examination of phakic intraocular lenses]. Ophthalmologe 2014; 111:935-41. [PMID: 25332044 DOI: 10.1007/s00347-013-2963-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND High myopia phakic intraocular lenses (IOL) have become an established means of surgical correction for high ametropia. Scheimpflug photography is one of the methods which are frequently applied for postoperative examination of the implants. MATERIAL AND METHODS Results from published studies employing Scheimpflug photography for examination of anterior chamber angle-fixated, iris-fixated and sulcus-fixated phakic IOLs were evaluated. RESULTS In several published studies Scheimpflug photography was used to examine the position of the implant and opacification of the crystalline lens. The results provided valuable evidence for the improvement of phakic IOL design. CONCLUSION Scheimpflug photography offers an easy to use, rapid non-contact examination of phakic IOLs.
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Affiliation(s)
- M Baumeister
- Klinik für Augenheilkunde, Klinikum Bad Hersfeld, Seilerweg 29, 36251, Bad Hersfeld, Deutschland,
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40
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Comparison of iris-claw and posterior chamber collagen copolymer phakic intraocular lenses in keratoconus. J Cataract Refract Surg 2014; 40:383-94. [DOI: 10.1016/j.jcrs.2013.07.052] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 02/07/2023]
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Lee TH, Park JW, Jeong SH, Park SW. The Change of Retinal Nerve Fiber Layer Thickness after Posterior Chamber Phakic Intraocular Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.5.702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Tae Hee Lee
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Jung Won Park
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Se Hyung Jeong
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
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Kim TG, Moon SW, Yang JH, Jin KH. Clinical Usefulness of UBM in the Sitting Position in Anterior Chamber Depth and Angle Measurements. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.7.1007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sung Woon Moon
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji Ho Yang
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyung Hyun Jin
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
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Anterior segment optical coherence tomography of long-term phakic angle-supported intraocular lenses. Am J Ophthalmol 2013; 156:894-901.e2. [PMID: 23938126 DOI: 10.1016/j.ajo.2013.06.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/11/2013] [Accepted: 06/11/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the long-term age-related anterior chamber changes by anterior segment optical coherence tomography (OCT) and the impact of such changes on the stability and behavior of angle-supported phakic intraocular lenses (IOLs). DESIGN A retrospective consecutive observational cohort study. METHODS A total of 23 eyes with high myopia implanted with an angle-supported phakic IOL between 1990 and 1996 at Vissum Corporación Oftalmológica de Alicante were included in the study. Patients were evaluated using OCT. Anterior chamber depth, anterior chamber width, crystalline lens rise, and the distance between phakic IOL and endothelium were measured. RESULTS Fifteen years after implantation, anterior chamber depth was 2.9 ± 0.3 mm, crystalline lens rise 748.18 ± 393.13 μm, and phakic IOL-endothelium distance 2.1 ± 0.30 mm. The predictive model showed that 30 years after implantation, endothelial cell count was less than 600 cells/mm(2) in patients with a preoperative spherical equivalent of -25 diopters (D). Twenty years after implantation, the safety zone of 1.5 mm between endothelium and the lens will not be respected in patients with a preoperative spherical equivalent of -20 D. CONCLUSIONS The findings of this study could have an important influence on the decision about the indication to implant angle-supported phakic IOLs in young patients with a long postoperative life expectancy, as age-related changes in the anatomy of the anterior segment may create a long-term hazard for the implanted eye.
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Alio JL, Peña-García P, Pachkoria K, Alio JL, El Aswad A. Intraocular optical quality of phakic intraocular lenses: comparison of angle-supported, iris-fixated, and posterior chamber lenses. Am J Ophthalmol 2013; 156:789-99. [PMID: 23849312 DOI: 10.1016/j.ajo.2013.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate internal aberrometric profiles following phakic intraocular lens (PIOL) implantation. DESIGN Retrospective and consecutive case series. METHODS One hundred and five eyes of 65 patients were included. The optical aberrations were measured with the Topcon KR-1W aberrometer. Comparisons of internal aberrations for different models were made. Comparisons at 4 and 6 mm were made also within the same model for all the lenses. Comparisons regarding the implantation site were also performed: angle-supported (AS) anterior chamber (AC) (n = 47), iris-fixated (IF) (n = 27), and posterior chamber (PC) (n = 31). RESULTS Root mean square (RMS) of internal optical higher-order aberrations (HOAs) changed significantly to higher values from 4-6 mm aperture diameter in each PIOL, as should be expected. However, this significant change was not detected in spherical aberration for Kelman Duet (P = .753) and in trefoil for Acrysoft (P = .059). Kelman lens showed significantly lower values of spherical aberration compared to Acrysoft at 4 mm (P = .022) and at 6 mm (P = .042). Acrysoft showed the lowest values at central zone for trefoil (P = .043) and tetrafoil (P = .002) in AC group. In the IF group, Artisan and Artiflex showed similar results for all internal aberrations. In the comparison between Visian Implantable Collamer Lens (ICL; STAAR Surgical Co, Monrovia, California, USA) and phakic refractive lens (PRL), both for posterior chamber, significantly lower values of coma were observed for ICL (P = .033). IF lenses showed clinical evidence, but not significant, of better centering capability than AS lenses (P = .096). CONCLUSIONS The study of intraocular aberrations is an adequate method to identify the clinical optical behavior and could help the surgeon to identify the most frequent problems related with each model.
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Affiliation(s)
- Jorge L Alio
- Vissum Corporation, Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
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Higueras-Esteban A, Ortiz-Gomariz A, Gutiérrez-Ortega R, Villa-Collar C, Abad-Montes JP, Fernandes P, González-Méijome JM. Intraocular pressure after implantation of the Visian Implantable Collamer Lens With CentraFLOW without iridotomy. Am J Ophthalmol 2013; 156:800-5. [PMID: 23876870 DOI: 10.1016/j.ajo.2013.05.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 02/05/2023]
Abstract
PURPOSE To compare the intraocular pressure (IOP) values during a 3-month period after implantation of the new Visian Implantable Collamer Lens (ICL; STAAR Surgical Company, Nidau, Switzerland) V4c design with CentraFLOW technology without iridotomy using a standard procedure followed by implantation of the conventional ICL V4b model. DESIGN Retrospective cohort study. METHODS This study included 17 eyes implanted with the ICL V4b model and 18 eyes implanted with the ICL V4c model. The mean preoperative spherical equivalent refractions were -7.48 ± 5.00 diopters and -8.66 ± 4.2 diopters, respectively. We compared the best-corrected distance visual acuity before surgery with the uncorrected distance visual acuity after surgery. The intraocular pressure (IOP) was measured 1 week, 1 month, and 3 months after surgery. The central vault at 3 months was measured using optical coherence tomography. RESULTS Three months after surgery, the mean uncorrected distance visual acuities were -0.09 ± 0.12 logarithm of the minimal angle of resolution units with the V4b and -0.07 ± 0.11 logarithm of the minimal angle of resolution units with the V4c. The mean distances between the ICL and the anterior crystalline lens surface were 557 ± 224 μm and 528 ± 268 μm for the V4b and V4c, respectively (P = .73). After 1 week and 1 month, the mean IOPs were 13.7 and 13.3 mm Hg and 14.7 and 15.1 mm Hg, respectively. There were no significant differences in IOP within or between groups during the follow-up period (P > .05, for all comparisons). CONCLUSIONS The new ICL with the CentraFLOW design seems to provide similar results as its predecessors for the correction of moderate to high myopia and maintenance of safe IOP levels without iridotomy.
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Costagliola C, Romano V, Forbice E, Angi M, Pascotto A, Boccia T, Semeraro F. Corneal oedema and its medical treatment. Clin Exp Optom 2013; 96:529-35. [PMID: 23679934 DOI: 10.1111/cxo.12060] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 11/01/2012] [Accepted: 11/20/2012] [Indexed: 11/30/2022] Open
Abstract
Corneal oedema is a common sign of acute or protracted corneal disease of various aetiologies. In this paper, we review the causes and pathophysiological bases of corneal oedema, as well as discussing the goals and modalities of its medical treatment. Corneal oedema, if adequately understood and appropriately treated, generally shows a good prognosis.
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Affiliation(s)
- Ciro Costagliola
- Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy
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Park Y, Hwang HB, Chung SK. Comparison of Anterior Chamber Depth Obtained from Applanation and Optical Principle Devices. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.8.1219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yuli Park
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyung Bin Hwang
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Kun Chung
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Sheng XL, Rong WN, Jia Q, Liu YN, Zhuang WJ, Gu Q, Sun Y, Pan B, Zhu DJ. Outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of the Toric implantable collamer lens for high myopic astigmatism. Int J Ophthalmol 2012; 5:459-65. [PMID: 22937505 DOI: 10.3980/j.issn.2222-3959.2012.04.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 06/27/2012] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the visual outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of Toric implantable collamer lens (TICL) for the correction of high myopic astigmatism. METHODS In this prospective, nonrandomized clinical study, 54 consecutive eyes of 29 patients with high myopic astigmatism received TICL implantation. To evaluate postoperative axis deviation from the intended axis, a digital anterior segment photograph was taken. The ultrasound biomicroscopy(UBM) was used to observe footplate-position. RESULTS After mean follow-up of 8.6 months, mean manifest refractive cylinder (MRC) decreased 79.3% from (-1.88±1.49)D preoperatively to (0.39±0.61)D postoperatively. MRC within 1.00 D occurred in 68.5% (37/54) of eyes, whereas 48.1% (26/54) had MRC within 0.50 D. Mean manifest refraction spherical equivalent (MRSE) changed from (-12.08±4.22)D preoperatively to (-0.41±0.61)D postoperatively. Uncorrected binocular vision of 20/20 or better occurred in 72.2% (39/54) of patients compared with binocular best-corrected visual acuity (BCVA) of 20/20 or better in 44.4% (24/54) preoperatively. The mean difference between intended and achieved TICL axes was (6.96±8.37)°. Footplates of TICLs were in the ciliary sulcus in 22 eyes (46.3%), below the ciliary sulcus in 32 eyes (53.7%). The angle of TICL rotation had significant correlation with the footplates-position (t=2.127; P=0.045) and the postoperative TICL vaulting (r=-0.516; P=0.000). CONCLUSION The results of our study further support the safety, efficacy and predictability of TICL for the correct high myopic astigmatism. The footplate-position of TICL and vault value should be taken into consideration as two possible risks factors for TICL rotation.
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Affiliation(s)
- Xun-Lun Sheng
- Department of Ophthalmology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750001, Ningxia Hui Autonomous Region, China
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