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Izquierdo L, Imken FC, Larco P, Chauca J, Henriquez MA. Comparison of the Biometric Characteristics After Long-term Implantation of Iris-fixated Phakic Intraocular Lens in Explanted and Nonexplanted Groups of Eyes. Am J Ophthalmol 2024; 265:54-60. [PMID: 38395331 DOI: 10.1016/j.ajo.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To evaluate and compare the biometric characteristics of the anterior chamber of a group of patients with significant endothelial cell loss (ECL) who required phakic intraocular lens (pIOL) explantation and a group of patients who did not fulfill the explantation criteria related to corneal decompensation. DESIGN Retrospective, consecutive, interventional case series. METHODS The study included all consecutive patients receiving a pIOL implantation at Oftalmosalud Instituto de Ojos, Lima, Peru, between 2001 and 2012. The explanted group (E group) consisted of eyes in which the pIOLs were explanted due to ECL, and the nonexplanted group (NE group) consisted of eyes randomly selected in which the pIOL was not explanted with a minimum follow-up time of 8 years. Slit-lamp biomicroscopy, visual acuity, refraction, endothelial cell count, and anterior segment optical coherence tomography were assessed at the preoperative evaluation for both groups and before explantation in the E group and 8 years post-implantation in the NE group. RESULTS pIOLs were implanted in 265 eyes. The annual percentage of ECL was 1.47% and 5.55% in the NE group and E group, respectively (P < .001). The mean minimum endothelial lens distance (ELD) was 1.44 ± 0.22 mm and 1.05 ± 0.23 mm in the NE group and E group, respectively (P < 0.001). The mean time for explantation was 12.58 ± 3.79 years for the E group. Annual ECL could accurately discriminate between the NE group and E group; a cutoff point of 3.5 (%/year) or 86.5 (cells/years) had a 100% sensitivity and specificity. A cutoff of 1.21 mm in the minimum ELD has a 91% sensitivity and 79% specificity to discriminate between the E group and NE group. CONCLUSIONS pIOL explantation due to ECL occurs in eyes with a significantly postoperative lower minimum ELD. Annual ECL and minimum ELC can effectively discriminate between the E and NE groups.
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Affiliation(s)
- Luis Izquierdo
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.); Universidad Nacional Mayor de San Marcos, Lima, Perú (L.I.)
| | - Fiorella Casanova Imken
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.)
| | - Pablo Larco
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.)
| | - Jose Chauca
- Department of Statistics, Demography, Humanities and Social Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú (J.C.)
| | - Maria A Henriquez
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.); From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.).
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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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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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Sudden rotation and technique for repositioning Add-On® piggy-back sulcus toric intraocular lenses. J Fr Ophtalmol 2021; 44:e287-e290. [PMID: 33589171 DOI: 10.1016/j.jfo.2020.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/17/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022]
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Gaurisankar ZS, van Rijn GA, Luyten GPM, Beenakker JWM. Differences between Scheimpflug and optical coherence tomography in determining safety distances in eyes with an iris-fixating phakic intraocular lens. Graefes Arch Clin Exp Ophthalmol 2020; 259:231-238. [PMID: 32766949 PMCID: PMC7790774 DOI: 10.1007/s00417-020-04874-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To investigate the agreement and reliability of anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging in measuring the distance from the anterior edge of an iris-fixated phakic intraocular lens (IF-pIOL) to the corneal endothelium. Methods Anterior segment configuration was assessed in a total of 62 eyes of which 25 hyperopic and 37 myopic eyes, all corrected with an IF-pIOL. Measurements were performed by two independent observers using AS-OCT (Visante, Model 1000, Carl Zeiss Meditec Inc.) and Scheimpflug imaging (Pentacam HR, Oculus Optikgerate). The distance from the anterior edge of the pIOL to the endothelium was measured in five different positions using both modalities with their corresponding pIOL software. The measurements as well as the inter- and intra-observer reliability of the two imaging modalities were then compared. Results Distance measurements for all positions performed by AS-OCT were found to be significantly larger than those performed by Scheimpflug imaging, with mean differences ranging from 0.11 to 0.22 mm. Both instruments exhibited good inter- and intra-observer reliability. Conclusion Anterior pIOL edge to endothelium distance measurements by AS-OCT and Scheimpflug imaging have good intra- and inter-observer reliability. However, as AS-OCT provides larger measurements, these two modalities cannot be used interchangeably. Correction of this difference might be essential for proper decision-making during pre-operative screening for pIOL implantation and post-operative safety monitoring. Electronic supplementary material The online version of this article (10.1007/s00417-020-04874-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zoraida S Gaurisankar
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
- , Leiden, the Netherlands.
| | - Gwyneth A van Rijn
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Gregorius P M Luyten
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan-Willem M Beenakker
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiology, C.J. Gorter Center for High-Field MRI, Leiden University Medical Center, Leiden, the Netherlands
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Vargas V, Marinho A, El Sayyad F, Alio Del Barrio JL, Alio JL. Safety and visual outcomes following Iris-claw phakic intraocular lens bilensectomy. Eur J Ophthalmol 2020; 31:1795-1801. [PMID: 32715788 DOI: 10.1177/1120672120944033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the visual outcomes, safety, efficacy, and causes of bilensectomy for iris fixated phakic intraocular lenses (pIOLs). METHODS This was a two center consecutive retrospective study that included 43 eyes that underwent iris-claw pIOL bilensectomy. Patients with follow up less than 4 months were excluded from the study. Uncorrected, corrected visual acuity (UCVA, CDVA), refractive outcomes, efficacy, safety (number of eyes in which the postoperative CDVA was worse than the preoperative CDVA), endothelial cell density (ECD), causes of bilensectomy, the time between the implantation of the pIOL and bilensectomy, intra and postoperative complications were analyzed. RESULTS There was a statistically significant improvement in UCVA and CDVA after surgery (p = 0.001). The efficacy index was 0.7, four eyes had a postoperative CDVA worse than the preoperative CDVA. The mean spherical equivalent 1 year after bilensectomy was -0.78 ± 1.70 D. There was a statistically significant endothelial cell loss after iris claw lens bilensectomy (p = .003). Cataract development and endothelial cell loss were the only reasons for bilensectomy. The mean time between pIOL implantation and bilensectomy was 12.2 ± 5.5 years. One patient had corneal edema 8 months after surgery and one had a retinal detachment 11 months after surgery. CONCLUSION Bilensectomy was successful in improving UCVA and CDVA with an acceptable refractive outcome. Significant loss of ECD was found after surgery. The results recommend a larger ACD as selection criteria when choosing to implant an Artisan lens, and a close postoperative monitoring of the endothelial cell count.
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Affiliation(s)
- Veronica Vargas
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain
| | | | - Fouad El Sayyad
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain
| | - Jorge L Alio Del Barrio
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain.,Universidad Miguel Hernández, School of Medicine, Alicante, Spain
| | - Jorge L Alio
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Research & Development Department, VISSUM, Alicante, Spain.,Universidad Miguel Hernández, School of Medicine, Alicante, Spain.,IBERIA eye bank, Oftalred, Universidad Miguel Hernández, Alicante, Spain
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Wang LY, Li BC, Sheng B, Xu BL, Huang YS, Ni ZJ, Zhang DW. Optimized multielement accommodative intraocular lens with a four-freeform-surface Alvarez lens and a separate aspheric lens. APPLIED OPTICS 2019; 58:7609-7614. [PMID: 31674416 DOI: 10.1364/ao.58.007609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
This paper proposes an accommodative intraocular lens (IOL), which consists of a two-element Alvarez lens and an aspheric lens for changing focal power and refractive power, respectively. The four-freeform-surface Alvarez lens is optimized for a multiple field of view; further, the aspheric lens also corrects the aberrations induced by the corneal asphericity of the human eye over the whole range of accommodation. A simulation using optical design software demonstrates its excellent performance in that the values of the modulation transfer function at 100 cycles/mm all reach ∼0.4 with a ±5° field of view for 3 and 5 mm pupils.
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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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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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Bohac M, Anticic M, Draca N, Kozomara B, Dekaris I, Gabric N, Patel S. Comparison of Verisyse and Veriflex Phakic Intraocular Lenses for Treatment of Moderate to High Myopia 36 Months after Surgery. Semin Ophthalmol 2016; 32:725-733. [DOI: 10.3109/08820538.2016.1170163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Maja Bohac
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Marija Anticic
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Natasa Draca
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Bojan Kozomara
- Eye Hospital “Svjetlost,” Banja Luka, Bosnia and Herzegovina
| | - Iva Dekaris
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Nikica Gabric
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Sudi Patel
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
- NHS National Services Scotland, Edinburgh, UK
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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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Asymptomatic haptic migration of phakic anterior chamber intraocular lens through the peripheral iridectomy. Can J Ophthalmol 2016; 51:83-6. [PMID: 27085263 DOI: 10.1016/j.jcjo.2015.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 10/18/2015] [Accepted: 10/28/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Case series of haptic migration in patients with angle-supported phakic anterior chamber intraocular lens (PAC-IOL: Phakic6H) through the superior peripheral iridectomy (PI). METHODS Charts of 23 patients (35 eyes) with at least 6 months' postoperative follow-up were retrospectively reviewed. Evaluation included preoperative and postoperative cycloplegic and manifest refractions, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp examination, fundoscopy, corneal topography, and biometry. RESULTS Mean UCVA was 1.67 ± 0.30 (1.17-2.00) for all 35 eyes preoperatively and 0.35 ± 0.25 (0.00-1.00) postoperatively (p < 0.001; 95% CI 1.21-1.44). BCVA had a mean of 0.31 ± 0.26 for all 35 eyes preoperatively, and a mean of 0.22 ± 0.25 postoperatively (p < 0.001; 95% CI 0.04-0.14). Haptic migration into the superior PI was noted in 8 eyes (23%). The first migration was noted 2 years postoperatively and the last 8 years after implantation (mean, 5.6 ± 2 years). There was no statistically significant difference in the BCVA and UCVA before and after haptic migration. Follow-up ranged from 8 months to 8.5 years. CONCLUSIONS Angle-supported PAC-IOL implantation resulted in significant improvement in both UCVA and BCVA. However, there is a 23% incidence of haptic migration in our series with no sequelae on BCVA or harmful effect on the intraocular structures. This IOL movement may be explained by changes in aqueous dynamics at the level of the PI leading to migration of the haptic into the area of least resistance.
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15
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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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An interesting case of implantable contact lens. Med J Armed Forces India 2015; 71:S69-72. [PMID: 26265876 DOI: 10.1016/j.mjafi.2013.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 02/26/2013] [Indexed: 11/23/2022] Open
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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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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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Sayman Muslubas IB, Kandemir B, Aydin Oral AY, Kugu S, Dastan M. Long-term vision-threatening complications of phakic intraocular lens implantation for high myopia. Int J Ophthalmol 2014; 7:376-80. [PMID: 24790887 DOI: 10.3980/j.issn.2222-3959.2014.02.32] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 09/27/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens (pIOLs) implantation for high myopia. METHODS This study was designed from a consecutive series of phakic intraocular lens complication and corrective surgeries. Sixteen eyes of 13 patients had implantation of phakic intraocular lens for correction high myopia and developed serious complications have been included in this study. The mean age of patients was 38.6±6.35y (range 32-50y) and the mean time of history of pIOL implantation for high myopia was 6±2y (range 2-10y). Before corrective surgery, best spectacle-corrective visual acuity (BSCVA) ranged from perception to 20/200 in the eyes in which severe complications occurred. RESULTS Corneal decompensation occurred in 12 eyes of 9 high myopic patients after anterior chamber pIOL implantation. Rhegmatogenous retinal detachment (RRD) occurred in 4 eyes of 4 high myopic patients following anterior chamber and posterior chamber pIOL implantation. Patients with corneal decompensation, had combined procedures consisting of pIOL removal and penetrating keratoplasty (PKP). Removals of pIOL, phacoemulsification and pars plana vitrectomy (PPV) with silicone oil tamponade were performed in patients with RRD. After corrective surgeries, all patients but one (P+, patient 2, right eye) achieved moderate BSCVA ranged from 20/200 to 20/50 at the last visit. CONCLUSION Phakic IOLs may be effective for the correction of high myopia. Although these IOLs may have severe complications and it affects safety and efficacy of this surgery. As seen here, corneal decompensation and rhegmatogenous retinal detachment are possible postoperative vision-threatening complications of phakic IOLs. Patients must be carefully examined before and after surgery for possible endothelial cell loss and vitreoretinal problems.
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Affiliation(s)
| | - Baran Kandemir
- Eye Clinic, Dr. Lütfi Kirdar Kartal Education and Training Hospital, Istanbul 34864, Turkey
| | - Ayse Yesim Aydin Oral
- Eye Clinic, Dr. Lütfi Kirdar Kartal Education and Training Hospital, Istanbul 34864, Turkey
| | - Suleyman Kugu
- Eye Clinic, Dr. Lütfi Kirdar Kartal Education and Training Hospital, Istanbul 34864, Turkey
| | - Metin Dastan
- Eye Clinic, Kars Government Hospital, Kars 36000, Turkey
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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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Schiano Lomoriello D, Lombardo M, Gualdi L, Iacobelli L, Tranchina L, Ducoli P, Serrao S. Stability of cachet phakic intraocular lens position during 6-months follow-up. Open Ophthalmol J 2013; 7:20-3. [PMID: 23898355 PMCID: PMC3722538 DOI: 10.2174/1874364101307010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/22/2013] [Accepted: 01/25/2013] [Indexed: 11/22/2022] Open
Abstract
Purpose: To evaluate the position stability of a phakic intraocular lens (Cachet pIOL; Alcon, Laboratories, Inc., Fort Worth, TX) in the anterior chamber (AC) during a 6-months follow-up. Methods: Thirty eyes of 16 subjects underwent a Cachet pIOL implantation for the correction of high myopia from -6.50 to -16.00 D with plano targeted refraction. The position stability of the Cachet pIOL was evaluated using an Anterior Segment-OCT (AS-OCT, Carl Zeiss AG, Oberkochen, Germany) at 1- and 6-months postoperatively. Three measurements have been taken into account: 1) the minimum distance between the anterior surface of the Cachet pIOL optic disk and the central corneal endothelium; 2) the minimum distance between the optic disk’s edges of the pIOL and the endothelium; 3) the minimum distance between the posterior surface of the pIOL optic disk and the anterior surface of the crystalline lens. The endothelial cell density (ECD) was also recorded. Results: No statistically significant changes of the Cachet pIOL position in the AC were found during follow-up. The average changes were ≤0.1 mm between 1- and 6-months postoperatively (P>0.05). At the end of follow-up, The mean ECD loss was 0.7 % (from 2794 ± 337 cell/mm2 to 2776 ± 388 cell/mm2; P>0.05). Conclusion: A high position stability of the Cachet pIOL in the anterior chamber was shown during a 6-months follow-up.
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Abstract
Implantation of phakic intraocular lenses (pIOLs) is a reversible refractive procedure, preserving the patient's accommodative function with minimal induction of higher order aberrations compared with corneal photoablative procedures. Despite this, as an intraocular procedure, it has potential risks such as cataracts, chronic uveitis, pupil ovalization, corneal endothelial cell loss, pigmentary dispersion syndrome, pupillary block glaucoma, astigmatism, or endophthalmitis. Currently, only two models of posterior chamber pIOLs are commercially available, the implantable collammer lens (STAAR Surgical Co.) and the phakic refractive lens (PRL; Zeiss Meditec). The number of published reports on the latter is very low, and some concerns still remain about its long-term safety. The present article reviews the published literature on the outcomes after PRL implantation in order to provide a general overview and evaluate its real potential as a surgical refractive option.
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Résultats à long terme de l’implantation phaque de chambre postérieure pour la correction des amétropies fortes. J Fr Ophtalmol 2012; 35:402-11. [DOI: 10.1016/j.jfo.2011.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 06/05/2011] [Accepted: 06/23/2011] [Indexed: 11/21/2022]
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Abstract
PURPOSE OF REVIEW To review the evidential basis of current practice in refractive lens exchange (RLE) vs. phakic intraocular lens (pIOL). RECENT FINDINGS Visual outcomes after pIOLs are better than RLE. With RLE, there still remain risks of retinal detachment, cystoid macular oedema, glare, halos and posterior capsule opacification. With pIOLs, risks include pigment dispersion, cataract formation, glaucoma and inflammation. The decision to choose between either is broadly based on age and type of refractive error, and the choice follows thorough evaluation and counselling taking into consideration patient's needs and expectations. SUMMARY With advancing technology, newer IOL models for RLE and phakic correction are becoming available. pIOLs provide better visual outcomes for distance correction and currently do not provide near-vision correction possible with RLE.
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Yang J, Lee JK. Long-Term Endothelial Cell Changes after Angle-Supported Anterior Chamber Lens Implantation in Phakic Eyes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.2.208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jenny Yang
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
| | - Jin Ki Lee
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
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Mittal V, Mittal R, Singh D. Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation. Indian J Ophthalmol 2011; 59:314-7. [PMID: 21666321 PMCID: PMC3129761 DOI: 10.4103/0301-4738.82004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL) implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm2) although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification) and Descemet's stripping and endothelial keratoplasty (DSEK) in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany) model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph) of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty.
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Affiliation(s)
- Vikas Mittal
- Department of Cornea and Anterior Segment Services, Sanjivni Eye Care, Ambala, Haryana, India.
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Alió JL, Toffaha BT, Laria C, Piñero DP. Phakic Intraocular Lens Implantation for Treatment of Anisometropia and Amblyopia in Children: 5-year Follow-up. J Refract Surg 2011; 27:494-501. [DOI: 10.3928/1081597x-20110120-01] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 11/19/2010] [Indexed: 11/20/2022]
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Knorz MC, Lane SS, Holland SP. Angle-supported phakic intraocular lens for correction of moderate to high myopia: Three-year interim results in international multicenter studies. J Cataract Refract Surg 2011; 37:469-80. [DOI: 10.1016/j.jcrs.2010.09.025] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 08/25/2010] [Accepted: 09/10/2010] [Indexed: 11/29/2022]
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Fukuda S, Kawana K, Yasuno Y, Oshika T. Repeatability and reproducibility of anterior ocular biometric measurements with 2-dimensional and 3-dimensional optical coherence tomography. J Cataract Refract Surg 2010; 36:1867-73. [PMID: 21029894 DOI: 10.1016/j.jcrs.2010.05.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 04/11/2010] [Accepted: 05/26/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the repeatability and reproducibility of central corneal thickness (CCT), anterior chamber depth (ACD), and anterior chamber width (ACW) measurements using 3-dimensional (3-D) corneal and anterior segment optical coherence tomography (CAS-OCT) and 2-dimensional (2-D) anterior segment OCT (AS-OCT). SETTING Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan. DESIGN Nonrandomized clinical trial. METHODS The CCT, ACD, and ACW were measured in normal eyes using a prototype 3-D swept-source CAS-OCT device and a 2-D time-domain AS-OCT device (Visante). The coefficient of repeatability and reproducibility and the intraclass correlation coefficient (ICC) were calculated to evaluate the repeatability and reproducibility of the measurements. RESULTS Eighty-five eyes (85 subjects) were evaluated. The mean CCT measurement was 557.5 μm ± 40.5 (SD) with CAS-OCT and 556.4 ± 39.4 μm with AS-OCT; the mean ACD measurement, 3.13 ± 0.40 mm and 3.16 ± 0.39 mm, respectively; and the mean ACW, 11.80 ± 0.47 mm and 11.79 ± 0.49 mm, respectively. There was no statistically significant difference in CCT or ACW measurements between the 2 devices (P>.05, Wilcoxon signed rank test). Although the ACD measurements were significantly different (P<.0001), the difference was small (0.03 mm). Significant linear correlations were found between the measurements of the 2 devices (P<.0001). The ICC was greater than 0.99 for CAS-OCT and greater than 0.96 for AS-OCT. CONCLUSION Corneal and anterior segment OCT and AS-OCT provided comparable and well-correlated anterior ocular biometric measurements, with sufficient repeatability and reproducibility.
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Affiliation(s)
- Shinichi Fukuda
- Department of Ophthalmology, University of Tsukuba, Ibaraki, Japan.
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Ultrasound biomicroscopy in pupillary block glaucoma secondary to ophthalmic viscosurgical device remnants in the posterior chamber after anterior chamber phakic intraocular lens implantation. J Cataract Refract Surg 2010; 36:2204-6. [DOI: 10.1016/j.jcrs.2010.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 08/10/2010] [Accepted: 08/10/2010] [Indexed: 11/19/2022]
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Kohnen T, Kook D, Morral M, Güell JL. Phakic intraocular lenses. J Cataract Refract Surg 2010; 36:2168-94. [DOI: 10.1016/j.jcrs.2010.10.007] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 09/01/2010] [Accepted: 09/01/2010] [Indexed: 11/29/2022]
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Güell JL, Morral M, Kook D, Kohnen T. Phakic intraocular lenses. J Cataract Refract Surg 2010; 36:1976-93. [PMID: 21029908 DOI: 10.1016/j.jcrs.2010.08.014] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Accepted: 03/10/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Jose Luis Güell
- Instituto Microcirugia Ocular, Autonoma University of Barcelona, Barcelona, Spain
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Intraocular stability of an angle-supported phakic intraocular lens with changes in pupil diameter. J Cataract Refract Surg 2010; 36:1517-22. [PMID: 20692564 DOI: 10.1016/j.jcrs.2010.02.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 02/10/2010] [Accepted: 02/17/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE To use anterior segment optical coherence tomography (AS-OCT) to evaluate the stability of a recently released angle-supported phakic intraocular lens (pIOL) in the anterior segment with changes in pupil diameter. SETTING Keratoconus Unit, Vissum Corporation, Alicante, Spain. METHODS In this observational cross-sectional study of consecutive eyes with moderate to high myopia, an AcrySof Cachet pIOL was implanted with the aim of minimizing the refractive error. An analysis of the position and stability of the pIOL before and after pharmacologic pupil dilation was performed 3 months postoperatively using the Visante AS-OCT system. A measurement protocol that included several anatomic parameters was developed and applied; the parameter values before and after dilation were compared. RESULTS Twenty eyes of 20 patients ranging in age from 24 to 48 years old were evaluated. The anterior chamber depth increased significantly with pupil dilation (mean change 0.06 mm +/- 0.08 [SD]) (P<.01). A significant change was also observed in the distance between the center of the cornea at the endothelial plane and the anterior surface of the pIOL (mean change 0.03 +/- 0.05 mm) (P = .01). The distances between the peripheral edges of the pIOL and the corneal endothelium and the distance between the crystalline lens and the pIOL did not change significantly (P>or=.14). CONCLUSION The angle-supported pIOL showed excellent intraocular behavior after pupil dilation, with no shortening of the distance between the pIOL and corneal endothelium at the center or peripheral edges of the pIOL.
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Rosman M, Alió JL, Ortiz D, Pérez-Santonja JJ. Refractive stability of LASIK with the Visx 20/20 excimer laser vs ZB5m phakic iol implantation in patients with high myopia (>-10.00 d): a 10-year retrospective study. J Refract Surg 2010; 27:279-86. [PMID: 20672763 DOI: 10.3928/1081597x-20100707-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Accepted: 06/17/2010] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the long-term outcomes of LASIK and ZB5M phakic intraocular lens implantation (PIOL) (Domilens) for high myopia (>-10.00 diopters [D]). METHODS This long-term (10 years) follow-up retrospective interventional case series study included 126 eyes that underwent LASIK and 52 eyes that underwent ZB5M angle-supported PIOL implantation. Both groups of eyes were similar in terms of preoperative spherical equivalent refraction (SE), corrected distance visual acuity (CDVA), and age. RESULTS Mean preoperative SE was -14.33 D in the LASIK group and -14.84 D in the PIOL group. At 10-year follow-up, mean postoperative SE was -1.47±2.00 D in the LASIK group and -1.01±1.36 D in the PIOL group (P=.21). In the LASIK group, 67% of eyes were within ±1.00 D of emmetropia at 2 years after surgery, compared to 42% at 10 years. In the PIOL group, 68% of eyes were within ±1.00 D of emmetropia 2 years after implantation compared to 53% at 10 years. In the LASIK group, 43.5% of eyes achieved UDVA of 20/40 or better 10 years after surgery compared to 67.9% in the PIOL group (P=.02). CONCLUSIONS The ZB5M angle-supported PIOL was shown to have better predictability and stability compared to LASIK over 10 years. However, reductions in endothelial cell count over time were observed in eyes with PIOLs.
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Affiliation(s)
- Mohamad Rosman
- Vissum/Instituto Oftalmológico de Alicante. Alicante, Spain
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Kymionis GD, Grentzelos MA, Kalyvianaki MI, Detorakis ET, Kounis GA, Tsilimbaris MK, Pallikaris IG. Fifteen-year follow-up after anterior chamber phakic intraocular lens implantation in one and LASIK in the fellow eye. Semin Ophthalmol 2010; 24:231-3. [PMID: 19954372 DOI: 10.3109/08820530903388751] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To report a patient fifteen years after anterior chamber phakic intraocular lens (AC-PIOL) implantation in one and laser in situ keratomileusis (LASIK) in the fellow eye. METHODS Case report. RESULTS A 56-year-old male underwent AC-PIOL implantation in one eye and LASIK in the fellow eye fifteen years ago. Preoperative uncorrected visual acuity (UCVA) was finger count in both eyes. Preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25 (-16.75 -0.50 x 40) in the LASIK eye and 20/32 (-24.50 -0.50 x 90) in the AC-PIOL eye. Fifteen years postoperatively, UCVA was finger count in the LASIK eye and 20/200 in the AC-PIOL eye, while BSCVA was 20/32 and 20/25, respectively. Endothelial cell density (ECD) was 2020+/-47 in the LASIK eye and 945+/-22 in the AC-PIOL eye. CONCLUSION Both procedures had similar visual outcomes. Furthermore, lower ECD was found in the AC-PIOL eye in comparison to the LASIK eye.
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Affiliation(s)
- George D Kymionis
- Institute of Vision and Optics, Faculty of Medicine, University of Crete, Crete, Greece.
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Park SH, Yum JH, Choi SK, Lee JH, Kim JH, Lee DH, Kim TJ. Changes in Higher Order Aberration After Implantable Contact Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.9.1210] [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)
- Se Hoon Park
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jung Hoon Yum
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Suk Kyue Choi
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jong Hyun Lee
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jin Hyoung Kim
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Do Hyung Lee
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Jin Kim
- Department of Ophthalmology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Evaluation of pupil diameter after posterior chamber phakic intraocular lens implantation. Eye (Lond) 2009; 24:588-94. [DOI: 10.1038/eye.2009.170] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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AcrySof Phakic Angle-supported Intraocular Lens for the Correction of Moderate-to-High Myopia: One-Year Results of a Multicenter European Study. Ophthalmology 2009; 116:1314-21, 1321.e1-3. [DOI: 10.1016/j.ophtha.2009.01.041] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 01/27/2009] [Accepted: 01/27/2009] [Indexed: 11/27/2022] Open
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41
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Piñero DP, Puche ABP, Alió JL. Ciliary Sulcus Diameter and Two Anterior Chamber Parameters Measured by Optical Coherence Tomography and VHF Ultrasound. J Refract Surg 2009; 25:1017-25. [DOI: 10.3928/1081597x-20091016-08] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Accepted: 10/22/2008] [Indexed: 11/20/2022]
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43
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Chen LJ, Chang YJ, Kuo JC, Rajagopal R, Azar DT. Metaanalysis of cataract development after phakic intraocular lens surgery. J Cataract Refract Surg 2008; 34:1181-200. [PMID: 18571089 DOI: 10.1016/j.jcrs.2008.03.029] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Accepted: 03/24/2008] [Indexed: 11/24/2022]
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Corneal diameter measurements by corneal topography and angle-to-angle measurements by optical coherence tomography: evaluation of equivalence. J Cataract Refract Surg 2008; 34:126-31. [PMID: 18165092 DOI: 10.1016/j.jcrs.2007.10.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Accepted: 10/08/2007] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the equivalence of corneal white-to-white (WTW) diameter and anterior segment angle-to-angle (ATA) measurements. SETTING Vissum Instituto Oftalmologico de Alicante, Alicante, Spain. METHODS Thirty eyes of 19 patients ranging in age from 20 to 51 years old with no previous ocular surgeries were included in this study. In all cases, the horizontal WTW diameter was measured with a tool provided by the CSO corneal topography system (Costruzione Strumenti Oftalmici) and the horizontal ATA was measured using an optical coherence tomography (OCT) system (Visante, Carl Zeiss Meditec AG). All measurements were repeated 3 times to evaluate intrasession repeatability. The correlation between WTW and ATA measurements was studied, and the interchangeability of the 2 parameters was assessed using the Bland and Altman method. RESULTS The mean corneal WTW diameter was 12.25 mm +/- 0.49 (SD) (range 11.34 to 13.16 mm), and the mean ATA distance was 11.76 +/- 0.52 mm (range 10.03 to 12.92 mm). The difference between the 2 parameters was statistically significant (P<.01). A weak, although statistically significant, positive correlation (r = 0.39; P = .03) and a nonpredictive linear model were found. The Bland and Altman analysis showed large limits of agreement between WTW and ATA measurements that are clinically relevant (limits of agreement, -1.59 mm and 0.61 mm). The intrasession repeatability scores for the WTW and ATA measurements were good. CONCLUSIONS The WTW and ATA distance measurements were not equivalent and thus are not interchangeable. There was no linear model for an accurate prediction of the ATA from the WTW.
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Medical applications of poly(styrene-block-isobutylene-block-styrene) (“SIBS”). Biomaterials 2008; 29:448-60. [DOI: 10.1016/j.biomaterials.2007.09.041] [Citation(s) in RCA: 215] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Accepted: 09/30/2007] [Indexed: 11/23/2022]
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Choi WS, Choi BJ, Her J. Two-year Endothalial Changes after Iris Fixed Phakic Intraocular Lens Implantation in Korean. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.2.230] [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)
- Woo Seok Choi
- Department of Ophthalmology, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea
| | | | - Jun Her
- Department of Ophthalmology, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea
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Yu A, Wang Q, Xue A, Zhu S, Wang S, Chen Y, Sun J. Comparison of Contrast Sensitivity after Angle-Supported, Iris-Fixated and Posterior Chamber Phakic Intraocular Lens Implantation for High Myopia. Ophthalmologica 2007; 222:53-7. [DOI: 10.1159/000109280] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Alió JL, Piñero D, Bernabeu G, Galal A, Vargas JM, Ismail MM. The Kelman Duet Phakic Intraocular Lens: 1-year Results. J Refract Surg 2007; 23:868-79. [DOI: 10.3928/1081-597x-20071101-02] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Van Cleynenbreugel H. Late postoperative complications of backward implantation of a Vivarte phakic intraocular lens. J Cataract Refract Surg 2007; 33:1474-6. [PMID: 17662446 DOI: 10.1016/j.jcrs.2007.03.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2007] [Accepted: 03/27/2007] [Indexed: 11/20/2022]
Abstract
A 34-year-old man had bilateral implantation of a Vivarte phakic intraocular lens (pIOL) (Ciba Vision) to correct high myopia. Postoperatively, both pIOLs appeared to have been implanted backward. After a few weeks, the position of the pIOL in the right eye was corrected in a second procedure. For unknown reasons, the pIOL in the left eye was untouched. Three years after the initial implantation, the patient visited our hospital for a second opinion. He presented with a decrease in visual acuity from an intrapupillary membrane in the left eye. Endothelial cell count of the left cornea showed markedly decreased endothelial cell density. The patient was successfully treated by removing the IOL and excising the intrapupillary membrane, leading to recovery of visual acuity. This case presents the rare occurrence and management of late postoperative complications of backward implantation of a Vivarte pIOL.
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Abstract
PURPOSE To assess efficacy and safety of angle-supported phakic intraocular lenses (PIOL) implanted after scleral buckling for retinal detachment. SETTING Private practice in Siena, Italy. METHODS Retrospective, noncomparative consecutive case series. Inclusion criteria for retrospective evaluation were previous uncomplicated external retinal detachment surgery (scleral buckling), and a complete follow-up superior to 3 years from PIOL implantation. RESULTS Nine eyes of seven patients were included. Mean time interval between retinal detachment surgery and PIOL implantation was 3.2 years +/- 4.5 (range 1 to 15). Mean spherical equivalent (SE) before PIOL implantation was -16.36 D +/- 3.98; range: -11.75 to -23. PIOL surgery was uneventful in all cases. Mean SE after PIOL implantation was -0.99+/-0.51 (95% confidence interval for the mean: -0.59 to -1.39). Mean follow-up after PIOL implantation was 4.2 years +/- 0.8 (range 3 to 5). Complications were pupil ovalization (inferior to 1 mm) in two eyes, and worsening of floaters in both eyes of one patient. No recurrences of retinal detachment were observed. CONCLUSIONS In selected eyes with no anterior chamber abnormalities, the implantation of angle supported PIOL after scleral buckling for retinal detachment is associated with good refractive results and minor complications.
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Affiliation(s)
- A Leccisotti
- Ophthalmic Surgery Unit, Casa di Cura Rugani, Siena, Italy.
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