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Lee Y, Han SB, Auffarth GU, Son HS, Khoramnia R, Choi CY, Moon K, An SI, Lee JM, Lee JH. Vertical implantable collamer lens as a novel method to increase rotational stability. PLoS One 2024; 19:e0308830. [PMID: 39159219 PMCID: PMC11333007 DOI: 10.1371/journal.pone.0308830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
PURPOSE We investigated the vertical implantation of a toric implantable collamer lens (ICL) and compared the rotational stability with that of horizontal implantation. METHODS This matched comparative study retrospectively reviewed and analyzed data from patients who underwent ICL implantation from 2003-2022 by 1:1 matching vertical and horizontal (V and H toric groups, respectively) implantation patients according to preoperative astigmatism, spherical equivalent, sulcus-to-sulcus, anterior chamber depth, and ICL size. Visual acuity, manifest refraction, vaulting, and rotation were measured 3 months postoperatively. RESULTS We included 646 eyes (323 each in the V and H toric groups). No statistically significant difference was observed between groups in postoperative visual acuity, refractive error, and astigmatism. Vaulting was lower in the V toric group. (P < 0.001). The mean lens rotation in the V toric group was less than that in the H toric group (1.11 ± 2.84° versus 3.02 ± 10.34°, P = 0.001). The proportion of eyes in the V and H toric groups showing ≥10° of rotation was 2.5% (8 eyes) and 6.5% (21 eyes), respectively (P = 0.014). Despite repositioning from rotation, three (0.9%) and eight (2.5%) eyes required removal owing to lens re-rotation in the V and H toric groups, respectively. CONCLUSION Toric ICL vertical implantation showed good rotational stability, and appropriate visual acuity correction results with relatively low vaulting. This procedure therefore presents an effective novel method that could replace horizontal toric ICL implantation.
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Affiliation(s)
- Yongwoo Lee
- Department of Ophthalmology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | | | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kun Moon
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Sang Il An
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Je Myung Lee
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Jong Ho Lee
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
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Zhang Q, Gong D, Li K, Dang K, Wang Y, Pan C, Yan Z, Yang W. From inception to innovation: bibliometric analysis of the evolution, hotspots, and trends in implantable collamer lens surgery research. Front Med (Lausanne) 2024; 11:1432780. [PMID: 39224608 PMCID: PMC11366652 DOI: 10.3389/fmed.2024.1432780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Background As one of several refractive surgeries, Implant Collamer Lens (ICL) surgery offers stable biocompatibility and consistent, high-quality visual outcomes. ICL has become an effective complement to corneal refractive surgery, gradually becoming one of the mainstream methods for correcting refractive errors. This study employs bibliometric methods to analyze research on ICL surgery to understand the progress, hotspots, and potential future trends in this field. Methods This study performed a bibliometric analysis of all ICL-related articles collected from the Web of Science Core Collection database between January 1st, 1996, and December 31st, 2023. The CiteSpace 6.2.R4 tool, Excel and the Web of Science website were used to analyze data by country, institution, keywords, and clusters of keywords. Additionally, an in-depth interpretation and analysis were conducted on the field's high-impact articles. Results Since the first clinical application report of ICL, there have been a total of 875 studies. The number of papers published annually has shown an overall increasing trend. Studies published from China are the most numerous, accounting for 29.14% (n = 255) of the total. Among the institutions, Fudan University and Kitasato University both have published more than 50 papers, with Kitasato University having the highest H-index of 26. The journals with the top 10 publication volumes are all specialized in ophthalmology. The burst keywords since the introduction of ICL surgery have been "intraocular lens," "refractive surgery," and "cataract surgery." The current burst keywords include "visual quality," "vector analysis," "axial length," etc. The results of keyword clustering included ICL, pIOL, high myopia, axial length, optical quality, refractive surgery, ICL implantation, and pupil size. In the High-impact Articles, it was found that the high-impact articles predominantly focus on the safety, efficacy, and predictability of ICL surgery. Conclusion Research on ICL has grown since its clinical introduction, with the advent of the central hole ICL sparking a surge in recent hotspots, particularly in China. Current hotpots in the field of ICL surgery are "visual quality," "ICL implantation," "vector analysis," "axial length," "evo ICL," "ICL v4c," and "ICL." ICL surgery research trends have evolved from implantation techniques to biological parameters associated with ICL surgery and the benefits of new ICL designs.
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Affiliation(s)
- Qing Zhang
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang Medical University, Xinxiang, China
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Di Gong
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kunke Li
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Yun Wang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Changfeng Pan
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Zonghui Yan
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
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Chung B, Choi JY, Kang DSY, Kim K, Kim BY, Kim TI. Ten-Year Clinical Outcomes of V4c Implantable Collamer Lens Implantation: Longitudinal Analysis of Visual Acuity, Endothelial Cell Density, and Vault Dynamics. Am J Ophthalmol 2024; 269:1-10. [PMID: 39142448 DOI: 10.1016/j.ajo.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE This study aimed to evaluate the long-term clinical outcomes of V4c Implantable Collamer Lens (ICL) implantation for myopia correction over a 10-year period. DESIGN Retrospective interventional case series METHODS: This retrospective interventional study involved 103 myopic eyes from 54 patients. Visual outcomes, including visual acuity and manifest refraction were assessed. Annual measurements of endothelial cell density (ECD), vault, anterior chamber depth, and intraocular pressure were analyzed using mixed-effects models. RESULTS At the 10-year follow-up, the mean Logarithm of the Minimum Angle of Resolution (logMAR) uncorrected distance visual acuity and corrected distance visual acuity (CDVA) were -0.037 ± 0.052 and -0.041 ± 0.046, respectively. The mean efficacy and safety indices were 1.11 ± 0.13 and 1.12 ± 0.12. A loss of one line of CDVA occurred in 2% of cases, while 59% gained one or more lines. Postoperative manifest refraction spherical equivalent (MRSE) was within ±0.5 diopters (D) and ±1.0 D in 74% and 99% of cases, respectively, with a mean MRSE of -0.19 ± 0.41 D. Data for ECD and vault fit an exponential decay model, demonstrating a continuous yet gradually slowing decrease over time. Decay rates were 0.012 ± 0.001 per year for ECD and 0.056 ± 0.003 per year for the vault. Notably, ECD lower outliers had significantly lower preoperative ECD values. There were no instances of cataract formation, angle closure, glaucoma, or ICL removal throughout the study. CONCLUSIONS The 10-year outcomes of V4c ICL implantation demonstrate effective and safe visual results. Both ECD and vault exhibit exponential decay patterns over the decade. Patients with lower preoperative ECD values require careful post-implantation monitoring.
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Affiliation(s)
- Byunghoon Chung
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - Jin Young Choi
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - David S Y Kang
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - Kangyoon Kim
- From the Eyereum Eye Clinic (B.C., J.Y.C., D.S.Y.K., K.Y.K.), Seoul, Republic of Korea
| | - Bo Yi Kim
- Corneal Dystrophy Research Institute, Department of Ophthalmology (B.Y.K., T.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Im Kim
- Corneal Dystrophy Research Institute, Department of Ophthalmology (B.Y.K., T.K.), Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Material Science and Engineering (T.K.), Yonsei University, Seoul, Republic of Korea; Affiliate faculty, Materials Research Center for Batteries (T.K.), Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea.
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Zhong X, Li Y, Li Y, Wang G, Du Y, Zhang M. Comparison of Predictability in Vault Using NK Formula and KS Formula for the Implantable Collamer Lens Surgery. J Ophthalmol 2024; 2024:4256371. [PMID: 39105180 PMCID: PMC11300086 DOI: 10.1155/2024/4256371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 06/25/2024] [Accepted: 07/10/2024] [Indexed: 08/07/2024] Open
Abstract
Background This study aims to investigate the agreement between the NK and KS formulas in predicting the vault after implantation of an EVO-implantable collamer lens (ICL). Methods This retrospective study included 106 eyes of 57 patients who underwent ICL-V4c implantation. Preoperative vault prediction was conducted by utilizing the NK and KS formulas, with postoperative measurements by anterior segment optical coherence tomography (AS-OCT) at one month. The analysis focused on the consistency between predicted and achieved vaults, as well as the correlation between the achieved vault and various biometric parameters. Results The mean achieved vault was 605.25 ± 212.72 µm, which was significantly smaller than the predicted vaults of 710.08 ± 195.08 and 673.80 ± 212.76 µm, using the NK and KS formulas, respectively (P < 0.05). The mean differences between the achieved vault and the predicted vault using the NK formula and KS formula were -104.82 μm (95% LoA: -600.38-391.19 μm) and -68.55 μm (95% LoA: -628.91-491.82 μm), respectively. Anterior chamber depth (ACD), vertical sulcus-to-sulcus (V-STS) diameter, and crystalline lens rise (CLR) were independent factors associated with the achieved vault (P < 0.05). The two formulas showed no statistically significant difference in absolute prediction error (APE). Conclusion The NK formula exhibited superior consistency and low predictive error compared to the KS formula in the 12.6 mm ICL group. AS-OCT measurements overestimated the predicted ICL vault, especially in the 13.2 mm ICL size selection. Relying solely on the NK or KS formulas for predicting vaults before ICL surgery is not recommended.
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Affiliation(s)
- Xin Zhong
- Joint Shantou International Eye Center of Shantou UniversityThe Chinese University of Hong Kong, Shantou, China
| | - Yan Li
- Joint Shantou International Eye Center of Shantou UniversityThe Chinese University of Hong Kong, Shantou, China
| | - Yuancun Li
- Joint Shantou International Eye Center of Shantou UniversityThe Chinese University of Hong Kong, Shantou, China
| | - Geng Wang
- Joint Shantou International Eye Center of Shantou UniversityThe Chinese University of Hong Kong, Shantou, China
| | - Yali Du
- Joint Shantou International Eye Center of Shantou UniversityThe Chinese University of Hong Kong, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou UniversityThe Chinese University of Hong Kong, Shantou, China
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Wan Q, He P, Wei R, Ma K, Yin H, Tang J, Deng YP. Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up. Eye (Lond) 2024; 38:1933-1940. [PMID: 38519715 PMCID: PMC11226664 DOI: 10.1038/s41433-024-03046-9] [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] [Received: 06/13/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia. METHODS We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was -11.50 D (interquartile range [IQR]: -13.00 to -9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation. RESULTS The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00-1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00-1.25), 1.20 (IQR: 1.00-1.33), and 0.8 (IQR: 0.65-1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery. CONCLUSION In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.
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Affiliation(s)
- Qi Wan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan He
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Health Management & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Ran Wei
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Hongbo Yin
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ying-Ping Deng
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Yuan J, Wu S, Hu Z, Chen C, Ye S, Ye J. Clinical Observation of Posterior-Chamber Phakic Implantable Collamer Lens V4c Implantation in Myopic Patients with Shallow Anterior Chamber Depth: A Retrospective, Consecutive Observational Study. J Ophthalmol 2024; 2024:3181569. [PMID: 38812725 PMCID: PMC11136544 DOI: 10.1155/2024/3181569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/09/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose The reference range for the preoperative anterior chamber angle width for ICL surgery is unclear. Our objective was to assess the clinical effect and the range of anterior chamber angle width of posterior-chamber implantable collamer lens V4c (ICL V4c) implantation in patients with anterior chamber depth (ACD) < 2.8 mm. Methods Patients who underwent ICL V4c implantation with shallow ACD were included in this retrospective study. The patients' uncorrected and corrected distance visual acuity, angle of trabecular-iris (TIA), angle-opening distance (AOD500), trabecular-iris space area (TISA500), corneal endothelial cell density, vault, retinal nerve fiber layer thickness, intraocular pressure, visual field, and complications were analyzed. Results Forty-one patients (68 eyes) completed at least 12 months of follow-up (median follow-up, 30 months). The effectiveness and safety indices were 1.09 ± 0.13 and 1.04 ± 0.21, respectively. The preoperative TIA values on the nasal and temporal sides were 39.78 ± 7.68 degree (range, 25.8-65.1 degree) and 41.54 ± 8.03 degree (range, 28.5-63.00 degree). Forty-seven eyes had uncorrected distance visual acuity ≥1.0, and 55 had corrected distance visual acuity ≥1.0 at the last follow-up visit. The TIA, AOD500, and TISA500 on the nasal and temporal sides were significantly reduced compared to those before surgery (all P < 0.01); no eye had an angle closure or elevated intraocular pressure. The ICL V4c vault was 290.88 ± 153.36 μm (range, 60.0-880.0 μm). No severe complications occurred in any patient. Conclusions In patients with myopia with shallow ACD (2.55-2.79 mm), a preoperative TIA >25.8° is safe and effective for a relatively long time after surgery; however, an extended long-term close follow-up is needed.
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Affiliation(s)
- Juan Yuan
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Shuang Wu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Zongli Hu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Chunlin Chen
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Shiyang Ye
- Department of Ophthalmology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jian Ye
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [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: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
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Ning J, Zhang Q, Liang W, Zhang R, Xing Z, Jin L, Zhang L. Bibliometric and visualized analysis of posterior chamber phakic intraocular lens research between 2003 and 2023. Front Med (Lausanne) 2024; 11:1391327. [PMID: 38651068 PMCID: PMC11034429 DOI: 10.3389/fmed.2024.1391327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Myopia is causing a major public health concern, with its prevalence increasing globally. This study aimed to discuss posterior chamber phakic intraocular lens (pIOL) research publication trends and hotspots over the past 20 years. Methods Bibliometric analysis was performed using the Web Science Core Collection to investigate posterior-chamber pIOL research publication trends. The extracted records were analyzed, and a knowledge map was built using VOSviewer v.1.6.20. The analysis included visualizing the annual publication count, countries/regions distribution, international and institutional collaborations, author productivity, and journal contribution, in addition to identifying knowledge bases and hotspots. Burst keywords were extracted using CiteSpace v.6.1.R. Results In total, 791 articles on posterior chamber pIOLs published between 2003 and 2023 were retrieved. China had the highest number of publications, whereas Japanese papers received the most citations. Fudan University had the highest number of publications, with articles from Kitasato University having the highest number of citations. Regarding individual research, Xingtao Zhou has published the most significant number of articles, and Shimizu Kimiya had the highest number of citations. The top productive/influential journal was 'Journal of Cataract & Refractive Surgery'. The top cited references primarily focused on reporting the clinical outcomes of implantable collamer lens (ICL) for individuals with moderate to high myopia. The keywords primarily formed four clusters: posterior chamber pIOL clinical outcomes for myopic astigmatism correction, posterior chamber pIOL implantation complications, ICL size selection and postoperative vault predictions, and postoperative visual quality following posterior chamber pIOL implantation. Conclusion This study presents the first bibliometric analysis of research trends in posterior chamber pIOL over the past two decades. We investigated the current state and emerging trends of global collaboration and research focal points in this field, offering fresh insights and guidance for researchers.
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Affiliation(s)
- Jiliang Ning
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Qiaosi Zhang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Wei Liang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Rui Zhang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Zequn Xing
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Lin Jin
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Lijun Zhang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
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Thompson V, Cummings AB, Wang X. Implantable Collamer Lens Procedure Planning: A Review of Global Approaches. Clin Ophthalmol 2024; 18:1033-1043. [PMID: 38601168 PMCID: PMC11005927 DOI: 10.2147/opth.s456397] [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: 12/23/2023] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
More than 2 million implantable collamer lenses (ICLs) have been implanted worldwide. With a central port to improve aqueous flow through the ICL, the latest iteration of this phakic intraocular lens (pIOL) has been shown to have stable outcomes with very low rates of adverse events. However, correct planning and ICL size selection continue to be important to achieve an optimal vault. Shallow or excessive vaults are not complications in and of themselves but may increase the risk of complications. Historically, surgeons have relied on measurements of anterior chamber depth (ACD) and manual, caliper-measured white-to-white (WTW) distance to select the ICL size. New diagnostic and imaging technologies such as optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) provide additional opportunities for visualization and measurement of the intraocular dimensions involved in phakic intraocular lens implantation, including sulcus-to-sulcus (STS) and angle-to-angle (ATA) diameters. This paper reviews various approaches to ICL planning and sizing that have been published in the peer-reviewed literature, all of which produce acceptable results for predicting vault and size selection. Surgeons may also want to identify a methodology for patient evaluation and ICL size selection that best aligns with their personal preferences, diagnostic technology, and familiarity with analytical optimization tools.
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Affiliation(s)
- Vance Thompson
- Vance Thompson Vision, Sioux Falls, SD, USA
- Department of Ophthalmology, University of South Dakota Sanford School of Medicine, Vermillion, SD, USA
| | | | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People’s Republic of China
- Shanghai Research Center of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China
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10
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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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11
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Lorger A, Luft N, Mayer WJ, Priglinger SG, Dirisamer M. One-stage versus two-stage bilateral implantable collamer lens implantation: a comparison of efficacy and safety. Sci Rep 2024; 14:5648. [PMID: 38453996 PMCID: PMC10920801 DOI: 10.1038/s41598-024-54101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/08/2024] [Indexed: 03/09/2024] Open
Abstract
Implantable collamer lens implantation (ICL) represents a safe and effective treatment for myopia and myopic astigmatism. To compare the outcomes of a bilateral one-stage same day approach to a two-stage approach, the databases of the University Eye Hospital Munich, Ludwig Maximilians-University and Smile Eyes Linz, Austria were screened for eyes that had undergone ICL implantation. Two-stage surgery was performed at an interval of 1 day (17 patients), 2 days (19 patients) and 1 week (2 patients). Variables analyzed were preoperative, 1-day and last follow-up uncorrected distance (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, refractive spherical equivalent (SEQ), astigmatism, age, endothelial cell count (ECD), intraocular pressure (IOP) and ICL vaulting. In total, 178 eyes (100 eyes one-stage, 78 eyes two-stage) of 89 patients were included in this study. Mean follow-up was 1.1 ± 0.8 and 1.3 ± 0.5 years. Mean preoperative SEQ was - 7.9 ± 2.6 diopters (D) in the one-stage and - 8.0 ± 1.7 D in the two-stage group (p = 0.63) and improved to 0.00 ± 0.40 and - 0.20 ± 0.40 D at end of follow-up, showing slightly better stability in the one-stage group (p = 0.004). There was no difference in the efficacy (1.1 vs. 1.2, p = 0.06) and the safety index (1.2 vs. 1.2, p = 0.60) between the two groups. No eye (0%) in either group lost 2 lines or more of UDVA (p > 0.99). Refraction within ± 0.50 D and ± 1.00 D around target was achieved comparably often (89 vs. 86%, p = 0.65; 99 vs. 99%, p > 0.99). Endothelial cell loss was slightly higher in the two-stage group (1.3 vs. 4.3%). Vaulting at the final follow up was higher in the one-stage group (373.8 ± 205.4 µm vs. 260.3 ± 153.5 µm, p = 0.00007). There were no serious intraoperative complications in either group. In conclusion, this study demonstrates that both the one- and two-stage approaches are equally effective, predictable and safe. Regarding endothelial cell loss, vaulting and SEQ stability, the one-stage group showed slightly better outcomes, but these results are clinically questionable because they are so small. Larger studies are needed to quantitatively evaluate a potential benefit.
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Affiliation(s)
- Anna Lorger
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
| | - Nikolaus Luft
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
- SMILE Eyes Linz, Linz, Austria
| | - Wolfgang J Mayer
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
| | - Siegfried G Priglinger
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany
- SMILE Eyes Linz, Linz, Austria
| | - Martin Dirisamer
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany.
- SMILE Eyes Linz, Linz, Austria.
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12
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Gong D, Deng S, Dang K, Yan Z, Wang J. Causes and management strategies for elevated intraocular pressure after implantable collamer lens implantation. Front Med (Lausanne) 2024; 11:1351272. [PMID: 38384405 PMCID: PMC10879591 DOI: 10.3389/fmed.2024.1351272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
With the widespread application of Implantable Collamer Lens (ICL) implantation surgery in the field of myopia correction, a comprehensive understanding of its potential complications, especially those related to intraocular pressure (IOP), becomes crucial. This article systematically reviews various complications that may lead to IOP elevation after ICL surgery. Firstly, common complications after ICL surgery, including residual viscoelastic, steroid response, and excessive vault of the ICL, are detailed, emphasizing their potential impact on intraocular pressure. Regarding residual viscoelastic, we delve into its direct relationship with postoperative elevated IOP and possible preventive measures. For steroid response, we stress the importance of timely adjustment of steroid therapy and monitoring intraocular pressure. Additionally, excessive vault of the ICL is considered a significant potential issue, and we elaborate on its mechanism and possible management methods. In further discussion, we focus on relatively rare complications such as Toxic Anterior Segment Syndrome (TASS), Urrets-Zavalia Syndrome (UZS), Pigment Dispersion Syndrome (PDS), and malignant glaucoma. For these relatively rare complications, this review thoroughly explores their potential mechanisms, emphasizes the importance of prevention, and provides guidance for early diagnosis and treatment. This is a comprehensible review that aims to offer eye care professionals a comprehensive understanding and effective management guidance for complications of elevated IOP after ICL surgery, ultimately providing optimal care for patients' visual health.
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Affiliation(s)
- Di Gong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Simin Deng
- The 2nd Clinical Medical College (Shenzhen People's Hospital) of Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Moshirfar M, Han KD, Jaafar MA, Santos JM, Theis JS, Stoakes IM, Hoopes PC. Comparative evaluation of multiple nomograms for predicting postoperative vault after implantable collamer lens surgery. J Cataract Refract Surg 2024; 50:64-71. [PMID: 37702514 DOI: 10.1097/j.jcrs.0000000000001304] [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: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To compare the vault predictability of most available implantable collamer lens (ICL) sizing nomograms and identify which preoperative measurements are predictive of vault. SETTING Private practice in Draper, Utah. DESIGN Retrospective chart review. METHODS This study was a retrospective analysis of 209 eyes of 106 patients who underwent STAAR Surgical ICL implantation. Analyses were performed based on the availability of preoperative parameters, varying the number of eyes for each test. Mean absolute error (MAE) of predicted vs actual postoperative vault was calculated for each nomogram. The frequency of Kim, Rocamora (least absolute shrinkage and selection operator-optical coherence tomography), Russo, and Reinstein recommending the correct ICL size in instances when Parkhurst, optimized white-to-white (WTW), and STAAR could not recommend a definitive ICL size was determined. Univariate and multivariate linear regression analysis was performed between preoperative measurements and vault. RESULTS The Kim, Rocamora, Russo, and Reinstein nomograms had significantly lower MAE of predicted vs actual postoperative vault than the KSV2 and Nakamura V3 nomograms. The Russo formula most frequently recommended the correct ICL size when the Parkhurst, Optimized WTW, and STAAR nomograms could not provide ICL size recommendations. At the 0.05 significance level, anterior chamber depth (ACD), ciliary body inner diameter (CBID), and pupil diameter were the parameters found to have significant correlation with postoperative vault. CONCLUSIONS The Kim, Rocamora, Russo, and Reinstein nomograms were the most predictive of vault. Additionally, ACD, CBID, and pupil diameter were found to be significantly correlated with vault and should be considered for use in future ICL sizing nomograms.
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Affiliation(s)
- Majid Moshirfar
- From the Hoopes Vision Research Center, Hoopes Vision, Draper, Utah (Moshirfar, Hoopes); John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah (Moshirfar); Utah Lions Eye Bank, Murray, Utah (Moshirfar); University of Arizona College of Medicine Phoenix, Phoenix, Arizona (Han, Jaafar, Santos, Theis); Pacific Northwest University of Health Sciences, Yakima, Washington (Stoakes)
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14
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Tan W, Wang Z, Zeng Q, Lei X, Pan C, Shu B, Jin L, Chen Q. The influence of iris -ciliary angle (ICA) on the vault after implantation of V4c implantable collamer lens: a chain mediation model of ICL haptic related factors. BMC Ophthalmol 2023; 23:403. [PMID: 37803302 PMCID: PMC10559582 DOI: 10.1186/s12886-023-03122-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 09/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND This study aims to identify the relationship between iris -ciliary angle (ICA) and the vault. Additionally, we also seek to investigate the chain mediating effects of the ICL haptic related factors on this relationship. METHODS The participants were categorized into three groups according to the ICA value as follows: low ICA group (< 35°); moderate ICA group (35°-70°); high ICA group (> 70°). We compared the preoperative ocular characteristics and postoperative examinations among the three groups. Multiple variable stepwise regression was performed to establish the vault prediction formula. The Process V4.0 in SPSS and Hayes's PROCESS model 6 was conducted to further elucidate the mediating effects of the final tip point of ICL haptic and the ICL arc-lens arc on the relationship between the ICA and vault. RESULTS There was a significant difference in the positions of the ICL haptic among three ICA groups. The regression vault equation was Vault = 679.42-7.26*TCA + 192.30*ACD-196.37*CLR + 73.21* STS(horizontal).A significant negative correlation was found between the ICA and vault (P < 0.01).The chain mediation model revealed that the final tip point of ICL haptic and the ICL arc-Lens arc were sequential mediators between ICA and vault (effect = -1.63, 95% CI = -2.72--0.73). CONCLUSION The ICA was associated with vault via the mediation effect of the final tip point of the ICL haptic and the ICL arc -lens arc. Assessment of ICL haptic related parameters adds significant information to interpret the vault after surgery.
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Affiliation(s)
- Weina Tan
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Zheng Wang
- Aier Institute of Refractive Surgery, Guangzhou, Guangdong Province, People's Republic of China
| | - Qingyan Zeng
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Xiaohua Lei
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Chao Pan
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Bao Shu
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Lina Jin
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Qian Chen
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China.
- Hongshan Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China.
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15
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Wei Q, Zhou X, Chang W, Jiang R, Zhou X, Yu Z. Retinal and Choroidal Changes Following Implantable Collamer Lens V4c Implantation in High Myopia Patients-A 1-Year Follow-Up Study. Diagnostics (Basel) 2023; 13:3097. [PMID: 37835840 PMCID: PMC10572683 DOI: 10.3390/diagnostics13193097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
This prospective study aimed to evaluate the impact of Visian Implantable Collamer Lens (ICL) V4c implantation on retinal and choroidal morphology in patients with high myopia. A total of 97 eyes from 52 high myopic patients who underwent ICL V4c implantation were followed up for 12 months. Preoperative and postoperative evaluations included comprehensive ophthalmic assessments and enhanced depth imaging optical coherence tomography (EDI-OCT) to analyze changes in central retinal thickness (CRT), retinal volume (CRV), choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), and choroidal vascular index (CVI). Repeated measures mixed-effects models were used for comparing pre- and postoperative measurement variables and exploring relationships among age, axial length (AL), spherical equivalent refraction (SER), and postoperative retinal and choroidal changes, with statistical significance set at p < 0.05. Follow-up assessments were conducted at various time points, with participation rates ranging from 21% to 98%. Baseline characteristics showed a median age of 26.7 years, -10.14 diopters of SER, and an AL of 27.44 mm. Throughout the 12-month follow-up, CRT and 3.0 mm CRV consistently increased compared to the baseline, with statistically significant rises observed at postoperative day 1, week 1, and month 12. Most ChT measurements, including subfoveal ChT, declined over the 12 months, except at postoperative 6 months. Horizontal and vertical TCA and LA values significantly increased throughout the follow-up, except for month 6. After surgery, both horizontal and vertical CVI parameters exhibited an increase compared to the baseline, with some changes reaching statistical significance. Correlation analysis performed by repeated measures mixed-effects models showed that no relationship was found between age, AL, and SER and changes in postoperative retinal parameters and CVI parameters. However, postoperative changes in ChT and choroidal area parameters showed a negative correlation with AL and a positive correlation with SER. Our research demonstrated that ICL V4c implantation resulted in noteworthy alterations in retinal and choroidal morphology over a 1-year follow-up period. Moreover, in patients with high myopia, individuals with longer AL and higher degrees of myopia exhibited more pronounced postoperative changes in the choroid and retina. Further studies with extended follow-up durations are necessary to comprehensively understand the long-term effects of ICL implantation on retinal and choroidal morphology and function.
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Affiliation(s)
- Qiaoling Wei
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (Q.W.); (X.Z.); (W.C.); (R.J.)
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China
- Ocular Trauma Center, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Xianjin Zhou
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (Q.W.); (X.Z.); (W.C.); (R.J.)
- Department of Ophthalmology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Weiteng Chang
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (Q.W.); (X.Z.); (W.C.); (R.J.)
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China
| | - Rui Jiang
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (Q.W.); (X.Z.); (W.C.); (R.J.)
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China
- Ocular Trauma Center, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (Q.W.); (X.Z.); (W.C.); (R.J.)
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China
| | - Zhiqiang Yu
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; (Q.W.); (X.Z.); (W.C.); (R.J.)
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China
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16
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Alfonso JF, Fernández-Vega-Cueto L, Lisa C, Alfonso-Bartolozzi B, Palacios A, Madrid-Costa D. Clinical and Aberrometric Outcomes of a New Implantable Collamer Lens for Myopia and Presbyopia Correction in Phakic Patients. J Refract Surg 2023; 39:589-596. [PMID: 37675906 DOI: 10.3928/1081597x-20230726-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia. METHODS The study included 80 eyes of 40 patients who had bilateral EVO Viva ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, presbyopic add power, binocular through-focus visual acuity, total ocular spherical aberration (SA), coma aberration, and root mean square of ocular higher order aberrations (RMS HOAs) (i-Trace Aberrometer; Tracey Technologies) for a 4.5-mm pupil size were evaluated. RESULTS The mean binocular postoperative UDVA and CDVA were 0.09 ± 0.19 and 0.02 ± 0.03 logMAR, respectively. The postoperative spherical equivalent was -0.61 ± 0.54 diopters (D). The presbyopic add power reduced from +1.31 ± 0.74 D preoperatively to +0.44 ± 0.58 D after surgery (P < .0001). The mean visual acuity was 0.1 logMAR or better (20/25 or better) across the vergence range from +0.50 to -1.50 D, better than 0.2 logMAR (20/32 or better) up to the vergence of -2.00 D, and remained better than 0.3 logMAR (20/40 or better) up to the vergence of -2.50 D. The total ocular aberrations induced by EVO Viva ICL were -0.34 ± 0.09 µm of SA, 0.24 ± 0.18 µm of coma, and 0.26 ± 0.12 µm of RMS HOAs. CONCLUSIONS The outcomes support that the new ICL might be a good alternative for myopia and presbyopia correction in patients aged between 45 and 55 years. Further studies are needed to evaluate the threshold lens misalignment from which the patient´s visual quality would be affected. [J Refract Surg. 2023;39(9):589-596.].
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17
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Tang C, Sun T, Duan H, Liu Y, Qi H. Evaluation of the Performance of Two Nomograms and Four Vault Prediction Formulas for Implantable Collamer Lens Size Selection. J Refract Surg 2023; 39:456-461. [PMID: 37449504 DOI: 10.3928/1081597x-20230605-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
PURPOSE To evaluate the performance of different nomograms and vault prediction formulas in predicting the optimal Implantable Collamer Lens (ICL; STAAR Surgical) size and vault. METHODS This retrospective study included 108 participants (214 eyes) who underwent ICL implantation. The efficacy of the manufacturer's nomogram, Parkhurst nomogram, NK formula, KS formula, Zhu formula, and ZZ formula was assessed by comparing the indicated ICL sizes to the postoperative vault measurements. Additionally, Bland-Altman plots and the Friedman test were used to assess the agreement and absolute error between the actual vault and predicted vault. RESULTS The proportions of the ideal ICL category recommended by the manufacturer's nomogram, Parkhurst nomogram, NK formula, KS formula, Zhu formula, and ZZ formula were 50.5%, 45.3%, 46.7%, 42.5%, 50.0%, and 28.5%, respectively. The mean differences between the actual vault and the predicted vault using the NK, KS, Zhu, and ZZ formulas were 144.1 ± 261.1, -19.3 ± 179.6, 70.8 ± 284.2, and 182.6 ± 361.5 μm, respectively. The predicted ICL vault tended to overestimate the actual ICL vault, particularly when choosing a larger ICL size. The KS formula shows the smallest deviation in prediction error and is least affected by variation in ICL size. CONCLUSIONS White-to-white distance from the Pentacam (Oculus Optikgeräte GmbH) coupled with the manufacturer's nomogram performed well for ICL size selection. Four vault prediction formulas tended to overestimate the actual ICL vault, particularly when selecting a larger ICL size. The KS formula appeared to have the least bias of the formulas. Simultaneously, vault prediction formulas need to be modified according to the ICL size. [J Refract Surg. 2023;39(7):456-461.].
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18
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Martínez-Plaza E, López-de la Rosa A, López-Miguel A, Holgueras A, Maldonado MJ. EVO/EVO+ Visian Implantable Collamer Lenses for the correction of myopia and myopia with astigmatism. Expert Rev Med Devices 2023; 20:75-83. [PMID: 36708714 DOI: 10.1080/17434440.2023.2174429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Intraocular lens implantation in phakic eyes for the correction of refractive error is currently a widespread procedure. The EVO and EVO+ Visian Implantable Collamer Lenses (ICL) are two of the most prevalent lenses implanted. They incorporate a central orifice to avoid the need for iridotomy. The main difference between both ICL is the higher optical diameter zone provided by the EVO+, allowing a better quality of vision at night. This review aims to provide an overview of the current ICL models available for correcting myopia and myopic astigmatism. AREAS COVERED During the last decade, more than 100 scientific papers analyzing the performance of EVO and EVO+ lenses have been published. This review describes the objective visual performance achieved with the implantation of central hole ICL lenses and the subjective perception of the patients implanted with these lenses. In addition, the safety and the potential complications associated with undergoing an EVO and EVO+ ICL implantation have been addressed. EXPERT OPINION Refractive surgeons and candidates to undergo ICL implantation should be aware of the excellent safety and visual outcomes provided by the implantation of central hole ICL lenses. However, future research could address minor issues currently not resolved.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | | | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Alfredo Holgueras
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
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19
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Wannapanich T, Kasetsuwan N, Reinprayoon U. Intraocular Implantable Collamer Lens with a Central Hole Implantation: Safety, Efficacy, and Patient Outcomes. Clin Ophthalmol 2023; 17:969-980. [PMID: 36998514 PMCID: PMC10046236 DOI: 10.2147/opth.s379856] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
This review summarizes the available literature and provides updates on the efficacy, safety, and patient outcomes of phakic intraocular lens implantation using implantable collamer lens (ICL), with a focus on newer models with a central port (EVO/EVO+ Visian Implantable Collamer Lens, STAAR Surgical Inc.). All studies included in this review were identified from the PubMed database and were reviewed for relevancy of their topic. Data on hole-ICL implantation performed between October 2018 and October 2022 in 3399 eyes showed a weighted average efficacy index of 1.03 and a weighted average safety index of 1.19 within an average follow-up of 24.7 months. The incidence of complications such as elevated intraocular pressure, cataract, and corneal endothelial cell loss was low. Moreover, both quality of vision and quality of life improved after ICL implantation, confirming the benefits of this procedure. In conclusion, ICL implantation is a promising refractive surgery alternative to laser vision correction with excellent efficacy, safety, and patient outcomes.
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Affiliation(s)
- Trakanta Wannapanich
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Ngamjit Kasetsuwan
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Correspondence: Ngamjit Kasetsuwan, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand, Tel +6622564142, Email
| | - Usanee Reinprayoon
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Zhu QJ, Xing XY, Zhu MH, Ma L, Yuan Y, Song E. Validation of the vault prediction model based on the sulcus-to-sulcus diameter and lens thickness: a 925-eye prospective study. BMC Ophthalmol 2022; 22:463. [PMID: 36451125 PMCID: PMC9714062 DOI: 10.1186/s12886-022-02698-z] [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: 04/24/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND To verify the accuracy and stability of the prediction formula based on the ciliary sulcus diameter and lens thickness and to analyse factors influencing the prediction results. METHODS In total, 925 eyes from 506 subjects were enrolled in this prospective study between July 1, 2020, and June 30, 2021. Subjects were divided into four seasons, each spanning three months. The target vault was set to be between 300 μm and 700 μm according the prediction formula. The actual vault was measured one month postoperatively. The Bland-Altman test, 95% confidence intervals (95% CI) and 95% limits of agreement (95% LoA) were used to evaluate the agreement between the predicted vault and the actual vault. Eyes with absolute prediction errors greater than 300 μm were further analysed. RESULTS The mean predicted vaults for the four seasons were 503 ± 99, 494 ± 96, 481 ± 92 and 502 ± 93 μm, while the mean actual vaults were 531 ± 189, 491 ± 179, 464 ± 179 and 529 ± 162 μm, respectively. The predicted and actual vaults of the overall subjects were 493 ± 95 and 500 ± 180 μm, respectively. Of the 925 eyes, 861 eyes (93.08%), 42 eyes (4.54%), and 22 eyes (2.38%) showed a normal vault, high vault, and low vault, respectively. Bland-Altman plots showed that the mean difference between the actual vault and predicted vault overall (± 95% LoA) was 6.43 ± 176.2 μm (-339 to 352 μm). Three UBM features may lead to large prediction errors (more than 300 μm): wide iris-ciliary angle (ICA), iris concavity and anteriorly positioned ciliary body. CONCLUSIONS This study demonstrated the accuracy and stability of the prediction formula through the validation of a large sample size and a long time span. Wide ICA, iris concavity and anteriorly positioned ciliary body may have an effect on vault.
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Affiliation(s)
- Qiu-Jian Zhu
- grid.452666.50000 0004 1762 8363Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou, China ,grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | | | - Man-Hui Zhu
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | - Lie Ma
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | - You Yuan
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
| | - E. Song
- grid.263761.70000 0001 0198 0694Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, China
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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22
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Goes S, Delbeke H. Posterior chamber toric implantable collamer lenses vs LASIK for myopia and astigmatism: systematic review. J Cataract Refract Surg 2022; 48:1204-1210. [PMID: 36179351 DOI: 10.1097/j.jcrs.0000000000001007] [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: 05/03/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
This systematic review compares the visual and refractive outcome of laser in situ keratomileusis with (toric) implantable collamer lens (ICL) in the treatment of myopic astigmatism. An electronic literature search led to 19 comparative articles. Refractive outcome, efficacy, safety, predictability, and stability as well as differences in contrast sensitivity and higher-order aberrations (HOAs) were analyzed for moderate (-3 to -6 diopters [D]) and high (≥-6 D) myopia. Results were either significantly in favor of (toric)-ICL or equal. Fewer HOAs and better contrast sensitivity after (toric)-ICL seem to be the largest asset in its refractive and clinical superiority. However, longer follow-up studies are indicated, specifically for systematically comparing long-term adverse effects.
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Affiliation(s)
- Stéphanie Goes
- From the Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium (Goes, Delbeke); KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research group Ophthalmology, Leuven, Belgium (Delbeke)
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Han T, Chen X, Xu Y, Niu L, Wang X, Zhou X. Refractive outcomes of implantable collamer lens implantation in 1212 eyes with suboptimal corrected distance vision acuity. Curr Eye Res 2022; 47:1419-1423. [PMID: 35757851 DOI: 10.1080/02713683.2022.2094418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: To analyze the factors related to corrected distance vision acuity (CDVA) after implantable collamer lens (ICL) implantation in patients with preoperative suboptimal CDVA.Methods: This retrospective study included patients with suboptimal preoperative CDVA (CDVA ≤20/25) who underwent ICL implantation (V4 or V4c). Preoperative and postoperative clinical evaluations included CDVA, uncorrected distance visual acuity (UDVA), and refraction.Results: A total of 1,212 eyes from 731 patients were identified. CDVA increased in 90.8% of the eyes after surgery. Among them, 57.5% of the eyes (697 eyes) gained more than one line. The preoperative LogMAR CDVA was 0.32 ± 0.23, which significantly improved to 0.13 ± 0.17 postoperatively (p < 0.001). There was no significant difference between ICL V4c and ICL V4 in the LogMAR UDVA, sphere, cylinder, SE, LogMAR CDVA, efficacy index, and safety index after surgery (p > 0.05). For eyes with full correction, the postoperative LogMAR CDVA =0.575 * preoperative LogMAR CDVA -0.061 (p < 0.001, R2 = 0.53). For eyes with partial correction, the postoperative LogMAR CDVA =0.536 * preoperative LogMAR CDVA - 0.007 * SE - 0.196 (P < 0.001, R2 = 0.55).Conclusion: ICL implantation can improve CDVA in eyes with suboptimal CDVA. This study provides the postoperative outcomes of eyes with different preoperative CDVA, which makes it convenient for surgeons to communicate with such patients before surgery.
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Affiliation(s)
- Tian Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Ye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
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Yang L, Pazo EE, Zhang Q, Wu Y, Song Y, Qin G, Zhang H, Li J, Xu L, He W. Treatment of contact lens related dry eye with intense pulsed light. Cont Lens Anterior Eye 2021; 45:101449. [PMID: 33933353 DOI: 10.1016/j.clae.2021.101449] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/25/2021] [Accepted: 04/21/2021] [Indexed: 01/11/2023]
Abstract
AIM The prevalence of contact lens related dry eye (CLDE) is high and can lead to ocular discomfort, reduced quality of vision and life. The aim of this study was to assess the efficacy of intense pulsed light (IPL) treatment in alleviating signs and symptoms of CLDE. DESIGN Prospective, randomised, examiner masked study. METHODS This prospective study was conducted on 152 eyes of 76 patients (IPL group, n = 76 eyes; control group, n = 76 eyes) wearing contact lens (CL) and experiencing CLDE for more than 1 year. The IPL treatment group underwent two IPL treatment sessions at 3-week intervals while the control group received sham IPL treatment. Best-corrected visual acuity (BCVA), ocular surface disease index (OSDI), non-invasive breakup time (NITBUT), tear film lipid layer (TFLL) quality, fluorescein staining (FS), meibum gland (MG) quality and expression, endothelial cell count (ECC) and intraocular pressure (IOP) were assessed at baseline (D-0), day-21 (D-21) and day-42 (D-42) after IPL treatment. RESULTS The mean age of treatment group and control group was 28.47 ± 5.16 years (21 females, 28 %) and 28.58 ± 4.33 years (23 females, 30 %) respectively. IPL treatment group had clinically and statistically significant improvement in mean NITBUT was observed at D14 (5.24 s, P<0.001) and D28 (6.08 s, P<0.001). OSDI, TFLL score and MG quality and expressibility all improved significantly (P<0.001) at D-42, whereas BCVA, ECC and IOP showed no significant changes at D-21 and D-42 in IPL treatment group. The control group showed no significant improvement in all parameters at D-21 and D-42. CONCLUSION Our findings suggest that CL related DE can be safely alleviated with IPL treatment as it reduced the severity of symptoms, improved the overall tear film stability and reduced artificial tear use in participants with CLDE.
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Affiliation(s)
- Lanting Yang
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China; The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Emmanuel Eric Pazo
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China.
| | - Qing Zhang
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China; The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yi Wu
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China; The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yilin Song
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China; The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guanghao Qin
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China; The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hongda Zhang
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China
| | - Jun Li
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China
| | - Ling Xu
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China
| | - Wei He
- He Eye Specialist Hospital, No.128 North Huanghe Street, Shenyang, China.
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