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Yoon HY, Byun YS, Kim HS, Chung SH. Causes and outcomes of implantable collamer lens explantation in patients with corneal endothelial cell loss. J Cataract Refract Surg 2024; 50:453-459. [PMID: 38270485 DOI: 10.1097/j.jcrs.0000000000001406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate the correlated factors of corneal endothelial cell density (ECD) loss and ECD change in implantable collamer lens (ICL) explantation patients. SETTING Seoul St. Mary's Hospital, Seoul, South Korea. DESIGN Retrospective analysis. METHODS The study cohort consisted of 93 eyes from 50 patients who underwent ICL explantation. Correlation analysis was performed to assess the ocular parameters associated with ECD loss, while percentage of ECD change (ΔECD%) was monitored up to 6 months postoperatively. Receiver operating characteristic (ROC) curve was used to set cutoff values of ocular parameters to prevent ECD loss after explantation. RESULTS In multiple regression analysis, high vaulting, high vaulting/anterior chamber depth (ACD), low anterior chamber angle (ACA), and high iris pigmentations are the significant factors of ECD loss. At postoperative 6 months, 14 eyes (15.1%) had decrease (10.5% loss), 47 eyes (51.0%) were stationary, and 32 eyes (34.4%) had increase (12.7% gain) of ECD. The ROC curve analysis showed that vaulting had the highest area under the curve (AUC = 0.822), followed by vaulting/ACD (AUC = 0.821), ECD (AUC = 0.753), and ACA (AUC = 0.723) (all P < .01). Preoperative ECD showed a sensitivity of 77.6% and specificity of 86.7% in preventing ECD loss after explantation, with a cutoff value of 1722 cells/mm 2 , as determined by ROC curve analysis. CONCLUSIONS Our study demonstrated that high vaulting is a significant factor in ECD loss among ICL-inserted patients. To prevent continuous ECD loss in ICL patients, close monitoring of ECD and making appropriate decisions regarding explantation may be necessary.
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Affiliation(s)
- Hye Yeon Yoon
- From the Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
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Kisiel FB, Gurumurthy GJ. Endothelial cell loss post-implantable collamer lens V4c: meta-analysis. J Cataract Refract Surg 2024; 50:420-423. [PMID: 38194352 DOI: 10.1097/j.jcrs.0000000000001389] [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: 10/02/2023] [Accepted: 12/03/2023] [Indexed: 01/10/2024]
Abstract
Endothelial cell density (ECD) loss is a noted effect of implantable collamer lens (ICL) V4c surgery. Current literature provides a wide range of values for ECD loss postsurgery, which may not be helpful in advising patients and clinicians. A meta-analysis exploring ECD loss in ICL V4c for myopia correction was undertaken. 18 studies were included in this meta-analysis with 2 subgroup analyses to account for the variability in follow-up lengths. The average ECD loss 3 months, 12 months, and 21.25 (mean) months postsurgery were 1.32% ± 1.28% ( P < .001, 95% CI, -75.158 to -1.19), 1.75% ± 2.17% ( P < .001, 95% CI, -134.09 to 14.52), and 3.84% ± 1.78% ( P < .001, 95% CI, -156.04 to -54.26), respectively. ECD loss is most pronounced 3 months postsurgery, suggesting that acute surgical trauma was the primary contributor rather than long-term lens implantation. Overall, ICL V4c is for myopia correction exhibits similar ECD loss as seen in other ICL models, thereby affirming its safety.
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Affiliation(s)
- Filip Blazej Kisiel
- From the Department of Chemical Engineering, University of Manchester, Manchester, United Kingdom (Kisiel); Department of Medicine, University of Manchester, Manchester, United Kingdom (Gurumurthy)
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Zdonczyk A, Tychsen L, Constantino JN, Culican SM, Badawi AA, Reynolds M. Impact of Ocular Conditions and Improvements After Refractive Surgery in Quality of Life for Children With Neurodevelopmental Disorders. Am J Ophthalmol 2023; 247:9-17. [PMID: 36343699 PMCID: PMC11331587 DOI: 10.1016/j.ajo.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aims to characterize the eye-related quality of life of children with neurodevelopmental and ocular disorders at baseline and after refractive surgery. DESIGN Prospective interventional case series. METHODS We enrolled children and adolescents 5 to 18 of age with neurodevelopmental disorders undergoing refractive surgery (6 for pre-/postsurgical assessment and 14 for baseline analysis). Eye-related quality of life was measured using the Pediatric Eye Questionnaire (PedEyeQ). Baseline levels of adaptive functioning and social behaviors were measured using the Adaptive Behavioral Assessment System (ABAS-3) and Social Responsiveness Scale (SRS-2). We assessed the correlation between baseline PedEyeQ scores, number of ocular comorbidities, magnitude of refractive error, and ABAS-3 and SRS-2 scores. RESULTS At baseline, 14 patients demonstrated decreased median eye-related quality of life (<60/100) in 5 of 9 PedEyeQ domains, moderate deficiencies in social behaviors (SRS-2 median 71, range 49-90), and low adaptive functioning (ABAS-3 median percentile for age of 0.100). Baseline PedEyeQ scores did not correlate with magnitude of refractive error or adaptive functioning scores but did correlate with number of ocular comorbidities and social behavior scores. Six patients have undergone refractive surgery without complication. Postoperatively, 11 of 11 eyes were within ±1.5 diopters spherical equivalent. Four of 6 patients exhibited clinically significant improvements in PedEyeQ scores after surgery. CONCLUSIONS Even in the presence of significant social and adaptive impairments, quality of life in children with neurodevelopmental disorders is decreased by ocular disorders. Refractive surgery is associated with clinically significant improvements in eye-related quality of life.
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Affiliation(s)
- Alexandra Zdonczyk
- From the Department of Ophthalmology & Visual Sciences (A.Z., L.T., A.A.B., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lawrence Tychsen
- From the Department of Ophthalmology & Visual Sciences (A.Z., L.T., A.A.B., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - John N Constantino
- Department of Psychiatry (J.N.C.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Susan M Culican
- Department of Ophthalmology and Visual Neurosciences (S.M.C.), University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Amer Al Badawi
- From the Department of Ophthalmology & Visual Sciences (A.Z., L.T., A.A.B., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Margaret Reynolds
- From the Department of Ophthalmology & Visual Sciences (A.Z., L.T., A.A.B., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA.
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Castro-Luna G, Sánchez-Liñán N, Alaskar H, Pérez-Rueda A, Nievas-Soriano BJ. Comparison of Iris-Claw Phakic Lens Implant versus Corneal Laser Techniques in High Myopia: A Five-Year Follow-Up Study. Healthcare (Basel) 2022; 10:healthcare10101904. [PMID: 36292351 PMCID: PMC9601292 DOI: 10.3390/healthcare10101904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background. This study aimed to compare the efficacy and safety of Femto-LASIK, PRK, and Artiflex/Artisan phakic lens implantation in the surgical correction of myopia at different moments of postoperative follow-up; to propose a linear predictive model of visual acuity without correction at five years of refractive procedures; and to evaluate its validity. Methods. A retrospective observational analysis was performed. Patients were clinically reviewed after three months, one year, two years, and five years. Univariate and bivariate analyses and a multivariate linear regression model were performed. Results. Six hundred seventy-nine eyes were analyzed: 18.9% Artiflex, 2.8% Artisan, 42.3% Femto-LASIK, and 36.1% PRK. There were significant differences in effectiveness and safety after five years when comparing Artiflex/Artisan versus PRK and Femto-LASIK (p < 0.01). The linear regression model explained 30.32% of the patients’ visual acuity variability after five years. Conclusions. PRK surgery, Femto-Lasik, and Artiflex/Artisan type phakic lens implantation are effective, safe, and predictable techniques with stable refractive results. Phakic lenses magnify myopic patients who improve their UCVA and BCVA. Concerning phakic lens implantation, corneal endothelial cells remain stable. The predictive model calculated that surgery with a phakic lens increased the UCVA result at five years, and surgery with PRK slightly decreased the long-term results.
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Affiliation(s)
- Gracia Castro-Luna
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04009 Almería, Spain
- Correspondence: (G.C.-L.); (B.J.N.-S.)
| | - Noelia Sánchez-Liñán
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04009 Almería, Spain
| | - Hazem Alaskar
- Department of Ophthalmology, Poniente Hospital, 04700 Almería, Spain
| | - Antonio Pérez-Rueda
- Department of Ophthalmology, University Torrecardenas Hospital, 04009 Almería, Spain
| | - Bruno José Nievas-Soriano
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04009 Almería, Spain
- Correspondence: (G.C.-L.); (B.J.N.-S.)
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Reynolds M, Hoekel J, Tychsen L. Safety of phakic intraocular collamer lens implantation in 95 highly myopic special-needs children. J Cataract Refract Surg 2021; 47:1519-1523. [PMID: 33929793 DOI: 10.1097/j.jcrs.0000000000000678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the safety of intraocular collamer lens (ICL) implantation in children with high ametropia by reporting rates and case specifics of perioperative and longer-term adverse events (AEs).
. SETTING St. Louis Children's Hospital at Washington University Medical Center, St. Louis, Missouri. DESIGN Retrospective case series. METHODS Clinical data were collated retrospectively for 95 special-needs children (160 eyes) implanted with a Visian ICL over the past 5 years. All surgeries were performed at St Louis Children's Hospital under brief general anesthesia. The mean follow-up period was 2.0 ± 1.4 years (range, 0.5 to 5.2). RESULTS The mean age at implantation was 9.3 ± 5.2 years (range, 1.8 to 25) and mean preoperative spherical equivalent refractive error was -11.20 ± 3.90 diopters (range, 4 to 22). 62 children (62/95, 65%) had a neurodevelopmental disorder. 3 eyes (3/160, 2%) reported minor AE, consisting of steroid-response ocular hypertension, which resolved with cessation of topical steroid drops. Endothelial cell loss averaged 8.1% over 2 years, comparable with that reported in ICL-implanted adults. The most common major AE (7 eyes [7/160, 4%]) was postoperative pupillary block, requiring revision of the peripheral iridotomy. 1 child (1 eye [1/160, 0.6%]) with self-injurious behavior required repair of a wound leak. 1 child (1 eye [1/160, 0.6%]) with Down syndrome developed a cataract 2.8 years after ICL surgery, and 1 child (1 eye [1/160, 0.6%]) with severe autism spectrum disorder experienced traumatic retinal detachment 1.2 years after implantation. CONCLUSIONS The most common major AE among the cohort with Visian ICL was pupillary block due to closure of the iridotomy. Overall, the AE rate was low in this higher risk, difficult-to-manage population of special-needs children.
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Affiliation(s)
- Margaret Reynolds
- From the Departments of Ophthalmology and Visual Sciences (Reynolds, Hoekel, Tychsen), Pediatrics (Reynolds, Tychsen), and Neuroscience (Tychsen) Washington University in St. Louis School of Medicine, St. Louis, Missouri
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Evaluation of Visual Outcome of 2 Phakic Posterior Chamber Implantable Lenses in High Myopia: A Comparative Study. Eye Contact Lens 2021; 48:38-44. [PMID: 34775453 DOI: 10.1097/icl.0000000000000854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate and compare the visual outcomes of two phakic intraocular lenses in high myopia. METHODS A prospective comparative study was undertaken on 50 eyes of 26 patients {age ≥21 years and divided into two groups (implantable collamer lens [ICL] V4c, n=25 eyes and refractive implantable lens [RIL], n=25 eyes)}. Patients were evaluated for uncorrected distance visual acuity (UCVA), best-corrected distance visual acuity, manifest refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure, dilated fundus examination, trabecular-iris angle (TIA), anterior chamber depth, horizontal white-to-white diameter, wavefront aberrometry, and endothelial cell (EC) count. All patients were followed up until 6 months and additionally evaluated for anterior chamber inflammation, cataract, and lens vault. RESULTS The baseline parameters (UCVA, MRSE, and EC count) and postoperative improvement in UCVA, contrast sensitivity, MRSE, EC loss, safety index, and efficacy index were comparable between both the lenses. The improvement in aberrometric profile was significantly better in the ICL group. The mean postoperative vault was higher in RIL group (434.88±162.48 μm vs. 547.24±159.83 μm, P=0.0173); however, the vault was within normal range in both the groups. The decrease in mean TIA was significantly higher in RIL group (8.58 vs. 13.45 μm, P=0.0073). CONCLUSION Acrylic phakic lens can be considered as a suitable alternative to collamer lens for refractive correction of high myopia. The collamer lenses showed slight superiority in some qualitative visual parameters; however, collamer lenses do not present with subjective complaints in the patients.
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Long term efficacy and safety profiles following posterior chamber phakic intraocular lens implantation in eyes with ≥ 10-year follow-up. J Cataract Refract Surg 2021; 48:813-818. [PMID: 34670948 DOI: 10.1097/j.jcrs.0000000000000848] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Evaluate long-term efficacy, safety, predictability and stability of a posterior chamber phakic intraocular lens (Visian ICL) in eyes with ≥10-year follow-up. SETTING Instituto de Microcirugía Ocular, Barcelona, Spain. DESIGN Retrospective study. METHODS Eyes undergoing ICL implantation from 2008-2011 with ≥10-year follow-up were included. Variables analyzed were: preoperative, 1-month, 1-year, 5-years and last follow-up uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent (SE), endothelial cell count (ECC) and intraocular pressure (IOP). Descriptive statistics were performed and results reported following the Standard for Reporting Refractive Surgery Outcomes. RESULTS 45 eyes (26 patients) were analyzed, mean follow-up 11.35 ± 1.30 years. Mean preoperative SE was -10.06 ± 3.40D and mean preoperative cylinder -1.55 ± 1.45D. At last follow-up, efficacy and safety indices were 0.79 and 1.12, respectively. In total, 32 (71%) eyes achieved an UDVA of ≥20/40. 22 (49%) eyes gained ≥1 line of CDVA, and 2 (4%) eyes lost ≥2 lines of CDVA. At final follow-up, 19 (42%) and 29 (64%) eyes were within ±0.50D and ±1.00D of attempted SE correction, respectively. 31 (69%) eyes had ≤1.00D of postoperative astigmatism and 29 (74%) eyes were within ±15° from the intended correction axis. At the last visit, a statistically significant myopic progression of -0.75 ± 1.20D was observed (p=0.01). ECC loss at last follow-up was 9.85 ± 11.35%. IOP remained stable. There were no intraoperative complications. 3 eyes (7%) developed cataract after 10 years. CONCLUSIONS Long-term results demonstrate that ICL is effective, predictable, stable and safe.
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Delbarre M, Le HM, Boucenna W, Froussart-Maille F. [Refractive surgery for hyperopia]. J Fr Ophtalmol 2021; 44:723-729. [PMID: 33836914 DOI: 10.1016/j.jfo.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/16/2020] [Indexed: 10/21/2022]
Abstract
Hyperopia is a refractive error in which light is focused behind, instead of on, the retina. Clear vision can be obtained by accommodation, but in the long run, this results in eye strain. Hyperopia can be classified as low [≤2.00 diopters (D)], moderate (2.00-4.00 D) and high (>4.00 D). Detailed preoperative evaluation is necessary and essential to obtain good postoperative results. Various surgical techniques can be proposed to correct this ametropia. The main techniques used act either by modifying the corneal curvature with the Excimer laser or by implanting a phakic intraocular lens. The anatomical peculiarities of the hyperopic eye (small corneal diameter, short axial length, narrow anterior chamber or large kappa angle) make refractive surgery for hyperopia a considerable challenge. Large optical ablation zones now allow correction of high hyperopia by reducing the risks of optical aberrations and regression. The patient must be informed and understand the postoperative course, which differs from that of surgery for myopia.
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Affiliation(s)
- M Delbarre
- Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France.
| | - H M Le
- Département d'ophtalmologie, Centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - W Boucenna
- Service d'ophtalmologie, CHU Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France
| | - F Froussart-Maille
- Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France
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Visual acuity, refractive error, and regression outcomes in 169 children with high myopia who were implanted with Ophtec-Artisan or Visian phakic IOLs. J AAPOS 2021; 25:27.e1-27.e8. [PMID: 33621682 DOI: 10.1016/j.jaapos.2020.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To analyze outcomes in a large cohort of spectacle-aversive children with high myopia who were treated by implantation of the Ophtec-Artisan or Visian phakic intraocular lens (pIOL). METHODS Outcome data were collated retrospectively in 78 children (115 eyes) implanted with the Ophtec-Artisan iris-enclaved anterior chamber pIOL and 91 children (154 eyes) implanted with the Visian ICL (intraocular collamer lens) sulcus pIOL. All children had difficulties with spectacle or contact lens wear. Mean age at surgery was 9.9 years; mean follow-up was 3.9 years (range, 0.6-14.1 years). RESULTS A total of 248 of 269 eyes (92%) were corrected to within ± 0.5 D of their target value. Spherical correction averaged 12.3 ± 1.0 D. Refractive spherical regression was -0.04 D/year at last follow-up. Uncorrected distance visual acuity improved from an average logMAR 1.8 to 0.4; corrected distance visual acuity improved an average 0.3 logMAR. Of the treated children, 68% had a gain in binocular fusion. Neurobehavioral and/or visuomotor comorbidities were present in 87% of children. Five eyes (2%) developed retinal detachment an average 6 years after implantation. Nine eyes (3%) implanted with the Ophtec-Artisan pIOL required repositioning after trauma. CONCLUSIONS Implantation of pIOLs in children is an effective method for correcting high myopia in spectacle noncompliant children. Rates of myopic regression after pIOL surgery are substantially lower than those reported for children treated by excimer laser photorefractive keratectomy (PRK). The prevalence of major complications was relatively low in this high-risk population.
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Chaitanya SR, Anitha V, Ravindran M, Ghorpade A, Rengappa R, Uduman MS. Safety and efficacy of toric implantable collamer lens V4c model - A retrospective South Indian study. Indian J Ophthalmol 2020; 68:3006-3011. [PMID: 33229687 PMCID: PMC7856968 DOI: 10.4103/ijo.ijo_1492_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the safety, efficacy, and complications of V4c Toric implantable collamer Lens (TICL) implantation for myopic astigmatism in the south Indian population. Methods: In this retrospective observational case series, a total of 109 eyes of 67 patients who underwent V4c TICL implantation (ICL, V4C Staar Surgical, Nidau, Switzerland) between January 2012 and August 2019 were studied with a minimum follow-up period of 6 months (mean 24 months). The main outcome measures were objective and subjective refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), safety, predictability, adverse events, and postoperative complications. Results: At 6 months, mean manifest refractive spherical equivalent (SE) decreased from - 10.90 ± 3.7D preoperatively to - 0.02 ± 0.13D postoperatively (P < 0.001) and mean cylinder decreased from - 2.3 ± 1.3 D preoperatively to - 0.04 ± 0.2 D postoperatively (P < 0.001). Postoperatively, SE within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 96.3 (105 eyes) and 100% (109 eyes), respectively. Manifest refractive cylinder within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 97.2 (106 eyes) and 100% (109 eyes), respectively. Sixty-two percent (68 eyes) showed no change in CDVA postoperatively, and no eye had lost lines of CDVA. The safety index was 1.12, and the efficacy index was 1.10. Complications were seen in two eyes (1.8%) due to high postoperative vault requiring secondary surgical interventions. Conclusion: V4c TICL is a highly effective, safe, and predictable option in treating myopic astigmatism with excellent improvement in vision and spectacle independence.
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Affiliation(s)
- S Ravi Chaitanya
- Fellow in Cornea and External Diseases, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Venugopal Anitha
- HOD, Cornea and Refractive Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Meenakshi Ravindran
- HOD, Paediatric and Strabismus Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Aditya Ghorpade
- Consultant, Cornea and External Diseases, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Ramakrishnan Rengappa
- Prof of Ophthalmology, Glaucoma Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Mahammed Sithiq Uduman
- Statistics, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
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Phakic intraocular lens implantation for the correction of hyperopia. J Cataract Refract Surg 2020; 45:1503-1511. [PMID: 31564323 DOI: 10.1016/j.jcrs.2019.05.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 11/27/2022]
Abstract
The prevalence of myopia is much higher than hyperopia. Hence, there are relatively few studies investigating phakic intraocular lens (pIOL) implantation for the correction of hyperopia. This review aimed to summarize the available relevant literature on the efficacy and safety of pIOL implantation for the correction of hyperopia and hyperopic astigmatism. At present, two types of pIOLs are used to correct hyperopia and hyperopic astigmatism: anterior chamber iris-fixated pIOLs and posterior chamber implantable collamer lenses. Both have been found to be safe and effective. No serious events (eg, retinal or choroidal detachment, endophthalmitis) were reported in the reviewed articles. Implantation of pIOLs might be the optimal refractive surgery for the correction of high hyperopia.
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12
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Abstract
We report a case of acute angle closure with significantly elevated intraocular pressure 9 hours after implantation of a phakic intraocular lens for high myopia.
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13
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Shaaban YM, Badran TAF. Three-Year Effect of Phakic Intraocular Lenses on the Corneal Endothelial Cell Density. Clin Ophthalmol 2020; 14:149-155. [PMID: 32021080 PMCID: PMC6980859 DOI: 10.2147/opth.s236041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/10/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare the effect of three different phakic intraocular lenses (pIOLs) on the corneal endothelial cell density (ECD). Patients and Methods This was a prospective observational cohort study that included 60 eyes (30 patients) with axial myopia of −6.50 to −22.00 diopters (D). The Verisyse anterior chamber (AC) rigid iris fixated pIOL, the Veriflex (AC) flexible iris fixated pIOL, and the Visian posterior chamber (PC) implantable collamer lens (ICL) were implanted in three equal groups of patients. The effect of the three pIOLs on the ECD was compared over a follow-up period of one week, and one, three, and six months, and one, two, and three years. Specular microscopy was done to evaluate the cornea before the surgery and throughout the study. Changes were statistically analyzed and compared. Results In the first three postoperative months, Verisyse and Veriflex pIOLs induced almost the same amount of endothelial cells loss of 10.3% and 10.6%, respectively, while ICLs showed endothelial cells loss of 3.5%. At the end of the three-year study, Veriflex pIOLs induced the highest rate of endothelial cell loss of 25%, while Verisyse and ICL lenses showed endothelial cells loss of 15.7% and 13.4%, respectively. The main effect of time and type of lens was statistically significant (p<0.001). Conclusion All pIOLs cause a decrease in ECD. The AC pIOLs tend to be associated with more cell loss than PC pIOLs. Surgical insult is the important factor responsible for the early endothelial cell loss, while the material from which the pIOL is made may be an important factor for the continuous corneal endothelial cell loss over a long time.
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Affiliation(s)
- Yasmine Maher Shaaban
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.,The Eye Subspecialty Center (ESC), Cairo 11402, Egypt
| | - Tamer Abdel Fattah Badran
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.,The Eye Subspecialty Center (ESC), Cairo 11402, Egypt
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Tahmaz V, Bachmann B, Tahmaz E, Schickhardt S, Fang H, Auffarth G, Cursiefen C. [Explantation of two historical posterior chamber phakic intraocular lenses 31 years after implantation]. Ophthalmologe 2019; 117:452-455. [PMID: 31324958 DOI: 10.1007/s00347-019-0942-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This article reports the case of a 56-year-old male patient who had undergone implantation of posterior chamber phakic intraocular lenses in 1987 in Russia. The patient presented to this clinic 31 years after the initial surgery with anterior cortical cataracts and initial stages of corneal decompensation in both eyes. Strategic planning and execution of surgical treatment and the further clinical course are portrayed in this report.
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Affiliation(s)
- V Tahmaz
- Medizinische Fakultät und Uniklinik Köln, Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
| | - B Bachmann
- Medizinische Fakultät und Uniklinik Köln, Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - E Tahmaz
- MVZ ADTC Mönchengladbach/Erkelenz, Erkelenz, Deutschland
| | - S Schickhardt
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg. Untersützt durch die Klaus Tschira Stiftung, Heidelberg, Deutschland
| | - H Fang
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg. Untersützt durch die Klaus Tschira Stiftung, Heidelberg, Deutschland
| | - G Auffarth
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg. Untersützt durch die Klaus Tschira Stiftung, Heidelberg, Deutschland
| | - C Cursiefen
- Medizinische Fakultät und Uniklinik Köln, Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
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Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses. Cornea 2019; 38:873-879. [PMID: 31170105 DOI: 10.1097/ico.0000000000001914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the temporal effect of toric implantable collamer lens (TICL) implantation and location on corneal endothelial cell density (ECD) over a period of 36 months after surgery. METHODS ECD [number of cells per square millimeter estimated using the Specular Microscope SP-1P (Topcon Europe Medical B.V., Netherlands)] data were collected from cases deemed suitable for the TICL (VTICMO, VTICM5; STAAR Surgical, Nidau, Switzerland). The preoperative refractive error (sphere and cylinder) ranged from -1.00 to -22.25 diopter sphere and from -0.50 to -5.50 diopter cylinder. ECD was evaluated at preoperative and all postoperative sessions. RESULTS Key findings were as follows: the mean ECD (±SD, 95% confidence interval) was 2720 cells/mm (±272, 2620-2820 cells/mm) preoperatively, which was reduced to 2372 cells/mm (±325, 2250-2490 cells/mm) at 36 months postoperatively (P < 0.001). Linear regression revealed the following significant correlations between the (1) log of the change in ECD (y1) and log of preoperative ECD (x1) at 2 years postoperatively, y1 = 2.513x1-6.2816 (n = 62, r= 0.3503, P = 0.005); (2) mean ECD (y2) and log time (in months, x2), y2= 2543.7-36.997x2-38.99x2 (r=-0.9654, n = 7, P = 0.0004); and (3) mean axial distance between the front surface of the crystalline lens and the TICL back surface (y3) and time postoperatively (in months, x3), y3 = 0.1035x3-5.2808x3 +473.18 (r = 0.8512, n = 7, P = 0.015). CONCLUSIONS Expected ECD loss after TICL implantation by 2 years postoperatively is predictable. On average, over 3 years after implantation, there is (1) an initial rapid decline in ECD, followed by a gradual fall in the rate of cell loss, and (2) a gradual fall in the distance between the TICL and the crystalline lens by 2 years postoperatively, followed by a reversal by the third year.
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Chen X, Guo L, Han T, Wu L, Wang X, Zhou X. Contralateral eye comparison of the long-term visual quality and stability between implantable collamer lens and laser refractive surgery for myopia. Acta Ophthalmol 2019; 97:e471-e478. [PMID: 30187653 PMCID: PMC6585688 DOI: 10.1111/aos.13846] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Purpose To investigate the long‐term visual quality and stability of implantable collamer lens (ICL) and laser refractive surgery (LRS) for myopia. Methods This study comprised 52 eyes of 26 high‐myopia anisometropia patients who were suitable for surgical treatment. In each patient, the higher‐myopia eye was implanted with ICL and the lower‐myopia eye was treated with LRS. The patients were followed for 3 years. During that time period, uncorrected (UDVA) and corrected distance visual acuity (CDVA), refraction, wavefront aberration and visual quality were evaluated. Results The spherical equivalent refractive error changed from −14.11 ± 3.39 D preoperatively to −1.27 ± 1.05 D 3 years after ICL implantation and from −8.75 ± 2.76 D to −1.12 ± 1.30 D after LRS. The changes in refractive error from 1 month to 3 years were −0.52 and −0.77 D for the ICL and LRS groups, respectively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.84 ± 1.00 and 1.32 ± 0.40, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.40 ± 1.10 and 1.11 ± 0.44, respectively. The postoperative coma, spherical and total higher‐order aberrations in the ICL group were lower than those in the LRS group. Conclusion Both ICL implantation and LRS are safe and effective procedures for myopia with suitable indications, but ICL implantation is more stable. Fewer induced aberrations are gained after ICL implantation.
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Affiliation(s)
- Xun Chen
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
| | - Lin Guo
- Department of Ophthalmology Xi'an No. 4 Hospital of Xi'an Jiao Tong University Xi'an China
| | - Tian Han
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
| | - Liangcheng Wu
- Department of Ophthalmology Jing'an District Centre Hospital of Fudan University Shanghai China
| | - Xiaoying Wang
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
| | - Xingtao Zhou
- Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai China
- Department of Ophthalmology NHC Key Laboratory of Myopia Fudan University Shanghai China
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Pjano MA, Pidro A, Biscevic A, Grisevic S, Pandzic B, Cerovic V. Refractive Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Correction of Myopia and Myopic Astigmatism. Med Arch 2018; 71:93-96. [PMID: 28790537 PMCID: PMC5511534 DOI: 10.5455/medarh.2017.71.93-96] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: The aim was to examine efficacy and safety after Implantable Collamer Lens (ICL) implantation for correction of myopia et myopic astigmatism. Methods: This prospective clinical study included 28 eyes of 16 patients which underwent implantation of ICL for correction of myopia up to -18,00 diopters (D) and myopic astigmatism up to -6,00 D in the Eye Clinic Svjetlost Sarajevo, from January 2013 to January 2016. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, six and twelve months. For statistical analysis SPSS for Windows and Microsoft Excel were used. Results: Out of 16 patients, with mean age of 28,21 ± 4,06 years, 12 of them had binocular and 4 of them had monocular procedure. After 12 months mean UDVA was 0,76 ± 0,16 compared to UDVA 0,04 ± 0,03 preoperatively. Mean SE preoperatively was -0,21 ± 0,27 D compared to -9,52 ± 3,69 D preoperatively. At 12 months one eye (3,57%) lost 2 Snellen lines. In this study 8 eyes (28,57%) gained 1 line, 5 eyes gained (17,56%) 2 lines, and 3 eyes (10,72%) gained 3 lines. EC loss was 5,50±4.71% after 12 months. There was no significant change of IOP by the end of 12 months follow up period. One haptic crack was reported as the only intraoperative complication. Three postoperative complications were: two lens rotations and one retinal detachment. Conclusion: Implantation of ICL is an effective and safe method for reducing or correcting myopia and myopic astigmatism.
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Affiliation(s)
| | - Ajla Pidro
- Eye Clinic Svjetlost, Sarajevo, Bosnia and Herzegovina
| | - Alma Biscevic
- Eye Clinic Svjetlost, Sarajevo, Bosnia and Herzegovina
| | | | | | - Vesna Cerovic
- University Eye Hospital "Svjetlost", Zagreb, Croatia
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Reinstein DZ, Carp GI, Archer TJ, Buick T, Gobbe M, Rowe EL, Jukic M, Brandon E, Moore J, Moore T. LASIK for the Correction of High Hyperopic Astigmatism With Epithelial Thickness Monitoring. J Refract Surg 2018; 33:314-321. [PMID: 28486722 DOI: 10.3928/1081597x-20170111-04] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate outcomes of high hyperopic LASIK using the MEL 80 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS Retrospective analysis of 830 consecutive high hyperopic LASIK procedures using the MEL 80 excimer laser and either the VisuMax femtosecond laser (Carl Zeiss Meditec) or zero compression Hansatome microkeratome (Bausch & Lomb, Rochester, NY). Inclusion criteria were attempted hyperopic correction of +4.00 diopters [D] or higher in one axis and corrected distance visual acuity (CDVA) of 20/20 or better. Patients were observed for a minimum of 1 year. Epithelial thickness monitoring by Artemis very high-frequency (VHF) digital ultrasound (ArcScan Inc., Morrison, CO) was used to evaluate potential for further steepening as a re-treatment. RESULTS One-year data were available for 785 eyes. Mean attempted spherical equivalent refraction (SEQ) was +4.52 ± 0.84 D (range: +2.00 to +6.96 D) for the primary treatment and mean cylinder was 1.05 ± 0.86 D (range: 0.00 to 5.25 D). Mean age was 50 ± 12 years (range: 18 to 70 years) and 61% were women. Postoperative SEQ was ±0.50 D in 50% and ±1.00 D in 77% of eyes after primary treatment. After re-treatment, 67% of eyes were within ±0.50 D and 89% were within ±1.00 D. Uncorrected distance visual acuity was 20/20 or better in 76% of eyes after final treatment. One line of CDVA was lost in 25% of eyes and two lines were lost in 0.4%. There was a clinically insignificant but statistically significant decrease (P < .05) in contrast sensitivity (CSV-1000) by less than 1 log unit at 3 and 6 cycles per degree (cpd) and by 1 log unit at 12 and 18 cpd. Diurnal fluctuation in refraction was identified in 2 eyes, proven by VHF digital ultrasound to be due to diurnal epithelial remodeling overnight and unrelated to maximum postoperative keratometry induced. CONCLUSIONS LASIK for hyperopia by cumulative treatment of up to +8.33 D with the MEL 80 excimer laser was found to satisfy accepted criteria for safety, efficacy, and stability when applying specialized protocols, including epithelial monitoring. [J Refract Surg. 2017;33(5):314-321.].
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Femtosecond laser–assisted cataract surgery in eyes with foldable anterior or posterior chamber phakic intraocular lenses. J Cataract Refract Surg 2018; 44:124-128. [DOI: 10.1016/j.jcrs.2017.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 11/17/2022]
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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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Goukon H, Kamiya K, Shimizu K, Igarashi A. Comparison of corneal endothelial cell density and morphology after posterior chamber phakic intraocular lens implantation with and without a central hole. Br J Ophthalmol 2017; 101:1461-1465. [PMID: 28292776 DOI: 10.1136/bjophthalmol-2016-309363] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 01/09/2017] [Accepted: 02/15/2017] [Indexed: 11/04/2022]
Abstract
AIM To compare the corneal endothelial cells after posterior chamber phakic intraocular lens with and without a central hole (hole implantable collamer lens (ICL) and conventional ICL) implantation for the correction of moderate to high myopia. METHODS This retrospective study evaluated 34 eyes of 34 patients who underwent hole ICL implantation and 25 eyes of 25 patients who underwent conventional ICL implantation. Preoperatively and 3 months, and 1 and 2 years postoperatively, we compared the central corneal endothelial cell density (ECD), coefficient of variation in cell size (CV) and the percentage of hexagonal cells (HEX) between the two groups using a non-contact specular microscope (EM-3000, Tomey). Preoperatively and 2 years postoperatively, we also compared them in the peripheral regions. RESULTS The mean central ECD loss was 0.3% and 1.1%, 2 years after hole ICL and conventional ICL implantation, respectively (Mann-Whitney U test, p=0.72). There were no significant changes in central ECD, CV or HEX at any time points either after hole ICL or conventional ICL implantation, and a significant decrease only in terms of ECD in the superior regions after conventional ICL implantation. CONCLUSIONS Both ICLs do not induce a significant change in the density, polymegethism or polymorphism of corneal endothelial cells even 2 years postoperatively, except for the density in the superior regions after conventional ICL implantation. However, hole ICL implantation may have advantages over conventional ICL implantation only in terms of the density in the superior regions, possibly because preoperative laser iridotomies are unnecessary.
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Affiliation(s)
- Hiroyasu Goukon
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Kocová H, Vlková E, Michalcová L, Motyka O. Implantation of posterior chamber phakic intraocular lens for myopia and hyperopia - long-term clinical outcomes. J Fr Ophtalmol 2017; 40:215-223. [PMID: 28291554 DOI: 10.1016/j.jfo.2016.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/21/2016] [Accepted: 10/18/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate long-term refractive outcomes of implantable collamer lens (ICL) implantation and late postoperative complications. METHODS We assessed outcomes of patients who underwent ICL implantation (type ICM V4 for myopia, ICH V3 for hyperopia, TICM V4 for astigmatism) in our department between 1998 and 2013. It comprised 62 eyes (40 myopic and 22 hyperopic). The average follow-up period was 10.5 years. We evaluated: uncorrected and best-corrected visual acuity (UCVA and BCVA), spherical equivalent (SE), ICL vault, endothelial cell density and late postoperative complications. RESULTS In myopes, the average UCVA was 1.0±0.37 and BCVA 1.18±0.38, in hyperopes 0.78±0.19 and 1.14±0.18, respectively. The average SE in myopes, whose target refraction was emmetropia, was -0.6±0.83 Dsf, in hyperopes +0.73±0.93. Central ICL vault was 206.16μm±105.94, (range 10-427) in myopes, 195.5μm±109.09, (range 20-404) in hyperopes. The most common late postoperative complication was cataract formation. Three myopic eyes (7.5%) developed symptomatic anterior subcapsular opacities with loss of at least two lines of BCVA. Cataract significantly affecting visual acuity occurred in 5 myopic eyes (12.5%) and 2 hyperopic eyes (9.09%). In these eyes, ICL removal and cataract surgery was performed. CONCLUSIONS In our experience, ICL implantation in moderate and high ametropia was effective and relatively safe. The most common late complication was cataract formation. This complication can be managed effectively surgically with good refractive outcomes without loss of BCVA.
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Affiliation(s)
- H Kocová
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic.
| | - E Vlková
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - L Michalcová
- Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - O Motyka
- Nanotechnology Centre, VŠB - Technical University of Ostrava, 17, Listopadu 15, 70833 Ostrava, Czech Republic
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Implantable collamer lens V4b and V4c for correction of high myopia. J Curr Ophthalmol 2016; 27:76-81. [PMID: 27239582 PMCID: PMC4881151 DOI: 10.1016/j.joco.2016.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To evaluate the visual outcome and intraocular pressure changes after Visian Implantable Collamer Lens (ICL) implantation V4b and V4c (with central hole) for correction of high myopia. METHODS A prospective, consecutive, interventional comparative case series of V4b and V4c ICL implantation was done in high myopic patients who were unsuitable for laser vision. The main outcome measures studied were uncorrected and corrected distant visual acuity (UDVA, CDVA), ICL vault, intraocular pressure (IOP), endothelial cell count (ECC), and development of subcapsular lens opacities. The patients were evaluated at postoperative 1,3,6, and 9 months. RESULTS A total of 62 eyes of 32 patients (24.56 ± 4.8 years) underwent V4b ICL implantation (21 non-toric, 41 toric ICL-TICL) with intraoperative peripheral iridectomy (PI), and 10 eyes of 5 patients (26.13 ± 3.8 years) had implantation of V4c ICL (4 non-toric, 6 TICL). The mean preoperative manifest spherical equivalent (MSE) was -9.98 ± 2.8 D and -9.14 ± 2.4 D in the V4b and V4c groups, respectively, which reduced to postoperative values of -0.24 ± 1.3 D and -0.2 ± 1.18 D, respectively. At the end of 9 months follow-up, mean ECC loss was 6.4% and 6.1%, mean vault was 573.13 ± 241.13 μ, and 612 ± 251.14 μ, respectively, in the V4b and V4c groups. Anterior subcapsular opacities were present in 6.9% and 3.14% of eyes with V4b and V4c groups, respectively. Four eyes from V4b (9.75%) and 1 eye from V4c (16.66%) had rotation of more than 30° and required realignment surgery, which was done successfully. Two eyes (3.22%) with V4b ICL implantation had high postoperative IOP (>35 mm Hg) due to blocked PI and required Nd:Yag laser iridotomy, which was done with successful control of IOP. The safety indices were 1.11 and 1.14, and efficacy indices were 1.4 and 1.5 in the V4b and V4c groups, respectively, at the end of 9 months. CONCLUSION ICL implantation is a safe and effective surgery for correction of high myopia. Implantation of ICL with a central hole showed negligible postoperative IOP fluctuations without a peripheral iridectomy.
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Lisa C, Naveiras M, Alfonso-Bartolozzi B, Belda-Salmerón L, Montés-Micó R, Alfonso JF. Posterior chamber collagen copolymer phakic intraocular lens with a central hole to correct myopia: One-year follow-up. J Cataract Refract Surg 2016; 41:1153-9. [PMID: 26189376 DOI: 10.1016/j.jcrs.2014.10.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/16/2014] [Accepted: 10/19/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess the predictability, stability, efficacy, and safety of a newly developed posterior chamber phakic intraocular lens (pIOL) (model V4c Visian Implantable Collamer Lens) to correct moderate to high myopia. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Prospective case series. METHODS This study evaluated eyes that had implantation of the new pIOL model with a central hole for myopia correction. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density, pIOL vault, and adverse events were evaluated over 12 months. RESULTS The study comprised 147 eyes of 80 patients. Preoperatively, the mean spherical equivalent (SE) was -8.80 diopters (D) ± 2.60 (SD). At 12 months, the mean SE was -0.14 ± 0.26 D, with 93.9% of eyes within ±0.50 D of the target and 100% of eyes within ±1.00 D. The mean UDVA and CDVA were 0.028 ± 0.055 logMAR and 0.003 ± 0.013 logMAR, respectively. The efficacy and safety indices were 1.00 and 1.04, respectively. All eyes had unchanged CDVA or gained 1 or more lines during the follow-up. The IOP remained stable over time; no eye developed anterior subcapsular cataract. Twelve months postoperatively, the mean vault was 405.5 ± 184.7 μm (range 100 to 980 μm), and the mean endothelial cell loss was 1.7%. CONCLUSION The good refractive and visual acuity outcomes and the highly stable IOP values obtained over 12 months support the use of the new pIOL model with a central hole for the correction of 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)
- Carlos Lisa
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Miguel Naveiras
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Belén Alfonso-Bartolozzi
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Lurdes Belda-Salmerón
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - José F Alfonso
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain.
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Abstract
Phakic intraocular lenses revolutionize refractive surgery and continue to serve as an excellent option for vision correction in patients who are not ideal candidates for laser vision correction. This article will review special indications of phakic intraocular lenses in the clinical practice.
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Affiliation(s)
- Roberto Pineda
- Keratorefractive Surgery Service, Massachusetts Eye and Ear Infirmary, Boston MA, USA
| | - Tulika Chauhan
- Keratorefractive Surgery Service, Massachusetts Eye and Ear Infirmary, Boston MA, USA
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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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Falcon C, Norero Martínez M, Sancho Miralles Y. [Laser Blended Vision for presbyopia: Results after 3 years]. J Fr Ophtalmol 2015; 38:431-9. [PMID: 25910743 DOI: 10.1016/j.jfo.2015.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/29/2015] [Accepted: 02/04/2015] [Indexed: 11/15/2022]
Abstract
PURPOSE Retrospective study of the first 173 patients with presbyopia who underwent LASIK with a non-linear aspheric ablation profile and micro-monovision for the correction of presbyopia with myopia, astigmatism, hyperopia or emmetropia: Laser Blended Vision(®) Program by Carl Zeiss Meditec(®) (Jena, Germany). METHODS We retrospectively studied the first consecutive 173 patients with presbyopia who underwent LASIK with the wavefront-guided Laser Blended Vision(®) Program by Zeiss(®) in our Excimer Laser Zeiss Mel-80 by Carl Zeiss Meditec(®) (Jena, Germany) over the last three years in our clinic (Optima Laser Clinic, Valence, Spain). The program has a non-linear aspheric ablation profile that increases the spherical aberration in both eyes. A slight myopia of -1.5 diopters (D) in the non-dominant eye is also programmed. We analysed the results and patient satisfaction. The patients were separated into two groups: less than 50 years old and 50 years or more. Follow-up was from 1 to 28 months. We also separated two groups: follow-up under 12 months and follow-up of 12 months or more. We analysed the efficacy, safety and predictability of the procedure. RESULTS Seventy-nine male and 94 female patients between 42 and 69 years old were studied, for a total of 337 eyes. Only eight patients (4.62%) were between 42 and 44; 55 (31.79%) were between 45 and 49; 110 patients (63.58%) were 50 years or more. Nine patients underwent the surgery in the non-dominant eye only. Twelve (6.94%) patients were emmetropic (0.5 or less spherical equivalent), 42 (24.28%) were myopic or myopic astigmatic, and 119 (68.79%) were hyperopic or hyperopic astigmatic. One hundred and thirty-six patients (78.61%) had pre-operative near vision between J4 and J10. One hundred and seventy-one patients (98.84%) had post-operative near vision between J1 and J3; 150 (86.7%) had J1 (efficacy). Post-operative visual acuity without correction for distance was 20/20 or better in 159 patients (91.91%) (binocular). The predictability within 0.5 D was 87.86%. Safety 99.7% (336/337 eyes): one eye of a diabetic patient lost two lines BCVA. A total of 93.64% were satisfied with the procedure, 2.89% used eye-glasses for certain activities, 1.73% reported dry eye, 0.58% reported a nonspecific lack of adaptation, and there were no serious complications; 3.47% did not achieve their expectations. Twenty-four patients (13.87%) needed an enhancement, 18 of them (75.5%) for only one eye, with 88.89% of these being the non-dominant eye. Forty-nine patients (28.32%) had over 12 months follow-up, with 95.92% still satisfied. CONCLUSIONS Laser Blended Vision(®) is an excellent option, well tolerated, stable and effective for patients with presbyopia and myopia, astigmatism, hyperopia or emmetropia, also avoiding an intraocular procedure.
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Affiliation(s)
- C Falcon
- Clinique Optima Laser, Gran Via Germanias, 6, 46006 Valencia, Espagne.
| | - M Norero Martínez
- Clinique Optima Laser, Gran Via Germanias, 6, 46006 Valencia, Espagne
| | - Y Sancho Miralles
- Clinique Optima Laser, Gran Via Germanias, 6, 46006 Valencia, Espagne
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Karimian F, Baradaran-Rafii A, Hashemian SJ, Hashemloo A, Jafari ME, Yaseri M, Ghahari E, Akbarian S. Comparison of three phakic intraocular lenses for correction of myopia. J Ophthalmic Vis Res 2015; 9:427-33. [PMID: 25709766 PMCID: PMC4329701 DOI: 10.4103/2008-322x.150805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 11/11/2022] Open
Abstract
Purpose: To compare the visual outcomes and complications of three different types of phakic intraocular lenses (PIOLs), for correction of moderate to high myopia. Methods: We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer lens (ICL, 36 eyes). Best corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared. Results: Mean follow-up period was 30 ± 11 months. Preoperatively, spherical equivalent (SE) refractive error was −11.6 ± 3.7, −9.59 ± 1.97, and −12.3 ± 4.8 D in the Artisan, Artiflex and ICL groups, respectively. SE was comparable among the study groups at final follow-up (P = 0.237). Mean astigmatic reduction was 0.31 ± 0.72, 0.45 ± 0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P = 0.007). Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P = 0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P = 0.158); pachymetric changes were minimal with no difference among the three groups (P = 0.754), and mean CEC loss was 10 ± 9%, 9 ± 6% and 9 ± 10% in the Artisan, Artiflex and ICL groups, respectively (P = 0.694). HOAs (P = 0.039), vertical trefoil (P = 0.032) and spherical aberration (P = 0.001) were higher with Artisan group as compared to ICL. Total aberrations (P = 0.028) and spherical aberration (P = 0.001) was also higher with Artisan group as compared to Artiflex. Conclusion: Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.
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Affiliation(s)
- Farid Karimian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Seyed Javad Hashemian
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Hashemloo
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Jafari
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ghahari
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shadi Akbarian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Son GS, Kim JW, Lim TH, Choi KY, Cho BJ. Comparison of Clinical Outcomes in Implantable Collamer Lens Implantation between AQUA ICL® and Conventional ICL. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.9.1316] [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]
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Lee D, Lee SJ, Kyung H. Rotational Stability after Toric Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.4.477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Seung Jae Lee
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Haksu Kyung
- Department of Ophthalmology, National Medical Center, Seoul, Korea
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Kang DW, Eom YS, Rhim JW, Kang SY, Kim HM, Song JS. Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.5.784] [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)
- Dong Wan Kang
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Sub Eom
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jay Won Rhim
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Su Yeon Kang
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Outcome of posterior chamber phakic intraocular lens procedure to correct myopia. Saudi J Ophthalmol 2013; 27:259-66. [PMID: 24371421 DOI: 10.1016/j.sjopt.2013.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To assess the safety and efficacy of the implantable contact lens (ICL™) to treat myopia. DESIGN Clinical, retrospective, single center, non-randomized case series. PARTICIPANTS Sixty-nine eyes of 46 patients with myopia ranging from -3.00 to 25.00 D were included in this study. INTERVENTION Implantation of the ICL™. MAIN OUTCOME MEASURES Uncorrected Visual Acuity (UCVA), refraction, best spectacle corrected visual acuity (BSCVA), adverse events, operative and postoperative complications, subjective assessment and symptoms. RESULTS The mean follow-up was 12.35 ± 6.13 (SD) months (range, 6 months-32 months). At the last visit, 49.20% of eyes had 20/20 or better UCVA compared to preoperative 20/20 or better BSCVA of 31.9% of eyes; 69.23% of eyes had postoperative UCVA better than or equal to preoperative BSCVA. The mean manifest refractive cylinder was 1.93 ± 1.21 D at baseline and 1.00 ± 0.92 D postoperatively. The mean manifest refraction spherical equivalent (MRSE) was -11.70 ± 4.24 D preoperatively and -0.69 ± 1.13 D postoperatively. A total of 69.8% of eyes were within ±0.5 D of the predicted MRSE; 84.1% were within ±1.0 D, and 88.90% were within ±2.0 D. BSCVA of 20/20 or better was achieved in 64.6% of eyes postoperatively, compared to 31.9% preoperatively. Mean improvement in BSCVA was 1line. One eye (1.5%) lost ⩾2 lines of BSCVA at the last visit, whereas 20% of eyes improved by ⩾2 lines. A total of 56.92% of cases gained ⩾1 line of BSCVA and 4.62% of cases lost ⩾1 line. Four ICL lenses were removed without significant loss of BSCVA, and 2 eyes with clinically significant lens opacities were observed. Four eyes (5.8%) developed a pupillary block the first day postoperatively. One eye (1.4%) developed a hypotony and AC shallowing. CONCLUSION Implantation of ICL for the correction of myopia was a safe procedure with good visual and refractive results from the early postoperative period to 1 year. Long-term follow-up is required to confirm the long-term safety of this implant.
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Alfonso JF, Lisa C, Cueto LFV, Belda-Salmerón L, Madrid-Costa D, Montés-Micó R. Clinical outcomes after implantation of a posterior chamber collagen copolymer phakic intraocular lens with a central hole for myopic correction. J Cataract Refract Surg 2013; 39:915-21. [DOI: 10.1016/j.jcrs.2013.01.036] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Revised: 01/04/2013] [Accepted: 01/05/2013] [Indexed: 02/02/2023]
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Ghoreishi M, Masjedi A, Nasrollahi K, Rahgozar A, Jenab K, Fesharaki H. Artiflex versus STAAR implantable contact lenses for correction of high myopia. Oman J Ophthalmol 2012; 4:116-9. [PMID: 22279398 PMCID: PMC3263163 DOI: 10.4103/0974-620x.91266] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: To compare two phakic intraocular lenses, Artiflex and STAAR® implantable contact lens (ICL), in high myopia. Setting: Isfahan Ophthalmology Clinic, Iran. Materials and Methods: In a randomized, prospective clinical trial study, 40 eyes of 20 patients who came to Isfahan ophthalmology clinic to correct their refractive error were examined. Artiflex was inserted in 20 eyes and ICL in the other 20 eyes. After 1 year, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, intraocular pressure (IOP), and specular microscopy of corneal endothelium were assessed in both the groups. Results: In this study, there was no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, and specular microscopy, 1 year after surgery. 40% of eyes in the Artiflex group developed anterior chamber cell and flare reaction 1 year postoperatively, but no patient in the ICL group developed the same. So, there is obvious difference in the rate of anterior chamber cell and flare reaction between these two groups. Conclusion: These two lenses have similar outcomes except in the incidence rate of anterior chamber cell and flare reaction that is greater in the Artiflex group. So, these two lenses are safe with predictable outcome in treating high myopia.
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Affiliation(s)
- Mohammad Ghoreishi
- Department of Ophthalmology, Isfahan University of Medical Sciences, Persian Eye Clinic, Isfahan, Iran
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Posterior chamber toric phakic intraocular lenses for myopic astigmatism: First experience in India. J Cataract Refract Surg 2012; 38:1583-9. [DOI: 10.1016/j.jcrs.2012.04.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 03/30/2012] [Accepted: 04/17/2012] [Indexed: 11/18/2022]
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Espinosa-Mattar Z, Gomez-Bastar A, Graue-Hernández EO, Navas A. DSAEK for implantable collamer lens dislocation and corneal decompensation 6 years after implantation. Ophthalmic Surg Lasers Imaging Retina 2012; 43 Online:e68-72. [PMID: 22823028 DOI: 10.3928/15428877-20120712-04] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 04/02/2012] [Indexed: 11/20/2022]
Abstract
A 39-year-old woman with a history of high myopia underwent uneventful implantation of phakic posterior chamber implantable collamer lenses (ICLs) 6 years earlier in both eyes with a visual acuity of 20/20 bilaterally. The patient presented as an emergency with sudden decreased vision in her right eye after blunt trauma. Slit-lamp examination showed a partially dislocated ICL in the anterior chamber, associated with ocular hypertension. It was decided to treat her with topical ocular hypotensive agents and surgical repositioning of the ICL. There was a progressive loss of endothelial cells and decreased visual acuity. Descemet stripping automated endothelial keratoplasty was needed to correct the endothelial failure. This case presents a potential complication of the ICL several years after implantation, and should be considered in these types of procedures.
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Affiliation(s)
- Zoraida Espinosa-Mattar
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
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Akcay L, Eser I, Kaplan AT, Taskiran-Comez A, Dogan OK. Phakic anterior chamber lenses in very high myopia: an 18-month follow up. Clin Exp Ophthalmol 2012; 40:275-81. [PMID: 21718404 DOI: 10.1111/j.1442-9071.2011.02632.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. DESIGN A prospective interventional case series at the Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey. PARTICIPANTS Sixty-two eyes of 31 patients received iris-claw lens (group 1) (Artiflex AC 401, Ophtec), and 43 eyes of 22 patients received angle-supported lens (group 2) (I-Care, Corneal). METHODS The mean preoperative spherical equivalents for group 1 and group 2 were -12.13 D and -18.95 D, respectively. Endothelial cell density was measured at day 1 and at 1, 3, 6, 12 and 18 months for follow ups. MAIN OUTCOME MEASURES Percentage change in endothelial cell density and improvement in visual acuity. RESULTS At the 18-months follow up, uncorrected visual acuity improved to logMAR 0.37 ± 0.23 from 1.60 ± 0.10 in group 1, and logMAR 0.47 ± 0.14 from 0.70 ± 0.20 in group 2; best spectacle corrected visual acuity improved to logMAR 0.23 ± 0.22 from logMAR 0.36 ± 0.14) in group 1, and logMAR 0.29 ± 0.18 from logMAR 0.50 ± 0.20) in group 2 (P<0.001, in both groups). Mean decreased endothelial cell density was 241 cells/mm(2) (8.61%) and 223 cells/mm(2) (8.42%) at 18 months follow up in group 1 and 2, respectively (P=0.17) but significant in comparison to preoperative values for both groups (P<0.001). CONCLUSIONS Although both iris-claw and angle-supported lenses offer good refractive outcomes significant endothelial cell density was observed at 18 months follow up.
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Affiliation(s)
- Levent Akcay
- Dr Lutfi Kirdar Kartal Training and Research Hospital, Eye Clinic Acibadem Hospital, Maslak, Istanbul
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Ozertürk Y, Kubaloglu A, Sari ES, Koytak A, Capkin M, Akçay L, Evcili PS. Foldable iris-fixated phakic intraocular lens implantation for the correction of myopia: two years of follow-up. Indian J Ophthalmol 2012; 60:23-8. [PMID: 22218241 PMCID: PMC3263239 DOI: 10.4103/0301-4738.91340] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose: To evaluate the safety, efficacy and potential risks of Artiflex foldable iris-fixated phakic intraocular lens (pIOL) implantation for the management of myopia. Materials and Methods: Seventy-eight eyes of 40 consecutive patients with a mean spherical refraction of –11.70 ± 3.77 diopters (D; range –5.50 to –17.5 D) were included in this prospective, noncomparative, interventional case series. Main parameters assessed were uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BSCVA), corneal topography (Orbscan II, BauchandLomb, Rochester, NY, USA), manifest and cycloplegic refractive errors, endothelial cell density (ECD) and applanation tonometry. Results: After 2 years, BSCVA was 20/40 or better in 82% of the eyes and UCVA was 20/40 or better in 84% of the eyes. After 1 month, 1 year, and 2 years, 51.3% (37 of 72 eyes), 58.9% (46 of 78 eyes) and 76.0% (38 of 50 eyes) of eyes gained 1 line or more of BSCVA, respectively. Compared to preoperative values, the mean endothelial cell loss was 2.6% at 1 month, 4.9% at 1 year and 7.4% at 2 years. Pigmented or non-pigmented precipitates were observed in17 eyes (21.7%) which were treated with topical corticosteroids. At the second postoperative year, pigmented precipitates persisted in nine eyes. However, this was not associated with a loss of BSCVA. Conclusion: The implantation of Artiflex pIOL is an effective surgical option for the management of high myopia. The most common complication observed within 2 years of follow-up was accumulation of pigmented precipitates with no effect on the final BSCVA.
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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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Kumar DA, Agarwal A, Prakash G, Sivanganam S, Jacob S, Agarwal A. Viscocannula-assisted reinversion of implantable collamer lens: comparison of postoperative outcomes with the fellow eyes. Am J Ophthalmol 2012; 153:62-7.e2. [PMID: 21907968 DOI: 10.1016/j.ajo.2011.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 05/27/2011] [Accepted: 06/04/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze and compare the postoperative outcomes of eyes with accidental intraoperative inversion of implantable collamer lens (ICL) and viscocannula-assisted reinversion in high myopia. DESIGN Retrospective observational case comparison. METHODS SETTING Institutional practice. PATIENTS Consecutive eyes with accidental intraoperative inversion of ICL and viscocannula-assisted reinversion from January 2007 to September 2010 were analyzed retrospectively. They were compared with the fellow eyes with normal ICL implantation at 1 month, 6 months, and 2 years. MAIN OUTCOME MEASURES Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), corneal pachymetry, endothelial cell loss, intraocular pressure, lens transparency, anterior chamber depth, and postoperative uveitis. RESULTS A total of 206 myopic eyes had ICL implantation. Eight eyes (3.8%) of 8 patients had accidental intraoperative reinversion. Their fellow eyes had normal ICL implantation. There was no significant change (P = .611) in UCVA (reinverted and fellow eyes) at 2 years. There was no significant difference in postoperative UCVA (P = .611) and BCVA (P = .854) between the reinverted and the fellow eyes. The mean endothelial loss at 1 month, 6 months, and 2 years was 0.96% ± 0.5%, 0.92% ± 0.63%, and 0.89% ± 0.52% respectively in the reinverted eyes. There was no significant difference in the endothelial loss between the 2 groups at 1 month (P = .753), 6 months (P = .834), and 2 years (P = .916). One out of 8 eyes with reinversion had postoperative corneal edema, which resolved at 48 hours. None of the eyes reported uveitis or glaucoma. There was no loss of lens transparency. CONCLUSION Intraoperative inversion can occur during insertion of ICL and viscocannula-assisted reinversion can be performed without significant complications.
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Kwak AY, Ryu IH, Kim JK, Kim TI, Ha BJ. Effect of Preoperative Crystalline Lens Rise on Vaulting after Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.12.1749] [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)
- Ae Young Kwak
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
- Siloam Eye Hospital, Seoul, Korea
| | | | | | - Tae Im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Portaliou DM, Kymionis GD, Panagopoulou SI, Kalyvianaki MI, Grentzelos MA, Pallikaris IG. Long-term results of phakic refractive lens implantation in eyes with high myopia. J Refract Surg 2011; 27:787-91. [PMID: 21739931 DOI: 10.3928/1081597x-20110628-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 05/27/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the long-term results of phakic refractive lens (PRL; Carl Zeiss Meditec) implantation in eyes with high myopia. METHODS In this retrospective, noncomparative, interventional case series, 143 myopic eyes of 82 patients were treated for high myopia with the implantation of the silicone PRL in the posterior chamber. RESULTS Mean follow-up was 3.8±1.7 years (range: 1 to 6 years). Six years postoperatively (n=34), a statistically significant reduction was noted in the cycloplegic spherical equivalent from -14.08±4.00 diopters (D) (range: -24.88 to -4.75 D) before PRL implantation to -0.45±0.62 D (range: -1.00 to 1.00 D) (P<.001). At 6 years, 67.6% (23 eyes) and 91.2% (31 eyes) were within ±0.50 and ±1.00 D of target refraction, respectively. Mean logMAR uncorrected and corrected distance visual acuity improved significantly (P<.001) (counting fingers preoperatively in all eyes to 0.17±0.15 [range: 0.54 to -0.06] and 0.19±0.19 [1.00 to -0.08] to 0.07±0.10 [range: 0.30 to -0.10], respectively). Complications included anterior capsule damage (3 eyes), temporary intraocular pressure increase (14 eyes), pigment dispersion (1 eye), and PRL decentration (1 eye). No eyes presented any signs of cataract up to 6 years postoperatively. CONCLUSIONS Long-term results show that PRL implantation is an effective and safe method for treating high myopia.
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Fernandes P, González-Méijome JM, Madrid-Costa D, Ferrer-Blasco T, Jorge J, Montés-Micó R. Implantable collamer posterior chamber intraocular lenses: a review of potential complications. J Refract Surg 2011; 27:765-76. [PMID: 21710954 DOI: 10.3928/1081597x-20110617-01] [Citation(s) in RCA: 186] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 05/27/2011] [Indexed: 01/31/2023]
Abstract
PURPOSE To review the peer-reviewed literature reporting postoperative complications of the most recent models of Visian Implantable Collamer posterior chamber intraocular lenses (ICL, STAAR Surgical Co). METHODS A literature search of the PubMed database was performed to identify all articles related to ICL complications. Articles were obtained and reviewed to identify those that reported complications using the latest ICL designs. RESULTS Cataract was the major postoperative complication reported: 136 (5.2%) in 2592 eyes. Of those, 43.4% (n=59) were reported within 1 year, 15.4% (n=21) between 1 and 3 years, and 35.3% (n=48) ≥ 3 years after ICL implantation. Twenty-one (15.4%) cataracts were reported as surgically induced, 46 (33.8%) eyes had poor vault (<200 μm), and cataract surgery was carried out in 27.9% (n=38) of eyes. Early acute intraocular pressure increase was also reported to be relatively frequent, whereas acute pupillary block was less frequent and mostly resolved with additional iridotomies. A total of 42 ICLs were explanted due to cataract and IOP. Reported endothelial cell loss varied from 9.9% at 2 years to 3.7% 4 years postoperatively. This loss was reported to be more pronounced within the first 1 to 2 years, with stability or lower progression after that time. CONCLUSIONS The majority of reported complications after ICL implantation are cataract formation. The improvements in lens geometry and more accurate nomograms applied to the selection of the lens to be implanted, in addition to the surgeon's learning curve, might be factors in the decreased occurrence of postoperative complications reported currently.
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46
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Alfonso JF, Baamonde B, Fernández-Vega L, Fernandes P, González-Méijome JM, Montés-Micó R. Posterior chamber collagen copolymer phakic intraocular lenses to correct myopia: Five-year follow-up. J Cataract Refract Surg 2011; 37:873-80. [DOI: 10.1016/j.jcrs.2010.11.040] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 10/21/2010] [Accepted: 11/03/2010] [Indexed: 11/30/2022]
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Chung YW, Byun YS, Chung SK. Long-Term Changes in Tilt, Decentration and Anterior Chamber Depth After Implantable Collamer Lens Insertion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2011. [DOI: 10.3341/jkos.2011.52.2.157] [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)
- Yeon Woong Chung
- Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea
| | - Yong Soo Byun
- Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea
| | - Sung Kun Chung
- Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea
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48
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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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49
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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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50
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Spherical implantable collamer lenses for myopia and hyperopia: 126 eyes with 1-year follow up. Clin Exp Ophthalmol 2010; 38:21-6. [PMID: 20447097 DOI: 10.1111/j.1442-9071.2010.02192.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND To report on 1-year follow up of a series of 126 eyes implanted with a spherical implantable collamer lens (ICL). METHODS Retrospective case note review of 126 eyes (68 patients) undergoing ICL placement by a single surgeon (TG) to correct preoperative mean spherical equivalents between +8.88 and -20.50 D. Main outcome measures included uncorrected visual acuity (UCVA), refraction, best spectacle-corrected VA, unaided binocular vision, adverse events, operative/postoperative complications and patient symptoms. RESULTS Complete data were available at 1 year on 121 of the 126 eyes (65 out of 68 patients). At 12 months 86% (104/121) had postoperative UCVA better than or equal to preoperative best spectacle-corrected VA, and 98% (118/121) had UCVA within one line of preoperative best spectacle-corrected VA. Ninety-six per cent (116/121) had postoperative UCVA of 6/9 or better, and 100% had postoperative best-corrected visual acuity of 6/12 or better. Ninety-eight per cent (64/65) patients had unaided binocular vision at 1 year of 6/7.5 or better. Average myopia treated was -8.83 D (116 patients), and average hyperopia +7.14 D (10 patients). Two ICLs were replaced because of high vaulting; one eye had increased intraocular pressure that resolved with smaller ICL placement. Four patients had visually insignificant pigment deposits on the ICL at 3/12, but no pigmentary glaucoma. Five patients noticed haloes around lights at night, none preventing driving. CONCLUSIONS One-year results from this study, the largest reported clinical investigation of the use of ICLs in New Zealand, support the safety, efficacy and predictability of ICL to treat both hyperopic and myopic spherical refractive errors.
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